Maternal Mental Health and Wellbeing

Motherhood is a beautiful journey. It comprises of a wide variation of physical, social, emotional and perceptive capacities including the mother's ability to regulate behaviour and feelings. Considering this, the most important and widely discussed concern is maternal mental health, which unfortunately is not given due importance. It not only includes the time frame of mother's health during the pregnancy period or post pregnancy period or absence of mental illness but also comprises of mother's general well-being, strengths, abilities and capabilities to cope with various stressors of day-to-day living.

Maternal mental health has become a public health priority because of its impact on both mother and child's health. In the previous eras, emotional well-being and prevention of psychiatric disorders especially postpartum depression, anxiety, panic, bipolar and post-traumatic stress were the most common causes of concern. However, in the recent times, growing evidences have largely shifted to care and protection during the pregnancy period for a "healthy pregnancy" indicating a child without any birth complications or acquired disabled conditions.

The perinatal period, which includes both antenatal and postnatal phases, is very significant both for the mother as well as for her child. Although the impact of maternal mental health on child development starts from conception, antenatal (before birth) mental health has gained momentum only in recent years due to changes in our lifestyle. Maternal mental health comprises of various factors like maintaining adequate nutritional status, reducing physical workload, periodic medical check-ups, avoiding non prescribed drugs, exposure to radiations and immunization against TORCH (toxoplasmosis, others like syphilis and hepatitis B, rubella, cytomegalovirus, herpes simplex) infections beginning from the period of conception. Mothers of children with disability are found to be at a higher risk for developing mental health issues than of mothers of typically developing children. Hence early screening for detection for genetic risk factors needs to be considered.

Apart from this, mental wellbeing has a lot to do with pregnancy and birth outcomes. If the mother is suffering from common or severe mental illness/distress/anxiety/depression, etc during her pregnancy, it directly or indirectly affects the fetus. The environment in the uterus during different critical periods can alter the development of fetus with permanent effect on the child.

Examples of antenatal stress include maternal anxiety and depression, partner or family discord, violence, major life events and the experience of trauma (man made or natural) like domestic violence, COVID 19, floods etc.

Untreated mental health issues like antepartum depression may lead to loss of interest to look after self and the fetus, increased use of tobacco, alcohol and other harmful substances, risk of self-harm or suicide, miscarriage or preterm birth, poor fetal growth and impaired fetal and postnatal development and postpartum depression.

A few stress reducing steps can be followed to enhance maternal wellbeing during and after pregnancy

• Practice deep breathing exercises as it helps oxygen flow to our entire body, relaxes our muscles, stabilizes blood pressure and reduces stress

• Always keep in touch with your healthcare provider if you experience any discomfort.

• Stay physically active. Walking, prenatal yoga, mindfulness meditation, always helps.

• For working professionals, prioritize your health over work. Plan ahead of your meetings, deadlines in order to maximise time for relaxation.

• Do not expect too much out of yourself – be realistic about what you can do; rest when you need to.

• Balance out your diet by eating what is right. Unhealthy choices may lead to nutritional deficits further impacting the child's growth and development.

• Try not to make major changes at this time, like moving house or changing jobs, unless you have to.

• Spend time with people who make you feel relaxed and good about yourself.

• Avoid using drugs or alcohol to deal with stress.

• Build a support network around you to talk and discuss about your emotional challenges

• Interact and take up some hobbies with your partner to relax

By:

Tanushree Choudhury

Rehabilitation Psychologist

Consultant MIND India

Ask Dr Sangeeta Goswami

Question: I am seven months pregnant and I have noticed mood swings. In a day I feel happy and then suddenly get irritated and feel low. Do I need to worry about my mood swings?

Congratulations on motherhood and our best wishes for the rest of your pregnancy and healthy baby. Mood swings are quite common during pregnancy as there are hormonal changes happening in your body. Not only that, there is a change in your lifestyle and there can be restrictions on movement as you come towards full term. It's a good idea for all expectant mothers and their partners to monitor their mental health and wellbeing. You can keep a lookout for signs that need to be treated by a mental health professional.

Check:

If you have felt consistently sad, weepy and lost all interest, for longer than 2 weeks

If you are having negative thoughts and feelings that are starting to affect your daily functions

If you are showing signs of anxiety or unable to cope with stress

If you show signs of having panic attacks, or develop obsessive or compulsive behaviours like repetitive behavior or thoughts

In the yellow box down go to the eight line….the two words in red have to be added

Dr. Goswami is running a comprehensive multi - disciplinary mental health and wellness centre, under MIND India which is one of its kind in the North East of India.

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