Perinatal depression and anxiety are serious mental health problems and are among the leading causes of maternal morbidity and mortality worldwide!
Pregnant women are at higher risk for suicidal ideation and behaviours compared to the general population.
Suicide has been identified as one of the major contributors to the global mortality burden and there is a growing concern over the increase in suicidal ideation and behaviour among pregnant women.
Studies in low- and middle-income countries put the rate of maternal death due to suicide at somewhere between 0.65% and 3.55%. In such cases, risk factors include poverty, lack of support, lack of trust in health systems and coexisting mental illnesses.
Suicidal thoughts experienced during pregnancy can continue beyond the initial postpartum period, affecting the well-being of both mother and child.
More about pregnancy and suicidal ideation in our infographic
The United Nations High Commissioner for Refugees (UNHCR) estimates that there are currently 24.5 million refugees and asylum-seekers in the world (UNHCR 2015).
Depression is the leading cause of disability worldwide and is a major contributor to the overall global burden of disease. Mental health among refugees is increasingly being discussed and researchers acknowledge:
Refugees are a vulnerable people.
We have found that uncertain refugee status is a key factor contributing to mental illness in pregnant women. Women with uncertain refugee status are particularly vulnerable to maternal mental illness. Psychological trauma, associated with political conflict, displacement, violence, loss of loved ones, torture, rape and poverty contribute to poorer general maternal health.
For more information see our Issue Brief and for a quick visual overview see our infographic below.
In response to Daily Maverick article: “Antidepressants during pregnancy linked to autism in kids: study”
We would like to take the opportunity to raise caution with regard to the article published in The Daily Maverick titled “Antidepressants during pregnancy linked to autism in kids: study” on 20 July 2017
“Single studies like this need to be interpreted with great caution. Risk does not mean an inevitable outcome. Furthermore, an association does not necessarily mean cause. An association may reflect a causal link between autism and severe depression or the association may reflect a causal link between the medication and autism.
The global evidence is increasingly showing that the risk of untreated depression or anxiety perinatally on the foetus and infant, are likely to outweigh the risks of antidepressants on offspring outcomes. Balancing the risks is an important part of the decision to treat with antidepressants or not. This decision needs to be individualized and made collaboratively, as part of the consultation between the woman and her practitioner.”
Dr Simone Honikman, Perinatal Mental Health Project (PMHP)
The article is published here
Further information on antidepressant use during pregnancy in our Issue Brief
Women are particularly vulnerable to domestic abuse during and after their pregnancy.
Protect yourself and your baby – help is available!
It is important to know what kinds of behaviour is considered domestic abuse – it is not only physical or sexual harm. Did you know that domestic abuse can happen between any persons sharing a household – not only at the hands of your partner?
Do you have a safety plan in place for you and your baby should anything go wrong?
Find out more about all this important information in our Violence against Women leaflet
Looking for more information for new mothers? Check out our resource pages.
Want to know how the Maternal Mental Health awareness campaign went this year?
Or want to check out our latest resources and developments in and around the PMHP?
Read our latest newsletter here
“As we celebrate International Day of Action for Women’s Health on May 28, we reflect on the physical, emotional and psychosocial dimensions of women’s health as well as the reasons to support girls’ and women’s health throughout the lifecycle.
With Sustainable Development Goal (SDG) 5 calling for an end to all forms of discrimination against all women and girls everywhere, the elimination of all violence against women and girls and universal access to sexual and reproductive health and rights by 2030, now is the time to draw attention to the many elements of and impediments to women’s health and rights […]
Intimate partner violence (IPV) during or before pregnancy is associated with many adverse health outcomes.
Pregnancy-related complications or poor infant health outcomes can arise from direct trauma as well as physiological effects of stress, both of which impact maternal health and fetal growth and development.
Antenatal care can be a key entry point within the health system for many women, particularly in low-resource settings. Interventions to identify violence during pregnancy and offer women support and counselling may reduce the occurrence of violence and mitigate its consequences.
This research will provide much-needed evidence on whether a short counselling intervention delivered by nurses is efficacious and feasible in low-resource settings that have a high prevalence of IPV and HIV.
Source: BMC Health Services ResearchBMC series
Follow the project: BioMed Central
The most common mental health condition to affect perinatal women and mothers worldwide are depression and anxiety.
These illnesses impact thoughts, feelings and behaviours.
Routine antenatal and postpartum health services provide an opportunity for heightened and psychologically informed mental health care. Even in the poorest countries, there is some provision for antenatal, perinatal, postpartum, and infant health care and other primary health care services.
Interventions to improve maternal mental health and related child survival, health and development can be integrated into these existing services.
At the PMHP service delivery sites, we provide routine screening for pregnant women and girls for depression and anxiety at the first antenatal visit. If they show signs or are at risk of depression or anxiety, free on-site psychosocial counselling, follow-up and case management is provided by our trained counsellors for up to one-year post delivery.
