Mental health involves emotional, psychological & social wellbeing. It is all about how we think, feel, act, manage stress, relate to others & make healthy decisions childbirth is a profound psychological experience which can have a positive, empowering impact or a negative, traumatizing impact. Changing hormones during pregnancy can cause heightened emotions & one generally swings between being overjoyed to being stressed & overwhelmed. 1 in 5 women have mental health problem in pregnancy or after birth.
According to World Health Organisation, about 10% of pregnant women & 13% of new mothers experience a mental disorder, most common being depression. Poor maternal mental health can have long term implications on children’s health & may result in low birth weight babies & preterm delivery.
Babies exposed to stress hormones during pregnancy seem to show increased anxiety levels.
Women feel stressed thinking about pregnancy
• Labour pains, interventions or pregnancy complications
• Good parenting
• Changes in relationship
• Lack of support
Risk factors for Poor Mental Health during pregnancy are:
1. Pre-existing mental illness – Stopping medication for pre-existing mental disorder
2. Adverse life events
3. Difficult childhood memories
4. Family history of psychiatric illness
5. Substance abuse
6. Physical, emotional or sexual abuse
7. Exposure to domestic violence
8. Social adversity
9. Discrimination, stigma, racism
Ways to improve health during pregnancy are:
1. One has to prepare mind, body &soul
2. Positive affirmations help e.g. I’ll be strong, I’ll be brave, I’ve the power to deliver naturally
3. See pain as a friend, something useful which helps the baby to come out
4. Listen to positive, inspiring stories about childbirth
5. Talk therapy –Talk about your feelings to a friend, family member, doctor, therapist or support groups. Understand options & risk factors
6. Self-care: Listen to your body & mind and be aware of what you need
7. Sleep- 8 hours sleep is vital for being in happy emotional state
8. Diet- Eating healthy & natural foods promotes physical & mental health
9. Deep breathing exercises & relaxation techniques are helpful
10. Physical exercise improves mood & promotes good sleep
11. Reduce alcohol intake, stop smoking, treatment may include prescription medicine but one must consult the doctor before starting or stopping any medication.
Post-Partum Depression is a depressive illness which affects 10-15% of women within 1-2 months of childbirth.
One may experience various symptoms like:
1. Feeling low, tearful, unhappy & depressed
2. Irritability, Fatigue, sleeplessness with loss of appetite
3. Loss of interest in sex or unable to enjoy anything
4. Negative thinking
5. Feeling guilty
6. Loss of confidence
7. Anxiety about baby’s overall health. May present with racing pulse, breathlessness, sweating, thumping heart, may resent the baby also
8. Feeling hopeless & having suicidal thoughts
9. Hostility to new born & decreased emotional involvement
While 12-16% of women experience postpartum blues, post-natal psychological distress is also prevalent across cultures.
Most common factor was history of depression in antenatal period. Other contributory factors may be: Biological, psychological, obstetric, economic & cultural factors:
1. Biological- Poor physical health
2. Psychological- Depression, anxiety, past psychiatric history stressful life, child care stress, low self esteem
3. Obstetric- Previous abortion, loss of baby, unplanned pregnancy, absence of breast feeding
4. Unemployed, uneducated, domestic violence, lack of emotional support
Few tips that may help you to keep well & prevent depression
• Do make friends with other women who are pregnant or had a baby
• Do find someone to talk
• Do go to antenatal class
• Do make a well being plan
• Don’t try to be superwoman
• Don’t stop antidepressant medications during pregnancy without advice
Treatment involves medications but most women get better without medications within 3-6 months. 1 in 4 mothers may have postpartum depressions till 1 year of birth.
PND can affect one’s child development & behaviour & hence treatment is essential.
By Dr Lovelina Nadir
Gynaecologist and obstetrician
At rosewalk hospital