This week we celebrate Maternal Mental Health Week in the UK, a week-long campaign dedicated to talking about mental health problems before, during and after pregnancy.
The awareness campaign, which is now in its seventh year since it first launched back in 2017, is all about raising public and professional awareness of perinatal mental health problems, as well as changing attitudes and advocating for the women and families impacted.
Founded by Perinatal Mental Health Partnership UK (PMHP UK), the campaign also aims to help people across the UK access the information, care, and support they need to recover from perinatal mental health problems.
What is perinatal mental health?
The terms perinatal and maternal are often used interchangeably. ‘Peri’ is the Latin for “around”, and ‘natal’ is the Latin for “birth”. So perinatal mental health refers to a woman’s mental health during pregnancy and the first years after birth.
This includes mental health problems that existed before pregnancy, as well as issues that develop for the first time or are greatly exacerbated in the perinatal period.
Examples of perinatal mental health problems include antenatal and/or postnatal depression, anxiety, obsessive compulsive disorder (OCD), postpartum psychosis and post-traumatic stress disorder (PTSD).
What you need to know
According to Maternal Mental Health Alliance, in the UK around one in five women experience a perinatal mental health problem during pregnancy or within the early postnatal years, with around 70% of those hiding or underplaying their illness.
However, what is probably most shocking is suicide is the leading cause of direct maternal death within a year of giving birth.
Maternal mental health has been gaining increasing attention in recent years, onus to the work of PMHP UK and various studies which have revealed the detrimental effects that maternal mental health issues can have on both mothers and their children.
In November 2022, Mothers and Babies: Reducing Risk through Audit and Confidential Enquiries (MBRRACE UK) published the MBRRACE-UK Saving Lives, Improving Mothers’ Care report. In the report, MBRRACE examined the deaths of women during or up to one year after pregnancy between 2018 and 2020.
The report highlighted that mental ill-health in pregnancy and beyond is an increasing cause of maternal death; 40% of deaths within the year after pregnancy were from mental health causes, with maternal suicide remaining the leading cause of direct deaths in this period.
In 2020, women were 3x more likely to die by suicide during or up to six weeks after the end of pregnancy compared to 2017-19, representing 1.5 women per 100,000 giving birth in the UK.
Risk factors for maternal suicide
Several risk factors have been identified that increase the likelihood of maternal suicide. These include:
- Existing mental health conditions: Mental health conditions such as depression, anxiety, bipolar disorder, and post-traumatic stress disorder (PTSD) can increase the risk of suicide in mothers.
- History of suicidal thoughts or suicide attempts: Mothers who have previously attempted suicide are at a higher risk of attempting suicide again.
- Substance abuse: Substance abuse, including drug and alcohol abuse, can increase the risk of suicide in mothers.
- Domestic violence and abuse: Mothers who experience domestic violence and abuse are at an increased risk of suicide.
- Lack of social support: Mothers who lack sufficient social support from family and friends are more likely to experience feelings of isolation and hopelessness, which can ultimately increase the risk of suicide.
- Regular sleep disturbances: Sleep disturbances can increase risk of suicide in depressed postpartum mothers.
- Past trauma: Depressed postpartum women who experienced childhood physical abuse are at significantly increased risk for frequent thoughts of self-harm.
It is important to note that maternal suicide risk is not limited to the immediate postpartum period. It’s crucial to continue providing women with mental health resources and support throughout the later postpartum period.
Invitations of maternal suicide
It can be hard to see the signs that a new mother is struggling – especially with the knowledge that around 70% of women suffering with perinatal mental ill health will hide or underplay their illness, however there are some things you can look for.
Along with the common signs of depression – such as changes in sleep or appetite, irritability and a hopeless outlook – new mothers may also seem very anxious about their baby and fixate on certain things, such as whether or not their child is warm enough.
A mother struggling with perinatal mental health and potentially suicidal thoughts may be afraid to be alone with her baby or not let anyone else hold them.
Signs of suicidal thoughts include self-harm, reckless behaviour and excessive sadness or moodiness, sudden calmness, withdrawing from loved ones and friends, making preparations (such as giving away their possessions), talking about feeling hopeless, not good enough or being trapped, and feeling like a burden to others.
To protect new mothers from maternal suicide, here are some suggestions for loved ones when supporting someone who may be at risk or struggling:
- Be supportive: New mothers may feel overwhelmed, isolated, or unsupported during this time. Loved ones can provide emotional support by checking in regularly, listening without judgment, and offering a helping hand.
- Watch for suicidal invitations: Be aware of the warning signs of maternal suicide, such as mood swings, social withdrawal, sleep disturbances, and thoughts of self-harm. If you notice any of these signs, take them seriously and seek help immediately.
- Encourage professional help: Encourage new mothers to seek professional help from a medical professional – such as their GP, a therapist, or counsellor. Offer to help them find a mental health professional who specialises in postpartum mood disorders.
- Help with practical tasks: New mothers may be overwhelmed with practical tasks such as caring for the baby, cooking, and cleaning. Offer to help with these tasks to alleviate some of the stress and pressure.
- Educate yourself: Learn about postpartum depression and other mood disorders that can affect new mothers. This will help you understand what they are going through and how to best support them.
- Connect with other new mothers: Encourage new mothers to connect with other new mothers who may be going through similar experiences. This can provide them with a sense of community and support.
- Reduce the stigma: Reducing the stigma surrounding mental health conditions can help new mothers feel more comfortable seeking help when they need it.
Maternal mental health is an essential aspect of overall maternal health and wellbeing. The link between maternal mental health and suicide risk is a serious concern that requires attention from healthcare providers, family and friends, and communities. By identifying the risk factors and invitations of maternal suicide and taking preventative measures, we can help protect new mothers and ensure that they receive the care and support they need to thrive.
This #MaternalMentalHealthWeek, let’s work together to raise public and professional awareness of perinatal mental health problems and ensure all new mothers feel confident in accessing the information, care and support they need to recover.