The latest statistics on maternal mental health indicate that at least one out of every five new mothers in the U.S. experiences some form of mental health challenge that makes it difficult for her to offer her children the full amount of care they need. Considering that almost four million children are born each year in the U.S., this means that there are over 750,000 mothers out there who need help and support to maintain a healthy psychological and emotional balance. It may come as a surprise to some that the scope of these mental health challenges far eclipses typical post-partum depression, which is the condition that most people hear about and discuss.
Research shows that maternal mental health issues can begin during pregnancy and persist far longer than is commonly realized. They have far more significant consequences for children than most people understand. They also have greater consequences than are typically recognized by mental and behavioral health professionals. The good news is that a recent study published by the Child Health and Development Institute of Connecticut outlines a simple and effective approach for the early diagnosis and effective treatment of maternal mental health challenges: involve the family pediatrician.
Maternal Mental Health Issues: Rates of Occurrence
The Connecticut study, Addressing Maternal Mental Health in the Home, addresses an array of issues new mothers face that are different than the usual ups and downs that accompany pregnancy, post-pregnancy and the early phases of motherhood. The authors identify disorders such as anxiety, panic, post-partum depression, bipolar, obsessive compulsive and post-traumatic stress. Here are the statistics on these disorders:
- Post-Partum Depression (PPD). This affects 10-20 percent of mothers after the birth of a child, with a typical onset about six weeks after the birth of a child. Symptoms include low mood, sadness, feelings of hopelessness, fear of being alone with the baby and excessive crying. They also include a range of symptoms typically associated with non-post-partum depression.
- Post-Partum Anxiety (PPA). This affects 8.5-18 percent of mothers after the birth of a child. The onset is similar to that of post-partum depression, and there are considerable overlaps between PPA and PPD. Symptoms include excessive worry, obsessive fear, inability to concentrate, insomnia and constant agitation.
- Post-Partum Obsessive Compulsive Disorder (PPOCD). This affects about 3 percent of mothers after the birth of a child. Symptoms include intrusive thoughts, anxiety, agitation, obsessive worry about cleanliness. PPOCD mothers may engage in repetitive rituals, such as hand washing or continuously checking in on the child.
- Post-Partum Post-Traumatic Stress Disorder (PPPTSD). This affects about 9 percent of mothers after the birth of a child. Many of the symptoms are similar to those related to Post-Partum Anxiety (PPA). But in the case of PPPTSD the new mothers experience the birth process as a traumatic event. They may repetitively re-live the event. They may also have difficulty gaining perspective and suffer nightmares related to the process of giving birth.
The authors of the study identify the negative effects of these maternal mental health conditions on children as infants, toddlers, school age children and adolescents. From impaired cognitive function to conduct disorders, depression, anxiety and learning disorders, maternal mental health can impact the long-term health and well-being of children.
Start at the Pediatrician
Every mother wants, more than anything in the world, to love, cherish, comfort and raise her children to become happy, successful and well-adjusted adults. The data from the Connecticut study show that hundreds of thousands of mothers each year in the U.S. experience emotional and psychological challenges. To address this issue, the study recommends that maternal mental health care become part of pediatric and family care. This approach can be effective for many reasons:
- The long-term relationships of trust established between mothers, children and pediatricians and/or family doctors make a difference.
- Pediatric care includes the whole family.
- The pediatrician is in a position to recognize, anticipate and recommend avenues for the treatment of maternal mental health conditions.
- Pediatricians have a wealth of experience coordinating with other health specialists.
Standard Screenings for New Moms
The authors advocate the inclusion of maternal mental health check-lists as part of the peri-natal and post-natal pediatric office visits. This approach is also supported by the American Academy of Pediatrics, who recommend the use of a maternal depression tool such as the Edinburgh Post-Natal Depression Scale or the Edinburgh Brief Screen during the standard one month, two month and four month pediatric visits. The full Edinburgh screen takes less than five minutes to complete. The brief Edinburgh screen takes less than one minute to complete. It’s a more feasible option that would not compromise the pediatrician’s time with the child. For mothers who have positive screens, the steps for proactive care hinge on the following concepts (adapted from guidelines created by the MotherWoman Training Institute):
- Comforting mothers by reminding them that they are not alone—many mothers experience what they are going through.
- Emphasizing that there is nothing wrong with recognizing and addressing emotional challenges related to motherhood.
- Teaching mothers that there are tools to address the issues that they are facing.
- Reassuring mothers that the emotional challenges they’re facing are treatable.
- Reminding mothers that in order to best take care of their children, they need to take care of themselves, too.
Total Family Health
The goal of the Connecticut study was to increase awareness of maternal mental health issues in general and to offer a series of specific, positive and actionable recommendations to mothers, mental health care professionals and the public at large in order to benefit the overall health and well-being of families across the country.
Maternal mental health is a complex, multi-layered issue. It deserves the full attention of everyone involved: public health officials, lawmakers, health care providers, employers and families. Maternal mental health challenges are treatable but require awareness and collaborative coordination that promotes education and support for mothers. By folding the emotional and psychological needs of the mother into the scope of early family pediatric visits, this support has a greater chance of coming on time and in the manner that best serves the entire family, which promises to have the net effect of solidifying the foundational fabric of society as a whole.