It’s often thought that a women is at her best and most dazzling during her pregnancy, however this (at times) deceiving exterior could be covering a very melancholy interior, filled with confusion, sadness and anxiety. It is not uncommon to hear that women hold fears for the baby's well being, their own and the postpartum period, all that can be attributed to pregnancy jitters, but what happens when these fears become more profound than the ‘run of the mill’ anxiety? Can you spot the signs, how informed are you about pre and postnatal depression, and how can we as partners, friends and the community help support not only the physical but emotional and psychological well being of expecting mothers.
Although we are becoming more aware of postnatal depression, how much do we know about the emotions felt during pregnancy? A woman's body is rather complex during pregnancy, which makes everyone's experiences unique, similarly, their emotional responses are vast and individual. As a society we expect that pregnancy should be the best time of a woman's life span, as she prepares to bring a new life into the world. However, an important aspect of pregnancy that is often overlooked and at times undermined, is that of a woman’s mental health during and post pregnancy.
A survey completed by Baby Glimpse in November 2017, highlights and challenges the society's views and understanding of mental health during pregnancy. Out of 1,000 women surveyed, a staggering 36.5% of participants reported experiencing mood swings and other emotional stressors (during or after pregnancy). Below we focus on the most common mental health components experienced by pregnant women, the possible effects and how to provide the most adequate support.
Mental Health Prior to Pregnancy
During the pregnancy more often than not, most of the attention is focused and centered on the baby, loved ones therefore also assume that the woman’s all and primary attention is on the baby as well. However what if there are mental health difficulties prior to conception, how will the expecting mother ensure that she is focused both on her and the baby's well being? It is important to be aware that there are preexisting mental health state that can be exacerbated during pregnancy, some of these conditions include:
- Type-A personality disorder
- Post-traumatic stress disorder
- History of physical or mental abuse
- Anxiety disorders
- Schizophrenia, bipolar or other mental disorders
Women facing these challenges, should involve their doctors and counsellors/psychologists at the most earliest time. Engaging the right support can ease anxiety, decrease stress and provide the necessary support to decrease the challenges faced by preexisting mental health conditions during pregnancy that might impact on mum’s emotional well being and in turn the baby’s stability.
The Role of the Partner
Being pregnant at any point in life can be stressful as the body is under constant change. The partner's support plays an important role when it comes to dealing with mental issues. A supportive partner listens to the woman and offers helpful advice during troubling times, and although it might seem that this is a given, it is remarkable to learn that 27.8% of survey participants reported having an overwhelming feeling of evident and excessive worries during pregnancy. A partner’s support, understanding and patience can not only provide the necessary support to decrease these worries, but can also have a positive impact on dealing with clinical symptoms of depression.
Organisations such as https://www.panda.org.au/ provide support to women, men and families dealing with such struggles to contribute to a positive pregnancy experience despite mental health disorders.
The Baby’s Environment and Hormonal Influences
Mental-health issues during pregnancy not only impact the mother, but as the baby is not isolated in the womb these issues are also transferred onto the baby. It is a well known fact that the baby can senses the world around them at some point. The concern is that if a mother is constantly under the stress, this can sometimes lead to excess synthesis and secretion of corticotropin-releasing hormone (CRH) into the bloodstream. This hormone (Cortisol) is often described as a ‘steroid hormone’ and is linked to as a response to stress. Since Placenta also generates additional values of CRH, a certain percent of maternal cortisol (via bloodstream) can travel through to the baby. An increase in such hormones can have an effect on baby brain, and most often than not in the postpartum period.
Support Through Safe Medication
Pregnant women are often concerned about taking any type of medication during the gestation period. Doctors are just as concerned, but there are alternatives that can help.
If the expecting mother has a serious mental health concerns, it is vital that she seek adequate support even during pregnancy, some might say that its is even more important to ensure to continue treatment during pregnancy. Many drugs have been tested for safety for both mum’s and baby’s and that can both prescribe and taken during pregnancy.
