What are the factors that affect maternal mental health?
Maternal mental health issues can strike whether you are a single mom, married heterosexual mom, married/partnered/unmarried lesbian mom, bisexual mom, ethnic minority, religious or not. The stress of being a mom and the subsequent mental and emotional struggles do not discriminate. There are no known causes of maternal mental health issues or PMADs but there are many factors which contribute. The reason the precipitants to PMADs are considered factors and not causes is because you need to have the right (or wrong) combination of factors for the result to be a mom experiencing a PMAD. One factor alone may cause stress or symptoms of sadness or anxiety but it is unlikely to result in a full Perinatal Mood or Anxiety Disorder.
These factors generally fit into several categories…
1. Environmental factors: Environmental factors can be socioeconomic, housing, or even the state or country in which you reside. For instance, if you are struggling financially or are at risk of losing your housing, this is likely to cause much anxiety, fear and stress in your life prior to having a child. Once you factor in the responsibility for another life, these factors are compounded. Also, if you are a lesbian mother, and reside in a state where same sex marriage is not legal, you are at a disadvantage for some government benefits or programs that might help support you as a mother.
2. Interpersonal Relationships/Support System: Relationships and supports in a mother’s life are integral to her ability to traverse life and engage in self-care. If you are a single mother (either quite literally or due to a partner who is checked-out), it is very difficult to prioritize caring for yourself and sometimes near impossible to make the time to do so. Having a supportive, engaged partner and other peripheral family and friend supports are imperative for a mother struggling with her mental and emotional health. Getting a babysitter may seem simple to some people, but what if finances are strapped and you already feel guilty about being away from your baby for work? And imagine being a lesbian mother whose family turned their backs on her when she came out. Family support is not available for some women. Or a woman in an abusive relationship who fears asking for help from anyone.
3. Personality/Character: A woman’s innate personality structure can often contribute to her struggles as a mother. Strong women often struggle most after childbirth. Being used to handling everything on their own, independently and efficiently, they are now in a position where they are feeling overwhelmed, exhausted and at a loss. Self-judgment sets in. Or a woman who normally feels she is burdensome to others. Someone who generally struggles silently is unlikely to independently change how she handles things after the baby is born. Instead she struggles in silence, alone. Or a woman who is an apologizer, always blaming herself. The guilt that comes from believing you are to blame for how you are feeling can be crushing. The desperation to change it. There are so many ways our natural personality and character traits work against us as mothers.
4. Other life stressors: It’s quite common to have too much on your plate, whether you work and have children or are a stay-at-home mom. There are house chores, shopping, other kids, homework, after school activities, playdates… Now these things alone may have been something you juggled well in the past but add in a new baby and it can all become too much. It amazes me how many moms will seemingly forget they have a new baby, saying “I could always handle it before, what is wrong with me now?” The tendency to self-blame and experience this as a change in your abilities rather than a change in your circumstances is quite common and so very incorrect.
5. Prior mental health issues: It goes without saying that if you struggled before, you may struggle again. Even if you never experienced mental health issues outside of a PMAD, that alone puts you at higher risk. If you experienced a PMAD with a previous pregnancy/birth, you are 75% more likely to experience one again. And even though it is not a definite, if you have experienced mental health issues outside of a PMAD in the past, you are at higher risk for a PMAD during pregnancy or after childbirth. Err on the side of caution and get into treatment early, plan ahead and stay in treatment until you and your providers feel confident you are stable.
6. Your pregnancy and birth experience: Every pregnancy is unique and every delivery is unique. You are a unique person experiencing them as well. And how you experience them can greatly impact how you feel as a mother. Upwards of half of women will experience childbirth as traumatic. And even those who do not, can be surprised by their inability to feel complete joy after the baby is born. A good or bad childbirth experience can both contribute to feelings of confusion, sadness or self-judgement after baby is born.
As you can see, there are many factors that contribute to a mother’s mental and emotional health. More than I even listed here. But, perhaps you can also see the interaction between these factors. How certain life circumstances might be manageable for one woman but not for another. You, your child, your family and your circumstances are unique. I hope this helps you judge yourself and other mothers less, realizing there are many things in life which contribute to a mother struggling. The important thing is to support her, raise her up, encourage her to get help and talk openly about the struggles she is experiencing.