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Effects of Maternal Mental Health on Both Mother and Child

Maternal mental health is a critical aspect of pregnancy and birth that can often be overlooked. While the birth of a child is a momentous occasion, it can also be a challenging time for many mothers. In fact, the World Health Organization estimates that approximately 10% of pregnant women and 13% of women post-birth experience a mental disorder. These disorders can have a significant impact on a mother's well-being, as well as the development and health of her child8.

There are two significant periods where maternity is categorized: prenatal and postnatal. Prenatal period refers to the period before birth (during pregnancy), whereas postnatal refers to the period post birth (after pregnancy). Lastly, perinatal refers to the short period of time, usually weeks, before and after birth. It is important to distinguish these periods pre and post birth because they generate disparate effects for the mother—and for the child, as well6.

The article “Prenatal mental health and the effects of stress on the fetus and the child. Should psychiatrists look beyond mental disorders?” by Vivette Glover discusses the impact of prenatal stress on the neurodevelopment of the child and the potential role of mental health professionals in addressing this issue. Glover highlights various types of prenatal stress, including the mother's exposure to natural or man-made disasters, emotional cruelty, and domestic abuse by her partner, among others2.

Recent data suggests external and internal stressors can increase the risk of emotional, behavioral, and cognitive problems in the child. Early childhood maltreatment of the mother has been found to be associated with altered brain structure in the newborn, with reduced cortical gray matter2. This association was independent of the mother's prenatal mood, and of other potential confounding variables. This suggests that such early trauma may affect the mother's biology in a way that in turn alters the development of the brain of her fetus and may indicate vulnerability to later depression and other problems for the child. Even more, research has consistently shown that postpartum depression can have negative effects on child development. For example, a systematic review of 28 studies found that children of mothers with postpartum depression were at higher risk of cognitive and behavioral problems3. Another study conducted in the US found that maternal depression in the postpartum period was associated with lower cognitive and language scores in children at age three8. A longitudinal study conducted in the UK found that maternal depression in the postpartum period was associated with lower academic achievement in children at age 16 7.

Maternal mental health postnatal has become a priority for hospitals and health systems in the United States. One in five women experience maternal mental health conditions, such as perinatal and postpartum depression, birth-related PTSD, and anxiety, yet 75% go untreated, with suicide and substance abuse being the leading causes of maternal deaths in the first year after childbirth 7. Women of color are more likely to experience these conditions but are less likely to seek help. The recent partnership between the American Hospital Association (AHA) and the national non-profit organization 2020 Mom aims to improve maternal mental health care by producing tools and resources specifically for hospitals and health systems.

Hospitals are the hub for 98% of births in the country and are therefore critical in improving maternal mental health outcomes. Efforts to improve maternal mental health vary depending on the patients and communities served . For example, Common Spirit Health engaged obstetrics providers, perinatal nursing staff, and social workers in a screening program to identify the mental health conditions of pregnant and postpartum women 4. Providers receive mental health training, and patients with identified risk of depression and anxiety relate to a social worker to assess their condition. Similarly, the integrated maternal mental health initiative at SCL Health administers a universal mental health screening, connects patients with mental health resources, and provides mental health training to obstetrics providers and staff.

Furthermore, it is important to identify and treat postpartum depression. A systematic review of 19 studies found that depression screening during pregnancy and the postpartum period was associated with increased rates of treatment and improved maternal and child outcomes5. Similarly, a study conducted in the US found that maternal depression screening and referral to mental health services was associated with lower rates of depression and improved maternal and child outcomes 3. As highlighted in various studies, maternal mental health issues can have long-lasting effects on the child's development and health, and therefore, addressing this prevalent issue in society should be a top priority. By providing access to mental health resources, promoting strategies that support maternal mental health, and engaging healthcare providers in screening programs, we can improve outcomes for both the mother and the child and create a healthier and happier society.

It is crucial to recognize and address maternal mental health concerns to ensure the best possible outcomes for both mother and child. In this context, it is important to explore and understand the various factors that contribute to maternal mental health and promote strategies that can support and improve it.


Edited by: Deven Gupta

Graphic Designed by: Eugene Cho


References

1) American Hospital Association. “AHA, 2020 Mom Partner to Improve Maternal Mental Health.” AHA News, 27 Apr. 2020, www.aha.org/news/headline/2020-04-27-aha-2020-mom-partner-improve-maternal-mental-health.

2) Glover, Vivette. “Prenatal mental health and the effects of stress on the fetus and the child. Should psychiatrists look beyond mental disorders?” British Journal of Psychiatry, vol. 208, no. 5, May 2016, pp. 399-400. doi: 10.1192/bjp.bp.115.172057.

3) Goodman, Sherryl H. “Depression in Mothers.” Annual Review of Clinical Psychology, vol. 9, no. 1, 2013, pp. 379-407, doi:10.1146/annurev-clinpsy-050212-185612.

4) “Improving Maternal Mental Health.” CommonSpirit Health, www.commonspirit.org/stories/improving-maternal-mental-health. Accessed 28 Mar. 2023.

5) “Maternal Mental Health Initiative.” SCL Health,

www.sclhealth.org/campaigns/mom/better-mental-health. Accessed 28 Mar. 2023.

6) Natalist. "The Importance of Prenatal and Postnatal Care." Natalist, Natalist, 16 Oct. 2020, https://natalist.com/blogs/learn/the-importance-of-prenatal-and-postnatal-care.

7) Sabo, T., Brown, A., Eckenrode, J., & Zimmerman, M. (2005). Gender differences in perceived social support and stress at entry into substance abuse treatment. Evaluation and program planning, 28(4), 391-398.

8) World Health Organization. (2013). Mental health action plan 2013–2020. World Health Organization.https://apps.who.int/iris/bitstream/handle/10665/89966/9789241506021_en. g.pdf;jessionid=9B9B101E0C324F2713F3E67A91F841D2?sequence=1


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