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Pregnancy, birth and mental health - why some women aren't seeking the help they need

by lizzi (follow)
Helping plant the seeds of positive birth. www.sproutbirthing.com.au
Birth Trauma (44)      Mental health (3)     
This blog post has been sparked by a conversation I had the other day. It was about, in the context of the recent babies that have been found abandoned, why mothers may be reluctant to seek help for pregnancy and birth related mental health problems. Because in 2014 there should be no stigma attached to mental health problems.

And in a way I agree. I think that a lot of the stigma associated with admitting to having a mental health problem and then seeking help for it has been removed. Except when it comes to pregnancy and birth related mental health concerns. There is still a huge taboo around pregnancy and birth related mental health problems. Because pregnant women *should* be happy.

Consider it this way – pregnant women are often criticised for complaining about the very real and physically obvious “discomforts” of pregnancy. How often have you heard of a pregnant woman complaining about all day morning sickness, a sore back, leaking boobs only to then hear of them being told “Just be grateful – after all there are so many women who can’t have children who would love to be in your shoes”. How do we imagine these people would respond to a pregnant woman or new mother telling them that they are depressed, anxious, panicked or simply unhappy?

Image courtesy of Wikimedia Commons

Pregnant women and new mothers are not “allowed” to express any feeling other than pure joy and happiness. We must be happy that we are pregnant and grateful for our healthy baby. It’s actually quite rare for anyone to ask how we are feeling, such is the low value placed on our feelings. When discussing our pregnancies with our family and friends we are often told how we are feeling “you must be so excited!” “Oh you’ve hit 13 weeks – bet you’re glad the morning sickness is over!” “You must be so pleased to be having a boy / girl!”

We are left feeling intense shame and guilt if we are unhappy or suffering depression. Because we “must be so excited!” The women who are suffering from ante-natal depression or experiencing anxiety and trauma (perhaps form their previous birth experience) are left feeling that if this is the opinion of their friends and family, those who care about them, then surely a stranger will feel the same. And it is very hard to continuously have your feelings invalidated by friends and strangers alike. So you learn to hide them.

We learn a tough lesson very early – Mothers don’t matter. Except in our capacity as incubators for a growing baby.

Image courtesy of Wikimedia Commons

And after the birth…If you suffer from birth trauma and seek help the stigma is significantly increased. “All that matters is a healthy baby – not what you want!” and “Just be grateful for your baby”. Women who suffer from birth trauma and related post natal depression (which can also be completely unrelated to trauma), post traumatic stress and / or anxiety feel shame and guilt for not feeling “happy enough”. I see the comments all the time “Please don’t judge me, I feel traumatised by my birth experience. Does anyone else feel this way?”

My own experience with this proves, once again, that I am a slow learner:
The midwife who caused a large portion of my trauma came to see me not long after I was put in my room after the surgery. I had barely seen my daughter and had no idea if she was okay. I was alone and terrified and rather drugged up. The only thing I remember the midwife saying is “Just remember that all that matters is the healthy baby”. Never mind that I didn’t even know if my baby was actually healthy.

I mentioned to a nurse on about day 3 that I “feel like a manic depressive. Up and down and up and down”. I was crying more often than not – unless I got some sleep in which case I would be so manically happy I worried myself. I was told not to worry, but to tell someone if I still felt this way in a few weeks.

The child health nurse came to visit me at about the 2 week mark. I started to tell her all about my experience and I was cut off. “All that matters is that you and bub are alive”.

At my daughter’s 8 month check up the GP asked about her birth. I started telling my story and as usual I was cut off. “Why on earth wouldn’t you want a caesarean?”

Not one of these people picked up that I was depressed and suffering from post traumatic stress and anxiety. Not one of these people actually asked me how I felt. And, sadly, I am not alone in my experience. I hear stories every day of women who are suffering deeply and are scared being told by family, friends and medical staff that they simply need to “get over it”. “All that matters is a healthy baby”. “You’re a mother now – isn’t that what you wanted?” “Don’t forget that there are so many other women out there who would love to be in your position”.

Sadly many women will never seek professional help for their pregnancy and birth related mental health problems. Suicide is a big killer of women in the post partum period and our maternity care system and society in general are letting down mothers. It’s time that we all stood up and proclaimed long and loud – Mothers matter too. Our babies deserve mothers who feel confident and empowered. They deserve mothers who feel heard and respected. Our healthy babies need and deserve healthy mothers.

#Birth trauma
#Mental health
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My guess as to why is that in Australia, as in the U.S., the primary goal of births is to make money for hospitals, not to make moms happy. Acknowledging that moms are unhappy with such a system would probably detract from hospitals' profits.
You make an incredibly good point. If we start to acknowledge that the system is having a huge, detrimental, effect on women's mental health then we would need to change the system (or openly acknowledge that women's health is not important in our culture) and there are many who benefit from how the system is currently set up.
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