By Aliyah Vinikoor, LICSW, JFS Mental Health Counselor
May is Maternal Mental Health Month. Despite my work as a therapist, and having supported many mothers throughout my career, this awareness month wasn’t on my radar until this year.
We’re living through an incredibly challenging time for parents – and for mothers most of all. The pandemic laid bare the stark gender gap that still exists in most heterosexual households: Even in 2021, mothers bear the brunt of childcare and housekeeping. This responsibility divide faced by mothers exists within an alarming mental health reality: The CDC estimates that women in their childbearing years experience anxiety and depression at about twice the rate as men.
Those are all reasons to raise awareness around maternal mental health this year. But the reason I just learned about Maternal Mental Health Month is because I recently became a mother myself.
Having a baby – especially for the first time – can be intense. The emotional, physical, and hormonal shifts that I experienced after childbirth came as a shock – even as a highly-informed therapist who prepared for the inevitability of these changes. After a very long labor and a couple of sleepless nights at the hospital, I returned home with my tiny baby having not slept for five days straight. Because of the pandemic, my husband and I were alone in those first chaotic weeks caring for a newborn who had some significant needs because of his low weight. The sleep deprivation, hormones, and overwhelming responsibility I suddenly felt for another human left me feeling frayed. At times, I was angry, tearful, and distrustful of my own mind. I was experiencing the “baby blues,” a moody period of up to three weeks post-birth that affects nearly 80% of new moms.
In my case, things stabilized after a couple of weeks. While the work of caring for a newborn was still incredibly hard, I felt less out of control, more able to lean into the joy of discovering my son, and open to receiving help from family and friends (if at a distance).
However, for 1 out of 7 women, these symptoms don’t subside after the first few weeks. According to the World Health Organization, 10% of pregnant women and 13% of women who have just given birth experience perinatal and postpartum mood and anxiety disorders (PMAD). Ongoing anxiety, depression, rage, and psychosis are even more common among women in less-wealthy countries and/or among mothers who have faced mental health challenges, low social support, extreme stress, or adverse experiences such as poverty and migration. Traumatic births and having a child after struggling with fertility or pregnancy loss are also contributing factors. PMADs often go underreported or untreated so these incidence rates may be even higher.
Even with awareness of mental health on the rise, I believe maternal mental health is still overlooked. Postpartum depression is not the only manifestation of post-birth mental health challenges – postpartum anxiety may be even more common. If you think you may be experiencing a perinatal or postpartum mood or anxiety disorder, please reach out to your healthcare provider as soon as possible. A PMAD may be suspected if you experience several of the symptoms listed below; if they’re intense, and if they occur daily for longer than two weeks:
- Intense anger or irritability
- Sleep troubles (such as too much or not being able to fall asleep)
- Difficulty concentrating or remembering things
- Complete lack of energy
- Appetite changes (not eating enough or too much)
- Frequent crying spells
- Loss of interest in doing things you used to enjoy
- Withdrawing from family or friends
- Feelings of guilt, worthlessness, or hopelessness
- Showing too much or not enough concern for your baby, feeling negatively about your baby, or fearful of being left alone with them
- Thoughts of harming yourself, your partner, or your baby
- Seeing or hearing things that aren’t there or having thoughts that don’t make sense
- Constant worry, fear, uneasiness, or sense of impending doom
- Obsessive, intrusive, or upsetting thoughts (often related to the baby)
- Compulsive behaviors
- Physical symptoms like dizziness, nausea, headaches, or fast heartbeat or breath
Despite birthing in a pandemic, despite my history of pregnancy loss, and despite having a high needs baby, I was lucky. I owe this in part to the care and support I received from family, friends, and my healthcare providers. I also benefited from newly established government programs such as Washington’s Paid Family Medical Leave, which allowed me and my husband to take months off of work together, and the federal Economic Income Payments that provided cash boosters for me and my family during the pandemic. Starting in July, we’ll also receive $300 per month as part of the federal child tax credit, which will go a long way toward covering the high cost of childcare.
Public health researchers have identified five key areas that impact people’s functioning and quality-of-life outcomes: (1) Economic Stability, (2) Education, (3) Health and Health Care, (4) Neighborhood and Built Environment, and (5) Social and Community Context. These “social determinants of health” greatly influence maternal mental health. It’s why we see much higher rates of perinatal and postpartum mood and anxiety disorders in the United States compared to countries with socialized healthcare, paid family leave, subsidized childcare and universal preschool, and better workplace protections for pregnant people.
As theologian Ekemeni Uwan wrote, the pandemic has proven “that much about our former life was actually abnormal—its frenetic pace, its inequalities, and its injustices.” This is certainly the case with parenting and family support. If we want to address maternal mental health, we need to address the root causes of PMADs—such as the prohibitively high cost of childcare, barriers to health and mental health services, and lack of paid parental leave.
I’m heartened to see so many of the family policies listed above gaining steam on both local and federal levels. Perhaps paid family leave will be extended around the country. Perhaps the monthly payments we’re about to receive will become a permanent subsidy for families. Perhaps by the time my son turns four, he’ll enter a publicly-funded preschool program and by the time he’s 18, “College for All” will be a reality.
While much is written about the need for mothers to engage in “self-care,” or the ways that social media leads to higher rates of depression and perfectionism, for many of us we’re just struggling to get by. Government programs are key to supporting maternal mental health, thriving children, and healthy families. As the saying goes, “It takes a village to raise a child.” Raising a family wasn’t meant to be done in a vacuum. We need governmental solutions to help unburden the high emotional and financial costs of raising a family. Doing so will go a long way in addressing the disproportional mental health impacts of parenting.
If you need mental health support, please contact firstname.lastname@example.org or (206)-861-3152. JFS is here to help, and we offer our services on a sliding scale. We also accept insurance. You can also visit our Counseling & Addiction Services webpage here for more information, as well as our Project DVORA (domestic violence services) page here. If you think you may be experiencing a perinatal or postpartum mood or anxiety disorder, please reach out to your healthcare provider as soon as possible.