The dilemma of postpartum depression and integration of maternal mental health into health programs has been a global concern for a long time. In this regard, through collective efforts, numerous international organizations have cooperated for betterment and integration of maternal and infant health into extensive public health programs. A trend has been noticed that in women of child-bearing age, depression is widely responsible for the burden linked to mental or neurological disorders in infants.
These maternal-infant morbidities account for a great economic burden and a hindrance in development, therefore cumulatively responsible for inter-generational weaknesses. WHO refers to maternal mental health as a state of health during which a mother realizes her own abilities, can cope with the normal stresses of life, and work productively to make a contribution to her community. Maternal mental health disorders primarily refer to anxiety and depression attacks during or after pregnancy, owed to a variety of factors. According to CDC 2019 statistics of U.S, almost 1 in 5 mothers suffer from mental health disorders but even less than 15% seek treatment.
Child development issues can include emotional or behavioral disorders such as autism, concerns related to cognitive learning or neuro development issues. A vast majority of factors might interplay to produce such circumstances. Through years and after several researches, it has been found that social, environmental or genetic factors can cumulatively or independently interfere in showing detrimental effects on child learning or development. A major key role is played by the maternal emotional disorders or trauma from past, which interferes with early parenting practices.
Often, it has been noticed that women having unstable emotions or lesser control on their reactions, exhibit violent behaviors towards their children which directly or indirectly affect the child’s learning capabilities or neurological afflictions. On a broader scale, genetic heritability is also accountable for transmission of unstable emotional patterns from mothers to children such as depression, bipolar disorder or schizophrenia which has been proved by presence of various DNA variations in both. Environment in which the child is raised and the types of practices or etiquettes he/she witnesses determines the future behavior patterns of the child. If the child grows up seeing unhealthy relationship between his parents, he/she would be more likely to exhibit similar manners.
Extended family system can be a source of better learning as it will involve more members but can have weaknesses too, which might be associated with harsh attitudes. Women also undergo higher levels of stress in these systems, contrary to nuclear family system. The diet of the mother during pregnancy or breastfeeding period is a major determinant of child’s physical and mental health. Several researches have found that women belonging to lower socioeconomic class have difficulty affording high nutritious diets and effects are visible in physical or mental retardation of their children.
The mother-infant relationship strongly associates with child’s positive progress. Post-partum depression usually deprives the mothers to develop a strong sense of attachment with their newborns. Moreover, body changes post pregnancy is another predisposing factor of postpartum depression. Lack of self-confidence and dealing with constant social pressure adds up to interfere with the prompt daily activities. In an era of widespread technological innovations, extensive use of smartphones have become another issue. Researches over the years have concluded that long term use of cell phones during pregnancy can result in preterm births or exposure to radio frequency generated electromagnetic fields can affect development or growth of the fetus.
The current situation of COVID-19 pandemic has now desperately frazzled, causing health deteriorating impacts and taking a major toll on mental health. Some studies during this pandemic have shown higher prevalence of mental health problems among women than men. Pregnant women during this time are specifically at a higher risk. Psychological stress in these women can result due to concerns about consequences of preventive measures, such as quarantine, home isolation or limited consultation facilities with doctors. If isolated, they spend most time using smartphones which can result in developmental defects of fetus. Due to COVID restrictions, visits by family or relatives to pregnant women during hospital stay are limited, therefore lack of support through these times can lead to anxiety. Some women might also opt for delivery at home but this can further increase the risk for maternal or infant mortality and postnatal complications.
Conversations involving maternal mental care are still considered a taboo to some extent in developing or resource poor countries which ultimately results in the inability of provision of basic mental health needs and an overall decline in health with high rates of mortality and morbidity. These maternal mental issues are continually on rise and a major concern as they increase the risk for maternal and infant mortality or morbidity. Therefore, in order to minimize the risk of its development and control on an early stage, steps should be taken at all levels; individual, inter-sectorial or community.
After being incorporated into the MDG’s, maternal mental health is now consolidated into private and public healthcare systems which require proper counselling during or after pregnancy, regular check-ups, specialist support and prescription of antipsychotics/mood stabilizers if required. Efforts at social and individual level are equally effective such as communicating the concerns to family/friends, taking antenatal classes for better understanding, maintaining a healthy and nutrient rich diet or indulging in activities that balance mood. Non-government organizations can also make volunteer contribution through awareness workshops or at-home consultation services. Implementation of strict policies along with regular surveillance systems can be a step forward to resolve the current weaknesses in health systems, public and private both.
*About Author: Mariyam Khalid has graduated in BS Microbiology from QAU, Islamabad. She is currently working as an internee at National Institute of Health and previously has been involved in volunteer work through collaboration with SOS Children’s village and PRCS. Her areas of interest include creating awareness for public health concerns, genome sequencing and genetic engineering in molecular biology. She can be contacted via email on [email protected].