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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