These medications include:
- Mood stabilizers
- Antipsychotics
- Antidepressants
Despite their assessments, it is best to consult with both your mental health and antenatal professionals to ensure that the right medication is prescribed for both you and your baby. Alternatives to prescribed meditation might include massage, pregnancy yoga and alike.
Mother’s Self-Preservation Instinct
Poor mental health and emotional states, can lead to a breakdown in mother's instinct to stay healthy for her baby. It is not uncommon that the mothers may forget to eat and in some instances resort to self-mutilation and other negative activities. Any harm to the mother eventually leads to unhealthy state of the baby, they must both have the necessary nutrients to survive birth and the first few months of baby’s life.
A woman who has a borderline diagnosis of depression or anxiety can see an escalation of such feelings during pregnancy as hormones travel through the body. Expecting mum’s should pay careful attention to these changes as hormonal shifts create extreme sadness and happiness that are often only hours apart. The survey shows that 22.5% of all participants experienced constant sadness and a heightened lack of joy. Certain studies indicated that depression can present with harmful effects, including the self harming concerns, and such warning indicators should be immediately brought up with a doctor.
For after hours support, you can contact:
After Hours GP Helpline: http://www.healthdirect.gov.au/ - Call 1800 022 222 or
LifeLine: http://www.lifeline.org.au/ - Call 13 11 14.
Rural Versus Suburban Living
Pregnant women can face the added challenges when it comes to their physical location.
A significant population of Australia’s pregnant women are living in rural and remote areas, where, as we are well aware services are scarce, which presents challenges for service delivery and assistance of professionals, adding to stressors relating to depression, fatigue and other issues.
Cost is also a concern. After a pregnancy, a general practitioner's costs may not be covered by insurance. Women deal with another charge that may be too expensive for their budgets. As a result, it is not rare to hear that women simply avoid treatment. Government assistance and legislation changes are necessary to provide equal and affordable mental health support to all women across Australia.
How Is the Government Helping
In November 2017, Australia saw the new legislation come to affect, supporting pregnant women across Australia to access the necessary mental health support they may need during pregnancy. The Government is demonstrating the need and understanding for expecting mothers and is trying to take care of mothers with better medical support through legislative measures. New guidelines and benefits, include:
- Free mental assessments during pregnancy
- Continued assessments two months into the postpartum period
- General practitioners given the right to bill for mental-health services
More benefits have yet to be announced. The Government has developed a task force to encourage an evolving process so that mental health can always be prioritised.
Putting Yourself First
A concept that the Government is trying to instill in Australian women is for pregnant women to put themselves first. The idea is a foreign one when you're trying to put a newborn first in your life, but current legislation changes are trying to turn their attention to and prioritise expecting mothers. Offering information through the Internet, Government hubs and medical facilities is just the first step.
Women must know that dealing with any mental-health issue isn't something to be ashamed of. They're part of a growing community that only seeks treatment and acceptance. Acknowledging that there is a problem is the first step to a happier pregnancy and postpartum period.
Video by - Jean Hailes Professor of Women's Health and Director Jean Hailes Research Unit, Monash University
The number of Australian pregnant woman encounter pre and postnatal depression is a concerning one, but actually the concerning factor is that these statistic may even underestimate the situation due to many women may not realising that they're facing these issues. Finding support among your loved ones and medical professionals is the best ways to move forward. Don't chalk up your emotions to just the "baby blues". Real solutions can help you enjoy those months in pregnancy and beyond. Every woman deserves a stress-free pregnancy so that each baby has the best chance at a healthy life.
USEFUL LINKS:
https://www.beyondblue.org.au/
https://www.pregnancysupport.com.au/
https://womhealth.org.au/pregnancy-and-parenting
http://raisingchildren.net.au/articles/antenatal_and_postnatal_depression.html