By Lorena Watson
Raise your hand if you've ever had these thoughts: "I shouldn't have had a child," "I'm the worst mother," "I'm afraid I'm going to hurt my baby," and so on. The good news? You are not alone. One in five mothers struggle with their mental health. I am sharing what I have learned as an OB Nurse Practitioner in Lake County for 10 years, as well as a proud Board member of Mother-Wise, a local nonprofit that provides respectful, informative, and judgment-free support to mothers and caregivers so that these issues are destigmatized and all aspects of motherhood are honored.
Maternal mental health refers to a mother's emotional, social, and mental well-being. The two most common disorders affecting women are what are generally known as postpartum depression and anxiety (now called "Perinatal Mood and Anxiety Disorders," or PMADs). PMADs most often occur during the two-year perinatal period (conception through the first year post-pregnancy). They are the most common complication of pregnancy and the baby's first year, yet remain one of the most under-reported and under-diagnosed. Up to 75% of women do not report symptoms due to negative stigma associated with mental health disorders.
Risk factors for PMADs include history of depression/anxiety, financial stress, immigrant parents, exposure to violence, and low social support. Lake County has higher levels of the above-named risk factors, making our percentages of women experiencing PMADs much higher. Women of color are 3-4 times more likely to experience complications during pregnancy and childbirth than white women. Intergenerational trauma and institutional racism also negatively affect Black women's ability to receive culturally competent and equitable birth practices.
So what should you look out for? First, know that these feelings don't make you a bad mother, and there is help. Signs of PMADs can include mood swings, anxiety, sadness, irritability, crying, withdrawing from friends or family, and feelings of shame or guilt. Thoughts of self-harm and suicide can also occur. Symptoms typically last more than 2 weeks, get worse over time, and make it hard to complete everyday tasks.
Barriers to accessing care exist. Patients experiencing PMADs often feel shame, guilt, and stigma, therefore they are likely not to report symptoms. Fear of child protective services or immigration involvement prevent women from openly expressing how they feel. Consequences of untreated PMADs include increased substance use, increased risk of physical and emotional abuse, risk of impaired bonding with the baby, and adverse childhood experiences. Maternal mental health conditions that are not treated can remain for many years.
Treatment options include early detection and screening, immediate assessment of self-harm thoughts or thoughts of suicide, counseling, peer-support groups, frequent visits with a provider, and educating mothers on ways support persons at home can help. Sometimes medications are needed to help control symptoms. The number one protective factor against PMADs? Support. Simply knowing you are not alone can have a tremendous impact on your mental health journey.
It is important that moms, support persons, community health workers, and providers have a clear understanding of signs and symptoms, risk factors, and consequences of untreated PMADs. Early screening and open, judgment-free conversations lead to early detection and treatment. Every mom should be given the opportunity to learn about PMADs and be screened regardless of race, socioeconomic status, or current health conditions.
Mother-Wise provides respectful, informative, and judgment-free support to Lake County mothers and caregivers so that maternal mental health issues are destigmatized and all aspects of motherhood are honored. This article was written by Lorena Watson, nurse practitioner.
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