Pre-natal and post-natal depression and mental health issues in the perinatal period – what are we missing?

Pre-natal and post-natal depression and mental health issues in the perinatal period – what are we missing?

Worldwide, childbirth is happening at an amazing rate with four births occurring every second of each day.[1] For most people, hearing about the safe arrival of a baby conjures up images of cute infants and smiling, contented parents, all of which brings a warm glow to our hearts. Why is it then that women’s rates of mental health conditions, especially pre-natal depression, post-natal depression, suicidal ideation and behaviours, and the use of drugs and alcohol continues to be problematic around the globe during pregnancy, childbirth and on into motherhood? This incongruency between how we like to perceive women sailing through during this period of their life versus the reality of how poorly many women are coping, strongly suggests it’s time we delve deeper into what is really going on here.

The mental health arena has certainly received more attention around the world in recent years, including during pregnancy and motherhood, yet the demand for answers far outstretches what is available in current medical, pharmacological and psychological fields of understanding and resources. Research shows that women in the peri-natal period (pregnancy and the first few years of a baby’s life) are at increased risk of depression and anxiety with studies suggesting 1 in 5 Australian women experience anxiety in pregnancy or in the year following birth, and up to 1 in 10 women experience pre-natal depression in pregnancy and around 1 in 7 experience post-natal depression.[2] These statistics certainly mirror my own experiences working as a counsellor with women in the peri-natal period.

Another worldwide mental health concern is the rising rates of self-harming behaviours, not just amongst young people as is commonly assumed, but across all age groups and stratas of society.[3],[4] Women having babies are no exception here and there has been a clear increase in the number of mothers I speak with who are relying on self-harming behaviours, such as cutting and burning themselves, and/or using excessive exercise, drugs and alcohol, as a crutch to get through their days. Self-harming behaviours are further ingrained as ‘normal’ when there are intergenerational patterns of similar types of self-abuse.

"You are your own best-managed version of how the world told you you needed to be. But that is not the real and true version of who you are."

Serge Benhayon Esoteric Teachings & Revelations Volume I, ed 1, p 193

Furthermore, I’m noticing that women are now regularly also speaking about thoughts of suicide and/or are coming to sessions with a history of having already attempted suicide previously. The serious prevalence of suicide is present in populations globally, but it’s particularly alarming to note that it is a leading cause of maternal death in many Western countries during pregnancy and within the first 12 months after childbirth.[5]

What’s also notable is that there is a known correlation between self-harming behaviours, suicide, poor mental health and difficult psychosocial issues such as domestic violence, poverty, homelessness, and drug and alcohol abuse. The outplay of these interlinking factors all place additional pressure on a woman’s general coping capacity, especially during the peri-natal period, and increase the risk of a decline in mental health.[6] Adding to the risk of suicide, poor mental health and generally increased levels of distress during pregnancy and early mothering is the fact that women often decide to cease taking medication and/or avoid mental health services due to fears about stigma and possible child safety services involvement.[7]

What I’ve also observed is that engaging in self-harming or suicidal behaviours and thoughts is now viewed as ‘normal’ by many women I speak with. Women naturally would like life to be different and to have any feelings of shame and self-loathing disappear. Yet there is an ambivalence because the prospect of change and the unknown is scary and leaves women feeling defenceless and unsafe, so the compromise is to stick with these thoughts and behaviours because at least they are familiar and therefore provide a type of comfort and sense of control. Hence, it’s easy to understand why women who are pregnant or are struggling with mothering and other aspects of their lives want to avoid deeper exploration of their circumstances and to instead reach for alternate ways to find relief. Yet women usually report that nothing they try works and so the quest for solutions continues and the black hole gets deeper …

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Suicide and disease – our new normal

Let’s get real about humanity and look at what is truly going on.

There is definitely a need for all that Western medicine offers and for the research and services that support women experiencing struggles during the peri-natal period (and indeed all people). But given that problems doggedly persist despite billions of dollars having already been invested into professional training and practice, research, services and products, can we really afford to shy away from taking a broader, more comprehensive look at what is going on here?