The PMHP model is based on a stepped care approach, which means that referrals are made to psychiatric services when necessary
Learn more about our integrated, stepped-care, collaborative service model, implemented through task sharing.
Guest blog post by Dyane Harwood – originally submitted to WMMHday Blog
Bipolar disorder, postpartum depression, and postpartum psychosis have made media headlines over the past couple years. Katie Holmes stars as a lovestruck poet with bipolar disorder in the film “Touched With Fire.” The British hit television show “EastEnders” featured a postpartum psychosis storyline that gained national attention. In a landmark decision, the U.S. Preventative Task Force called for screening for depression during and after pregnancy.
While the greater awareness of postpartum mood disorders is promising, postpartum bipolar disorder, the mood disorder I was diagnosed with, is virtually unheard of. Postpartum bipolar is also known as bipolar, peripartum onset, and it’s arguably the least known of the six postpartum mood and anxiety disorders. It might seem unimportant to publicize an obscure mood disorder, but every mom’s postpartum experience counts. Many medical professionals are unaware that postpartum bipolar exists. Some postpartum and bipolar organizations are unfamiliar with postpartum bipolar or they’re unclear about its definition. When I was pregnant, my obstetrician didn’t question me about my mental health or my family’s mental health history. My father had bipolar disorder, but before and during my pregnancy I didn’t show any signs of mental illness.
When I went into labor, my life changed overnight. We went to the hospital and I stayed up all night in pain. When my daughter Marilla was born the next day, I became hypomanic. I was exuberant and talkative (both signs of hypomania), but I appeared relatively normal. My baby attracted most of the attention, and no one noticed that I was in trouble. Exhausted, I sensed something was off, but I kept my fearful feelings inside. Within forty-eight hours I had hypergraphia, a rare condition in which one compulsively writes. I wrote at every opportunity, even during breastfeeding, when I should’ve been resting and focusing on my baby. I could barely sleep as my mania escalated, and poor Marilla didn’t gain enough weight because I didn’t breastfeed her sufficiently. A month postpartum, I knew I was manic; after all, I had witnessed mania in my father. I frantically searched the internet about postpartum mania, but my search only yielded postpartum psychosis statistics. During Marilla’s six-week checkup, her observant pediatrician heard my racing voice and pressurized speech (both behaviors are symptoms of bipolar disorder) and blurted out “Dyane, I think you’re manic!” I burst into tears. While I felt ashamed, I was relieved that he realized what was happening. It was clear I needed hospitalization, but leaving my newborn was agonizing. I admitted myself into a hospital’s psychiatric unit where I was diagnosed with postpartum bipolar disorder. After years of hospitalizations, medication trials, and electroconvulsive (ECT) therapy, I’m stable and doing well. While bipolar disorder ravages many relationships, my husband and I have stayed together, in part, thanks to the guidance of counselors and psychiatrists. Life will always be a challenge, but my two daughters inspire me to take care of myself.
While chances of postpartum bipolar are low, it can affect any mother. Obstetrician and Perinatal Mental Health Lead Dr. Raja Gangopadhyay of West Hertfordshire Hospitals NHS Trust, UK, explains, “The risk of developing new-onset severe mental illness is higher in early post-childbirth period than any other time in women’s life. Family history, pre-existing mental health conditions, traumatic birth experience and sleep deprivation could be potential risk factors. Bipolar illness can present for the first time during this period. Accurate diagnosis is the key to the recovery.” Confusion abounds regarding postpartum bipolar and postpartum psychosis. While the two conditions can present together, postpartum bipolar isn’t always accompanied by postpartum psychosis. Perinatal psychologist Shoshana Bennett Ph.D., co-author of the bestselling classic “Beyond the Blues: A Guide to Understanding and Treating Prenatal and Postpartum Depression and Anxiety\” says, “Many women I’ve worked with had been previously misdiagnosed with postpartum depression. I always make a point of discussing this during my presentations. In addition, postpartum bipolar disorder deserves its own category separate from postpartum psychosis.” Mental health screening during pregnancy would be of immense value to every mom. Women with a family history of bipolar disorder could be observed postpartum, and if symptoms manifested they’d be treated immediately. It’s imperative that doctors and other caregivers assess women not only for postpartum depression but also bipolar symptoms. Everyone who lives with a stigmatized illness deserves a chance to find support and empathy from others who understand her experience. Through connecting with those who can relate to our mood disorder, we may not find a magic cure, but virtual support can be profoundly helpful.
Postpartum Support International created online support groups in English and Spanish led by trained facilitators, while the Postpartum Progress website offers moms a private forum to interact with one another. I’ve never personally met another mom who has postpartum bipolar and I yearn to do so. If you or someone you know is or might be suffering from postpartum bipolar disorder please reach out to me at my blog www.proudlybipolar.wordpress.com — I’d love to hear from you!
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.