Category Archives: Maternal Mental Health
Perinatal Mental Health Toolkit by the Royal College of General Practitioners
Up to one in five women and one in ten men are affected by mental health problems during pregnancy and the first year after birth. Unfortunately, only 50% of these are diagnosed.
Without appropriate treatment, the negative impact of mental health problems during the perinatal period is enormous and can have long-lasting consequences on not only women, but their partners and children too. However, this is not inevitable. When problems are diagnosed early and treatment offered promptly, these effects can be mitigated.
This toolkit provides a set of relevant tools to assist members of the primary care team to deliver the highest quality care to women with mental health problems in the perinatal period.
Source: Perinatal Mental Health Toolkit
We know a mom who is clinically depressed has a lot of negative outcomes. Those negative outcomes are not just for the mom, they can also have long-term implications for children.
Researchers and clinicians alike have been particularly concerned about the effects of maternal depression during and after pregnancy on children.
But a new study suggests that a mother’s depression during the preschool years may be more harmful to children than either her prenatal or immediately postnatal depression. It is the first study to track the effects of maternal depression on children from pregnancy until the children turn 5.
Domestic violence is any physical, sexual, psychological or economic abuse that takes place between people who are sharing, or have recently shared a home.
In Africa, there is more violence against women than on any other continent. Three women are killed by their partners in South Africa every day, thats twice as many women than in the United States of America. Violence during pregnancy has negative effects for both the mother and the child. Abused women are more likely to delay getting pregnancy care and to attend fewer antenatal visits.
Our recent research study looked at pregnant women who experience domestic violence in Hanover Park, Cape Town. We looked at the profile of women who reported domestic violence and what factors in their lives were associated with this abuse.
We found that women who were experiencing domestic violence were more likely than those without domestic violence to:
– have a current mental health problem like depression, anxiety, suicidal thoughts or behaviours, alcohol or drug abuse
– have had past mental health problems
– have experienced past abuse
– not feel supported by their partner
– not likely feel pleased about being pregnant
– more likely experience food insecurity and not have a job
Out of this study with developed a learning brief which targets any service providers who interact with vulnerable women and children, especially those service providers who work with pregnant women. Such services providers can arise from nongovernmental organisations (NGOs) or civil society organisations and may be healthcare providers or social service providers.
Find this and more on our resources for professionals pages.
While perinatal mood and anxiety disorders (PMAD) have a global footprint, the majority of research related to this group of illnesses has come largely from more affluent, Westernized countries. Similarly, the tools used to detect and screen for PMADs were developed and tested in these Westernized countries.
The instrument most commonly used to detect PMADs is the Edinburgh Postnatal Depression Scale (EPDS), which was originally developed in Great Britain. While it has been translated into many different languages and used in many different countries, it is unclear if these translated versions of the EPDS accurately identify PMAD in disparate, non-English speaking countries. Specifically there has been concern that simply translating the EPDS may not fully capture the cultural determinants of mood and anxiety disorders.
Particularly vulnerable to mental health problems are the women who are pregnant or have recently given birth living in resource-constrained, low- and lower-middle-income countries (LALMICs) as defined by the World Bank. A recent systematic review appraised formally validated local language versions of the EPDS used in resource-constrained settings (Shrestha et al., 2016).
In our last newsletter of the year we’ve thanked you, our supporters, families and friends who believed in the work we do and supported us throughout 2016.
With your donation of expertise and money we were able to care for mothers in need and engage with those providing health and social support for them.
Enjoy this festive season and we are looking forward to an even more exciting 2017 with you!
In this newsletter we are highlighting some of the achievements of the previous two months. Happy reading.
What is empathic engagement and why is it important?
Empathy is the ability to perceive the meaning and feelings of another person and to be able to communicate these to that person. Empathy is a core aspect of building relationships and positive client interaction. When care workers engage empathically with clients, clients feel empowered, service uptake is improved and clients are more likely to adhere to recommended interventions and treatment regimens. There are also benefits for the care workers who report less burnout and enhanced work satisfaction.
