Whenever people think about giving birth and having children, they think about a wonderfully peaceful birth that delivers a perfectly happy mother and child. Then the mother and child go on to be perfectly tender, loving and happy with the newborn and the entire birthing process is so idyllic that it is the best feeling in the world. However, this isn’t always the case and for some mothers pregnancy can be traumatic. In this clinical psychology episode, we investigate how mental health is impacted during and after pregnancy on women. If you enjoy clinical psychology, mental health and maternity care you’ll enjoy this episode.
Today’s episode has been sponsored by Abnormal Psychology: The Causes And Treatments For Depression, Anxiety and More. Available from all major eBook retailers and you can order the paperback and hardback copies from Amazon, your local bookstore and local library, if you request it.
What Happens When a Mother Has A Bad Birthing Experience?
I think it’s a massive shame that a lot of women don’t have the traditional idyllic, joyous experience giving birth and becoming parents. Since a lot of people can feel cut off and distant from their own bodies, offspring and identities both during and after their pregnancy. And it’s important to note that this isn’t because the parents don’t care about the child and they don’t want a bond, because this can happen even when they really, really want that idyllic bond with their child.
In addition, this distance that the parents feel can be increased or made worst by a range of mental health challenges that can and do change the course of lives for generations, particularly when the pregnancy wasn’t wanted in the first place. That’s something we’ll cover later in the episode.
Also, this is a lot more common than people believe because Vegas-Lopez et al. (2008) found that across the globe 15% to 20% of people developed mental health conditions because of the birthing experience and their pregnancy. One example of these conditions is Postpartum Depression, and this is the most studied and common of these pregnancy-related conditions.
Since nearly 1 in 6 women develop Postpartum Depression according to Wang et al. (2021) with symptoms including excessive sadness, crying, severe mood swings and unexpected changes in their sleeping, eating, lower energy and they not only withdraw from their friends and family but they struggle to bond with their child.
Then to make things even worse for the mother, the depression they feel is in stark contrast to how they’re meant to feel after giving birth making them feel isolated, guilty, shameful and sad. With the external and internal stigma surrounding mental health conditions only interfering with the mother’s likelihood of seeking professional help and some studies find less than 20% of mothers actually do get help (Manso-Cordoba et al., 2020).
Personally, this is why I hate stigma around mental health conditions because it is so negatively impactful and it does ruin so many lives. Since if there are less stigma then these mothers could seek professional help, get treated and then learn how to cope with their condition so they could have that idyllic bond that they want so badly. This is why it’s important to talk about these sort of mental health challenges so we can raise awareness and hopefully decrease this stigma.
Moreover, a range of healthcare providers as well as researchers are continuing to learn about other mental health difficulties associated with pregnancy like the development of anxiety, OCD and posttraumatic stress disorder (Ali, 2018). For example, some pregnant women develop constant worrying, fear of uncleanliness and contamination and intrusive thoughts about aggression and harm towards the baby. We don’t understand why pregnant women get these symptoms but some people do, so we have to keep learning.
As a result of these symptoms, parents can impose very strict rules and avoidance behaviours and since it’s so terrifying to talk about these thoughts about harming a child to a healthcare provider, so many parents suffer in silence and great shame. Due to if a parent does disclose these symptoms then they risk getting misdiagnosed, involuntary hospitalisation, inappropriate care and even getting separated from their families.
And I don’t think there is a good way to deal with this disclosure from the point of view of a healthcare provider. Especially because I know about safeguarding procedures and this is a clear safeguarding risk so this does have to get reported. But equally we need to balance the need for child protection with what will help the mental health of the parent. They need to be treated regardless.
What Happens If A Mother Doesn’t Get Professional Help?
Sadly, the longer a mother goes without seeking professional help for their mental health during pregnancy and afterwards, the greater risk of the mental, financial and physical health problems getting worse. A lot worse. Since if the symptoms persist and get worse then the mother tends to withdraw more and more from their baby and toddler. So the child in turn is less likely to develop a secure attachment style so this has long term impacts for the rest of their childhood and adulthood. This is even more concerning when we consider how these people might then start to become parents themselves.
In addition, if a mother doesn’t get the needed treatment, then naturally they will try to cope themselves. And as we know from clinical psychology, these strategies are always maladaptive and not helpful in the long term. Therefore, the parent would probably turn to drugs and alcohol.
With the worst impacts of mothers not getting treated is that OCD is the 5th most cause of disability for women aged between 15 and 44 (Speisman et al., 2011) and suicide as well as overdoses are two most common causes of death for new mothers.
That is why treatment is so critical.
How Pregnancy and Postpartum Period Impact Existing Mental Health Conditions?
However, pregnancy and the postpartum period afterwards aren’t only a risky time period for developing new mental health conditions because existing conditions can be made worse during this time. Since pregnancy requires mothers to make changes to their lifestyle and jobs and they might have to take certain medications. This is all before we consider the massive financial burdens that having children places on families.
