When a baby is born, people stop acting like themselves. Gruff grown-ups make goofy faces at infants. Nostalgic moms share their birthing experiences with pregnant strangers. Shy kids clamber onto strollers of babies they don’t know, just to coo at newborns.
In some cases, emotions brought up during this motherhood transition can become intense and get in the way of day-to-day functioning, much more severe than the “baby blues.” There are biological factors such as genetics and hormonal changes, as well as psychological factors and social stressors that can impact mood during and after pregnancy.
Also, there are high societal expectations around mothers to perceive pregnancy and infant care as a time of bliss and happiness. When reality doesn’t match this assumption, the disparity can lead to mental health symptoms or further exacerbate existing mental health conditions.
In fact, one in five women develop maternal depression, making it the leading complication of pregnancy. More importantly, there is vast scientific evidence showing that untreated mental health conditions can cause a wide range of complications for both mother and baby. It is no longer acceptable to ask a mother to power through these conditions on her own due to misinformation. These mothers deserve attention and help in a timely manner.
When we launched our Maternal Mental Health Program in 2017, the prevalence of these mental health challenges in our community came into stark, clear focus. I feel fortunate that through the support of philanthropy, we were able to address these needs through a specialized outpatient clinic where women can meet with a psychiatrist, licensed marriage, and family therapist or a licensed clinical social worker to receive care or to be connected to appropriate resources.
The fact that the Orange County community understands and is committed to addressing this need, is incredible. And I hope the work being done through community support will inspire other hospitals, physicians and communities to address maternal depression head-on.
By offering pre-conception planning and mental health assessments, the medical community can provide early intervention, education and treatment for women who have mental health concerns prior to pregnancy. For women whose mental health needs only become apparent during or after pregnancy, a strong program can also provide individual and group psychotherapy, medication safety evaluation during pregnancy and breastfeeding, and linkage to community agencies to help address social needs.
Ideally, maternal mental health will become a routine part of prenatal care: While we work to ensure that baby is developing well, we need to support expecting mothers and new mothers as their bodies change as well. When women know that they are understood and supported, they feel more confident to say, “I’m not OK. I need help.”
It is then up to the rest of us to see how we can act differently — and offer that help.
Patricia De Marco Centeno is a psychiatrist and medical director, Maternal Mental Health Program, Hoag Memorial Hospital Presbyterian, Newport Beach, CA.
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