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What is Maternal Mental Health?

Published in Behavioral Health Services, Birthing Services, Women's Services, OB/GYN Services, Mental Health, For the Health of It Author: Angela M. Williams Schroden, MS, LADC, LPCC, Staff Psychotherapist, CentraCare – St Cloud Hospital

Maternal mental health refers to the mental health of a woman during pregnancy, childbirth and the first year after delivery. During this time, one in seven women experience perinatal mood and anxiety disorders.

Perinatal mood and anxiety disorders encompass a range of emotional disorders including:

  • Major depression
  • Generalized anxiety
  • Obsessive-compulsive disorder
  • Panic disorder
  • Bipolar disorder
  • Posttraumatic stress disorder

Symptoms vary in severity from being bothersome to debilitating.

Women experience anxiety more often during the time period between conception and the years of parenting. In fact, according to Postpartum Support International, approximately 6% of pregnant women and 10% of postpartum women develop anxiety. Sometimes they experience anxiety alone, and sometimes they experience it in addition to depression or other disorders.

What are symptoms of perinatal anxiety and depression?

Perinatal anxiety disorders can encompass any anxious symptoms, including but are not limited to:

  • Frequent worry
  • Feeling that something bad is going to happen
  • Racing or intrusive thoughts
  • Sleep disturbances
  • Appetite changes
  • Irritability
  • Lack of bonding or attachment with baby
  • Panic attacks
  • Physiological reactions like increased heart rate, dizziness, hot flashes and nausea

Approximately 15% of women experience severe depression following childbirth. The percentages are higher for women dealing with poverty and significant psychosocial stressors and two times higher for teen parents. Ten percent of women experience depression in pregnancy, and it is the most common complication of childbearing. Symptoms of depression can include, but are not limited to:

  • Irritability/anger
  • Feeling detached from baby and/or others
  • Isolative behaviors
  • Appetite changes
  • Sleep changes
  • Crying or sadness
  • Hopelessness
  • Loss of interests/ joy/pleasure
  • Lack of motivation
  • Thoughts of harming self, baby, or other

What is postpartum psychosis?

Postpartum psychosis occurs in about one out of every 1,000 deliveries (.1-.2% of births). It is usually sudden and typically occurs within the first two weeks but can occur anytime in the postpartum year. Postpartum psychosis symptoms include:

  • Delusional thoughts
  • Hallucinations
  • Irritability
  • Hyperactivity
  • Decreased need for sleep
  • Paranoia
  • Difficulty communicating
  • Severe depression
  • Rapid mood swings

Postpartum psychosis is most common in people with bipolar disorder, history of psychosis, or family history of a bipolar disorder.

Are some people more likely to develop maternal mental health issues?

Risk factors of perinatal anxiety and mood disorders can include:

  • Previously having an anxiety or mood disorder
  • Family history
  • Past trauma
  • Increased stress
  • Financial issues
  • Lack of social emotional support
  • Traumatic birthing experience
  • Pregnancy complications
  • Marital/relationship discord
  • Mothers of multiples
  • Thyroid imbalance
  • Diabetes
  • Premenstrual dysphoric disorder (PMDD)
  • Baby in the NICU

Postpartum panic disorder and postpartum obsessive-compulsive disorder are more specific anxiety disorders that can be experienced. New mothers are said to experience anxiety and obsessive-compulsive disorder more frequently than mood disorders.

When to be worried about maternal mental health and how to get help?

Concern arises if the mother’s mental health interferes with her ability to care for herself and/or her baby. If a mother experiences multiple symptoms (perinatal mood and anxiety disorders) for consecutive days over two weeks, it is important to seek help and talk with family.

Imminent help is needed if symptoms are severe, such as suicidal thoughts or self-harm, thoughts of harming baby or not wanting baby, thoughts of harming others, and/or other significant changes in mood and or behavior. Call or text 988 for help 24 hours a day.

Knowing that pregnancy can be especially difficult for those who are already struggling with their mental health and/or psychosocial stressors, it is important to be proactive by increasing support. Treatments include psychotherapy, support groups, psychotropic medication, peer/ family support, and increased self-care.