Studies have shown that empathic engagement does not necessarily take up more time, is not emotionally exhausting like being sympathetic, and does not overburden the care worker, as the client maintains responsibility for their own problems. In addition, this type of communication can actually save time, effort and expense as the relevant client issues are more quickly identified resulting in early and more effective management.
Building up to empathic skills: learning about maternal mental health
Stigma, related to a lack of understanding and negative stereotyping of those with mental illness, is a significant factor in communities and among care workers. We attempt to reduce this stigma through the provision of background information about maternal mental illness and related medical and social problems. We encourage participants to work in small groups, engage with, discuss and apply our training material in a way which is relevant to their unique situations and work environment.
We noted a gap between the perceived ability and actual ability of workshop participants to engage empathically. Most participants struggle to “listen” and accept the client’s perspective without judgment. Instead, they very quickly assume they understand the problem and revert to “telling” and “fixing” based on their own perspective and experience.
Read more on how to develop a meaningful training, how to support trainers and how to evaluate the training process in our Learning Brief
A number of new studies have found that stress, depression or anxiety during and after pregnancy can have long lasting effects on the development of your child.
We have translated some of those findings into an Issue Brief and added some of our recommendations for evidence based interventions for parents.
This Issue Brief outlines not only the risk factors for parents, but also encourages the building of resilience to prevent or lessen the negative impacts for children.
“Caring for mothers and fathers – is caring for the future”
One in three migrant women from low- and middle-income countries has symptoms of perinatal depression
Migration and perinatal mental health in women from low- and middle-income countries.
In this systematic review and meta-analysis the authors summarising the prevalence, associated factors and interventions for perinatal mental disorders in migrant women from low- and middle-income countries (LMIC).
Even though they found that the prevalence of perinatal depression is very high among migrant women, the data they found was insufficient to assess the burden of anxiety, post-traumatic stress disorder or psychosis in this population.
Furthermore the authors stress, that given the adverse consequences of perinatal mental illness on women and their children, further research in low-resource settings is a priority.
Read the abstract in the BJOG – International Journal of Obstetrics and Gynaeocology
Interested in mental illness among displaced, migrant and refugee women in South Africa? Read our Issue Brief
Depression during and after pregnancy is affecting up to one in five women globally.
Previous studies from around the world suggest that depression during and after pregnancy affects the bonding between mother and child and can have direct implications for infant survival and early childhood development.
In this new review, the authors focused mainly on low and middle income countries and are calling for urgent interventions for mothers and children.
There is a substantial lack of research specific to women in poorer countries, where interventions such as cognitive behavioural therapy may not be available
– Prof Vivette Glover, Imperial College London
Previously, research into perinatal depression has focused on high income countries. But current studies suggest that the problem is more common in low- and middle-income countries, some even suggest that up to 50% of women living in adversity are experiencing depression during or after pregnancy.
Therefor more resources are needed to support expectant and new mothers. Urgent investment is needed in research and the development of appropriate low cost interventions that are specific to these areas.
To mark World Suicide Prevention Day we’d like to focus on suicidal thoughts during the perinatal period
Mothers’ emotional needs can go undetected during the perinatal period where there is much attention on the baby and women often face multiple difficulties. Studies have shown that women at risk for suicide may be easier identified, by increasing screening of expectant and new mothers for major depression and conflicts with intimate partners. Thus care providers and family may be able to detect symptoms and signs of suicidal thoughts and possibly prevent further distress or the development of suicidal behaviour.
Symptoms and warning signs include
– Talk of suicide or dying “If I died, would you miss me?” or “It would be better if I were not here or dead.”
– Depressive symptoms, including feelings of guilt, hopelessness or no sense of the future.
– Feeling isolated or wanting to be alone “No one understands me”.
– Obsessive thinking – thinking ‘too much’, especially about harming oneself or dying
– Giving things away (clothes, expensive gifts), “When I am gone, I want you to have this.”
Read this and other Issue Briefs on our website
#WSPD16 will be commemorated on 10 September
Join the conversation on Twitter with the hashtag #WSPD16