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May is Maternal Mental Health Month: A Mother Shares Her Brave Journey
More than half a million women suffer from a maternal mental health disorder every year
Maternal Mental Health Month is observed in May. The goal of the observance is to raise awareness of maternal mental health issues before, during and after pregnancy so that more new parents can get the treatment and support they deserve.
When women become mothers, they change.
Not just their bodies.
Not just their schedules.
Who they are — hormonally and mentally — is different than who they were before.
“It’s a matter of biology,” said Dr. Nicole Cirino, a reproductive psychiatrist at Texas Children’s Pavilion for Women. “There is a maturation that takes place — the brain matures into what it needs to be for this new phase of life. And that transition can be challenging.”
Challenging is spot on, according to Houston mother Liz Hughes, who struggled with postpartum depression, postpartum anxiety and obsessive-compulsive disorder following the birth of her children. Difficult, exhausting and scary are also words that come to mind when she thinks about her life pre-diagnosis.
But Liz is far from alone.
According to the World Health Organization, about 10% of pregnant women and 1 in 5 women who have just given birth experience a mental health disorder.
In the United States, 600,000 women each year suffer from a maternal mental health disorder, according to the Centers for Disease Control and Prevention.
Liz gave birth during the height of the COVID-19 pandemic. On top of the usual worries that come with a pregnancy, she began to stress about her son catching the new virus when he was born.
“If that wasn’t enough, I had a very difficult labor and ended up losing a lot of blood, which I learned is linked to postpartum depression and anxiety,” she said.
Liz’s son, Owen, was born in December of 2020 and because of COVID-19, Liz’s life after having her son was completely different than she expected. She was more isolated than she would have normally been while on maternity leave. For protection, Liz wore a mask around her baby for two weeks, and had to undergo COVID-19 testing every three days.
“When I went in for my six-week check-up, I was experiencing anxiety and depression,” Liz said. “But when I filled out the mental health screening form I gave into the pressure to pretend that everything was okay. I wanted everything to be okay. We live in a day and age where you feel like you have to have this Instagram-filtered life. There is a real pressure there, and I told the doctor that I was fine.”
But just two weeks later when Liz took her son to his eight-week appointment at Texas Children’s Pediatrics, she broke down.
“My son’s pediatrician, Dr. Jocelyn Lambuth, began asking questions to assess how the baby was doing,” she said. “All of a sudden she stopped, looked me in my eyes and asked how I was doing. I lost it. I wasn’t doing well and knew I needed to be honest about it.”
Dr. Lambuth referred Liz to Texas Children’s Pavilion for Women, which was the first step to getting the help she needed.
Liz was diagnosed with postpartum depression and postpartum anxiety. Among the most challenging aspects of these disorders are the intrusive thoughts.
“As an example, I would be walking down the stairs with the baby and worry that I might trip and fall and one or both of us would die,” said Liz. “It was paralyzing. You have the worst thoughts and you play them out to the worst possible outcome. There was this deep sadness and it was overwhelming. I couldn’t stop catastrophizing.”
Liz’s treatment plan consisted of medication and talk therapy, which made all the difference. So much so that when she and her husband began trying for their second child, Liz was better prepared and even made an appointment with Dr. Cirino six weeks before the birth of her daughter.
“With my daughter, I did develop postpartum depression, postpartum anxiety and obsessive compulsive disorder, but I was ready (this time) and began treatment right away.”
The stigma on mental health is decreasing
“The amount of stigma around maternal mental health disorders is improving,” Dr. Cirino said. “When I think about now compared to 20 years ago, women are more willing to talk about the struggles they are having and our society is more willing to listen, so that is good news. However, there is still so much work to be done.”
She adds that the causes of maternal mental health are numerous and layered — and are different for each mother. Genetics, hormones, family situations, support systems and socioeconomics can all contribute to a diagnosis. “There is no one formula for a good or bad postpartum experience.”
Speak up. Speak often.
Both Dr. Cirino and Liz agree that women must speak up and ask for help.
“I think the most important thing we need to let go of is this idea that being a “good mom” looks and feels a certain way,” Liz offered. “I would tell women that a struggle with mental health does not disqualify you from being a good mother. It doesn’t mean that you have failed or that you don’t love your baby. It just means that you’re struggling, and there are professionals at Texas Children’s who want to help you get through the hard times.”
Are you at risk for a maternal mental health disorder?
Know the risk factors.
Biological risk factors
- A history of mental illness
- A history of depression or anxiety during the menstrual cycle
- Psychiatric family history, especially first-degree relatives with a history of postpartum depression
- Substance use problems and disorders
- Chronic illness or medical illness or obstetrical complications
- Multiple births
- Previous preterm or low birth weight births
Psychosocial risk factors
- Past stressful life events
- Limited social supports
- Relationship problems
- Domestic violence, previous abuse
- Low socioeconomic status
- Unplanned pregnancy
- Anxious or perfectionistic personality style
- Breastfeeding challenges