Perinatal period and mental health: this is something that is being discussed
According to global statistics, 1 in 5 women experiencing the perinatal period suffer from some form of mental health problem , primarily anxiety and depression. It is also estimated that 7 out of 10 women hide or minimize their symptoms , without the understanding, support, and treatment necessary to mitigate the impact these symptoms have on them and their families. These figures may initially alarm us, but they also contribute to raising awareness about these issues during this crucial stage of life and highlighting where to seek early help. That's why today we're saying, "This is something we need to talk about!" And I invite you to continue reading this article to learn more.
While we don't usually set rigid boundaries for the perinatal period, some authors describe its duration as extending from the moment pregnancy is planned until one year after delivery (Garcia & Yim, 2017; National Institute for Health and Care Excellence, 2014), and in clinical practice, we can extend it to two years after birth. To date, we know that the perinatal period constitutes a life crisis for the entire family unit (Garcia-Esteve & Valdés Miyar, 2017). Although "crisis" can lead us to think negatively, in psychology we refer to a life crisis as a moment in life that most people experience at some point (moving, job changes, bereavement, pregnancy). It is in these circumstances that we and our environment change in relation to a previous state, and while we often have coping mechanisms that help us adjust to the new reality we face, these resources often prove insufficient. In response to this, we need to generate new and more adapted resources (Keegan, 2007).
Each stage of the perinatal period has its own particularities . The desire or anticipation of having a baby can generate everything from fears to anxieties that are difficult to bear. Sometimes the journey yields results quickly, within a few months, or it can extend over long periods, causing discomfort, uncertainty, and distress for the couple. Around childbirth, we have other unique aspects that add to what has already been mentioned: the arrival of a new person into the family system, the creation of a new bond, new (or non-)routines, hormonal changes, and various adjustments.
Much has been done in recent decades at the regional and international levels to prevent, treat, and improve the quality of life of pregnant women, their children, and their families. Today, we have more specialized training for healthcare professionals, greater knowledge of effective and safe pharmacological and psychological treatments for pregnant and breastfeeding women, and activities aimed at reducing the impact of potential problems inherent to this stage of life, such as isolation, overload, and the likelihood of feeling that it is never enough (Garcia-Esteve and Valdés Miyar, 2017).
Problems can be mild and self-resolving, although, as we mentioned at the beginning, they can also be acute, with moderate to severe distress, impacting both the woman's mental health and her relationships with others, including the new family member. Despite the progress we have made, barriers still exist for women to access timely professional help. One of these is the stigma surrounding a stage that is often perceived as rosy. The influence of mass media, which portrays exceptions as the rule (new mothers, just days after giving birth, in photos with makeup, perfectly styled hair, and smiling), and the stigma we still hold when discussing mental health, reinforce the idea that we should enjoy this most important moment of our lives (Adams, 2015).
Maternal mental health: warning signs
But sometimes, in addition to being a wonderful experience , the perinatal period can bring anxieties, overwhelming fears that terrible things might happen to those we love most in this world, low spirits when everyone assumes we should be happy, constant crying, and listlessness. The positive aspect of this is that the more we talk about and share that these problems occur, the more visibility we give them, the greater the chances of treatment, and the greater the likelihood of connecting with other significant people who can help ease the burden.
What can we do? It's difficult to answer this question in just a few lines, but I'll try to highlight what I consider to be the gateway to feeling better: networking, raising awareness, listening, and seeking professional help. These recommendations are based on international clinical practice guidelines (Curry et al., 2019; Maldonado-Durán, 2011; National Institute for Health and Care Excellence, 2014).
If you'll allow me, I'll go through subgroups of key agents.
General healthcare professionals: inquire about the mood and anxiety levels of women in the perinatal period. Screening and discussing mental health issues can create a space for listening and expressing symptoms that are not readily apparent.
Family members: Don't assume this has to happen alone. Promote active and non-judgmental listening. Encourage conversations about how we feel and how we see ourselves in this new stage of life, gradually accepting that we can be very happy to receive a new life, but we can also experience sadness, tiredness, anxiety, and a desire for some solitude.
Women: ask for help, talk to professionals who are managing your pregnancy. Get all your questions answered. Also, trying to connect (virtually or physically) with other women going through the same stage can help alleviate feelings of isolation, especially during these times.
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