What are women truly seeking and why do they feel so exposed during pregnancy, childbirth and in their early experiences of mothering that they feel the need to resort to self-harming behaviours and/or suicidal thoughts and behaviours, or fall into the anxiety trap and/or the black hole of depression?

Women report to me that they feel lost, empty, angry and sad, and that they struggle with their sense of identity. Motherhood has often proven more challenging than expected and mothers speak about feeling little sense of who they are at their core – in their essence. Many went through pregnancy with high hopes around the love and closeness they would share with their child and then feel confused as to what to do when things don’t work out according to plan. They speak about a sense of failure and subsequently struggle with guilt around how they feel and what they offer their baby compared to what they had pictured they would feel and the standard of love and care they believe they should provide as a good mother. Fears around rejection and abandonment often swirl around unspoken yet are keenly felt in their minds and bodies and are expressed through peri-natal mental health issues.

What adds further angst for women is that as a society we send mixed messages about motherhood and pregnancy. On the one hand we highly value women pursuing academic achievements and careers and generally competing in a male driven environment, yet we also send them the message that they are not complete as women if they don’t go down the motherhood path where they are expected to be soft, nurturing and self-sacrificing. The associated images and ideals behind each of these contrasting investments means there is no settlement for the women regardless of what choices they make.

The reason for this setup is that we have made everything in life about undertaking roles so as to have our needs met from the outside world. We learnt from young that this was what life was all about, but through adopting such a way of living we lost something that is fundamental to our health along the way, and that is our connection to our bodies. Instead we find ourselves living in a world where harmony within and between people struggles to find a footing and our mental health suffers as a result.

Our mechanisms of life are all determined by pictures. But these pictures drive our society and create massive pressures and expectations around motherhood. They also underpin an ever-widening gap between the rich and the poor and produce work environments that are not about working together with a purpose, and instead are focussed firmly on making money and gaining positions of power and status. They are places where systematic bullying is normalised, and rates of absenteeism, burnout, depression, suicide etc. are spiralling out of control. We get totally lost making it all about the pictures we have used to define our identity and don’t realise we are trying to achieve something that we have placed outside of ourselves. As a result, we find we are never good enough, smart enough or have enough time or skills to achieve what’s contained in the images we hold so dearly.

To stop the constant spin of trying to reach an idealised picture we can turn to the resourceful vessel we each have – our body. We have made the body an object for achievements; a vessel that has to constantly deliver us something, and it mostly is never good enough, pretty enough, too exhausted, not well functioning, etc. We then constantly strive to improve this body, instead of going to the true resources it holds; its true power, and then live from all that is already there. The truth is we are very sensitive beings, we feel all the time and when we learn to honor our sensitivity, we discover it is our biggest strength. Alternately, living in opposition to our true selves leaves the door open for mental health issues to easily develop or escalate, as so often happens during the peri-natal period.

It is the quality of expression we live in that fulfills us and makes us feel complete within ourselves without the need for any outer achievement or identity. Any role we assume from there, whether that be motherhood or anything else we undertake, is then originating from a purpose and not to achieve or gain something, but from a lived way that confirms we are already everything.

"Re-connect to your inner-heart - you will then know that you know it all … and always did."

Serge Benhayon Esoteric Teachings & Revelations Volume I, ed 1, p 287

There is no magic wand; the work required to undo all the harm done through years of self-abuse, self-loathing and neglect (either intentional or non-intentional) takes time, commitment and effort, and not all women feel able to go down this path. But amazing transformations can occur for those who do feel ready to work on learning to connect with and trust their body’s communication through physical signs and feelings. As women gradually discover that they do have an inner ‘being’, they find they have access to a wealth of resources regarding themselves and their lives. The more strongly they feel connected to their bodies, the more women’s relationship with their sensitivity develops and the higher their self-esteem becomes, which helps to close the gaps that allow mental health issues to creep in originally. Yes, it’s a case of a few steps forward and then learning to deal with setbacks as they inevitably occur along the way, but the sense of joy and wonderment women experience as they increasingly come to know and appreciate themselves is priceless.

Learning to self-love – be that through small acts of self-kindness through to bigger acts of saying ‘no’ to self-sacrificing to please others – is such an undervalued resource we all have available to us. Developing an understanding of our choices gives us the opportunity to expose and discard many of the ideals and beliefs that weigh us down, opening space for more simplicity and settlement to our lives.

