Maternal Mental Health & Birth Trauma: A Comprehensive Guide
Through pregnancy and after birth, many women experience mental health symptoms they may not have expected. While mixed emotions are typical in early motherhood, more serious symptoms can indicate a maternal mental health condition that needs treatment and support.
Maternal mental health refers to a mother’s overall emotional and mental well-being during and after pregnancy. Approximately 20% of U.S. mothers, both expecting and postpartum, are affected by maternal mental health disorders annually, impacting over 800,000 families nationwide. These disorders can include a range of symptoms, including depression, anxiety, psychosis, and more, all occurring during the perinatal period.
Maternal mental health disorders can be incredibly difficult not just for mothers, but also for their families and children, too. If you or a loved one is suffering from a maternal mental health disorder during pregnancy or after giving birth, help is available, and healing is possible.
What Is Maternal Mental Health?
Maternal mental health conditions are the most common complication of pregnancy and birth for mothers in the U.S. Despite this, 75% of women with MMH conditions remain untreated, increasing the risk of long-term negative effects on them and their families.
Anxiety and depression are the most common childbirth complications, affecting up to 20% of women. Not every case of postpartum anxiety or depression is severe, although suicide and overdose are leading causes of death for women in the first year following pregnancy. The impact of maternal mental health conditions on women and their families is clear.
Causes of Maternal Mental Health Decline
Maternal mental health disorders result from a combination of biological, psychological, and social factors, including a lack of support, a family history of mental health issues, and more. Proper care can reduce the risk of these conditions, and recovery is possible.
Common causes of maternal mental health issues include the following:
- Single marital status
- Young age
- Domestic violence
- Living in poverty
- Unintended pregnancy
- Pregnancy complications such as birth injuries
- Social isolation
Meanwhile, several high-risk demographics are more likely to experience maternal mental health disorders. These include people of color, low-income individuals, people with disabilities, and military members or spouses. However, the number one predictor of MMH disorders is a personal or family history of mental health disorders.
Common Mental Health Conditions Affecting Mothers
Postpartum Depression
Postpartum Depression is a type of major depressive disorder that occurs during pregnancy or within the first year after birth. It is treatable, and the risk can be mitigated. Symptoms of postpartum depression can range from mild to severe and include sadness, trouble concentrating, difficulty finding joy in once pleasurable activities, and difficulty bonding with the baby.
Up to 40% of women develop symptoms of postpartum depression after childbirth, while 33% develop symptoms during pregnancy, and over a quarter enter pregnancy with pre-existing depression, which increases the risk of developing the condition.
Postpartum Anxiety
About 20% of women experience anxiety disorders during the perinatal period, with the highest rates in early pregnancy. Postpartum anxiety is often comorbid with PPD or OCD, and causes symptoms like excessive fear, worrying, nervousness, restlessness, racing heartbeat, and inability to sleep.
Birth-related Post-Traumatic Stress Disorder
While a “traumatic childbirth experience” refers specifically to events or interactions associated with childbirth, birth-related post-traumatic stress disorder, or PTSD, refers to psychological symptoms that arise as a result of experiencing a traumatic event during childbirth. About 33% of women experience a traumatic birth event and identify experiencing at least three trauma symptoms.
Perinatal Obsessive-Compulsive Disorder
The incidence of obsessive-compulsive disorder, or OCD, is roughly 8% during the prenatal period and 17% during the postpartum period. The symptoms include obsessions, intrusive thoughts, and compulsive actions to relieve obsessions.
About half of people with maternal OCD have intrusive thoughts about intentionally harming their infant. However, such ideation is not the same as psychosis and does not increase the risk of mothers harming themselves or their child.
Postpartum Psychosis
Postpartum psychosis is a medical emergency. While it is rare, occurring in only about 0.1% of births, the onset is sudden and severe within the first two weeks of birth. Postpartum psychosis increases the risk of suicide for mothers and has a 4% infanticide rate.
The most significant risk factors are a family history of bipolar disorder or previous psychotic episodes. If you or a loved one is experiencing postpartum psychosis, seek emergency medical help immediately.
Baby Blues
The “baby blues” are not technically a disorder, but a temporary condition affecting up to 80% of women because of sudden shifts in hormones after giving birth.
Symptoms may include sadness, crying episodes, and mood swings, and usually resolve within a few days. However, if symptoms persist beyond two weeks after birth, you may be experiencing postpartum depression.
Chronic Stress
Chronic stress can occur when mothers try to do everything and function beyond their means in daily life. Constant worry, high anxiety, headaches, irritability, and sleep issues can result. Burnout can lead to total emotional numbness, anger, and feelings of being trapped.
Maternal Burnout
Maternal burnout is the final, extreme stage of chronic stress, characterized by total exhaustion, detachment, and reduced parental efficacy. Burnout can also cause mothers to dream of leaving their child or family behind. Proper support, treatment, and care can resolve this condition.
When To Seek Support for Maternal Mental Health Conditions
If you or a loved one is experiencing mental health complications during pregnancy or after birth, seek professional medical assistance. Watch for any of the following symptoms:
- Persistent sadness, hopelessness, or despair
- Panic attacks or extreme anxiety
- Severe insomnia
- Lack of interest in previously enjoyed activities
- Thoughts of harming yourself or your baby
- Difficulty bonding with your baby
Treatment Options and Support for Maternal Mental Health
Maternal mental health conditions are treatable and can often be resolved quickly with the right balance of self-care, medication, counseling, and social support. Exercise, mindfulness, relaxation, and medication can also be powerful tools when recovering from a maternal mental health disorder.
Postpartum Support International offers multiple peer support groups for perinatal mental health, pregnancy or infant loss, fertility challenges, and more. PSI also has an international support hotline, reachable at 1-800-944-4773. Additionally, the National Maternal Mental Health Hotline is available 24/7 at 1-833-TLC-MAMA for free, confidential support with maternal mental health struggles.
If you are in severe mental health distress or have a suicidal crisis, call or text the Suicide and Crisis Lifeline at 988 for free and confidential support.
Practical Coping Strategies for Everyday Mental Wellness
There are several practical coping strategies and a range of resources to help mothers maintain their mental wellness during pregnancy and after birth. It’s important to build a support system of family, friends, neighbors, support groups, or anyone you trust, so you do not feel alone.
Don’t be afraid to ask for help. Additionally, get enough sleep, practice self-care and grounding techniques, get exercise, and be kind to yourself. Motherhood isn’t easy, and no one is perfect.
Mothers, You Are Not Alone
Maternal mental health conditions are common and can affect anyone, both during pregnancy and after birth. While it can be difficult, healing and recovery are possible with support, treatment, and self-care.
Mental health struggles are not a failure of motherhood, and asking for help does not make you less of a good mother—it takes a village to raise a child. If you or a loved one is experiencing maternal mental health struggles, seek support from people you trust.