I find along the way it’s not uncommon for mental health issues, such as peri-natal depression and anxiety, self-harming and suicidal thoughts and behaviours, to decrease or even cease as the burdens carried by women lighten or even disappear and are replaced by a stronger sense of self-worth. It goes without saying that the benefits for mothers and their children are pure gold and continue to unfold over time.

What the above suggests is that assisting women to re-build a positive relationship with themselves, connect to and trust their bodies and from there to nurture and nourish their relationship with others around them, including their babies, may well be far more fundamental to building and sustaining sound mental health than previously considered. A simple but strategic pathway for peri-natal mental health care is offered that complements what the medical model and other services currently provide to women experiencing pre-natal depression, post-natal depression and other mental health concerns.

We have an opportunity here to experiment with breaking through old patterns and beliefs and to genuinely work on building a positive relationship with ourselves through a more caring connection with our bodies. Such a foundational way of life helps to create the loving environments we have always wanted to help nurture and raise our children into kind, caring adults. Admittedly, the majority of people are a long way from recognising the value of living this way on a consistent basis. However, any changes you make within yourself then reflect to others the choices on offer and what is possible through a loving commitment to self and hence, each person’s own unique map for health and wellbeing.

"We only need to look at children in how they move and carry themselves to see that vitality, ease and contentment in our body is natural to us. On this note we should not ever discount what we see that is true and obviously good in children simply because they are children; we have a right to make that our life as adults. This is not posed from any atop or aloof posture and neither is it utopian. The richness our children show us should not be crushed out of them. And if this is so, and it only takes one generation to start it, we will be the living adults of that richness, the real asset we are born with."

Serge Benhayon Esoteric Teachings & Revelations Volume II, ed 1, p 79


References:

  • [1]

    Ecology Global Network. World Birth and Death Rates. World Birth and Death Rates 2019 [cited 2019 01/06/19]; Available from: https://www.ecology.com/birth-death-rates/.

  • [2]

    Centre for Perinatal Excellence. 2019 [cited 2019 01/06/2019]; Available from: https://www.cope.org.au/health-professionals/health-professionals-3/perinatal-mental-health-disorders/perinatal-mental-health-factsheets-for-professionals/.

  • [3]

    Australian Instituate of Family Studies. Teenage Self-Harm and Suicide Rates Under-Reported. Media Release Teenage Self-Harm and Suicide Rates Under-Reported 2017 [cited 2019 01/06/2019].

  • [4]

    Tracy, N. Self-Harm in Adults: Self-Injury Not Limited to Teens,. 2012 [cited 01/06/2019 2019]; Available from: https://www.healthyplace.com/abuse/self-injury/self-harm-in-adults-self-injury-not-limited-to-teens.

  • [5]

    Ellwood, D. FactCheck: Is Suicide One of the Leading Causes of Maternal Death in Australia? 2019 [cited 2019 01/06/2019]; Available from: https://theconversation.com/factcheck-is-suicide-one-of-the-leading-causes-of-maternal-death-in-australia-65336.

  • [6]

    Orsolini, L., Valchera, A., Vecchiotti, R., Tomasetti, C., Iasevoli, F., Fornaro, M., De Berardis, D., Perna, G., Pompili, M., Bellantuono, C., Suicide during Perinatal Period: Epidemiology, Risk Factors, and Clinical Correlates. Frontiers in Psychiatry, 2016. 7(138).

  • [7]

    Khalifeh, H., et al., Suicide in Perinatal and Non-Perinatal Women in Contact with Psychiatric Services: 15 Year Findings from a UK National Inquiry. Lancet Psychiatry, 2016. 3: p. 233-242.

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DepressionPregnancyMotherhoodBirthMental health

  • By Helen Giles, Accredited Mental Health Social Worker, MMH (Family Therapy), Post Grad Cert Family Therapy & Counselling, M. EPA.

    I love that life is amazing with every relationship offering constant drops of pure gold, whether that be in my work as a perinatal counsellor or through friends, family and others I meet in everyday life.

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