As well as because so many medications for mental health conditions aren’t deemed safe for babies, people are often advised to stop taking them which is good for the baby’s health during both the pregnancy and the feeding period. But what about the mother’s mental health?
Therefore, the break from medication, the financial burden, the immense lifestyle changes and stress caused by a pregnancy. It’s actually amazing more people don’t have a mental health crisis during pregnancy.
Personally, I can see how this would be a nightmare for any family because all these are factors are stressful, negative, awful. And I think families are heroes for having to deal with everything before you add in mental health conditions. So whilst I don’t think there is a “true” answer about how do we manage this better and better support pregnant women with mental health conditions during this time. It is still something we have to focus on.
Even worse, this is all whilst mothers go through with a birth that they wanted to complete. What happens when a mother goes through a pregnancy they don’t want?
What Happens When A Mother Is Forced To Complete An Unwanted Pregnancy?
Very interestingly there was ground-breaking research published in the book “The Turnaway Study” in 2020 and it examined the impact of women being denied an abortion and chance to terminate their pregnancy with it looking at over 1,000 women over the years (Foster, 2020). They got very clear data and it went way beyond mental health implications. Since a woman wanting an abortion was NOT associated with negative mental health outcomes.
In other words, just because a woman wanted an abortion did not mean she was “to put in coequally” not in her right mind.
On the other hand, if a woman was denied an abortion then she did suffer from negative mental health outcomes. A real shocker I know. Since these women are more likely to experience anxiety, stress, physical and financial harm when compared to women who had abortions.
In addition, women who were denied abortions were more likely to have life-threatening complications during the pregnancy and have more chronic health problems after birth. But of course making abortions illegal helps protect everyone. Yeah right?
Furthermore, if a woman was denied an abortion then they were more likely to live in poverty, have a lower credit score and have more debt. As well as their children and the mother themselves were more likely to remain with a violent partner or have no partner or family support.
And all those negative outcomes are before we consider that women who are denied abortions experience all these social, financial and physical problems resulting in negative impacts for a child’s development becoming a certainty.
But of course as everyone says, abortions are flat out wrong.
To me whoever says that is just flat out stupid.
Pregnancy Mental Health Conclusion
As we bring this clinical psychology episode to a close, let me just say that I truly hope all of you have a brilliant pregnancy if you’re a mother and if you’re a male listener, then I hope your partner is okay. Whilst the vast majority of people having a pregnancy will be okay, there are of course some people that will not be.
And that’s okay.
It doesn’t make them rubbish parents, bad people or evil monsters that need their child to be ripped away from them. It just means that they need help, support and love and despite nothing on the podcast ever being official advice, if you’re a mother having a hard time, please seek professional help.
Pregnancy can be a magical time for everyone given the right support, guidance and most importantly, love.
I really hope you enjoyed today’s forensic psychology podcast episode.
If you want to learn more, please check out:
Abnormal Psychology: The Causes And Treatments For Depression, Anxiety and More. Available from all major eBook retailers and you can order the paperback and hardback copies from Amazon, your local bookstore and local library, if you request it.
Have a great day.
Pregnancy Mental Health References
Ali, E. (2018). Women’s experiences with postpartum anxiety disorders: a narrative literature review. International Journal of Women’s Health, 237-249. https://doi.org/10.2147/IJWH.S158621
Miller, S., Wherry, L. R., & Foster, D. G. (2020, May). What happens after an abortion denial? A review of results from the Turnaway study. In AEA Papers and Proceedings (Vol. 110, pp. 226-230). 2014 Broadway, Suite 305, Nashville, TN 37203: American Economic Association.
Foster, D. G. (2020). The turnaway study: ten years, a thousand women, and the consequences of having–or being denied–an abortion. NY: Scribner.
Manso-Córdoba, S., Pickering, S., Ortega, M. A., Asúnsolo, Á., & Romero, D. (2020). Factors related to seeking help for postpartum depression: a secondary analysis of New York City PRAMS data. International Journal of Environmental Research and Public Health, 17(24), 9328-9340. https://doi.org/10.3390/ijerph17249328
Speisman, B. B., Storch, E. A., & Abramowitz, J. S. (2011). Postpartum obsessive‐compulsive disorder. Journal of Obstetric, Gynecologic & Neonatal Nursing, 40(6), 680-690. https://doi.org/10.1111/j.1552-6909.2011.01294.x
Vesga-Lopez, O., Blanco, C., Keyes, K., Olfson, M., Grant, B. F., & Hasin, D. S. (2008). Psychiatric disorders in pregnant and postpartum women in the United States. Archives of General
Psychiatry, 65(7), 805–815. http://dx.doi.org/10.1001/archpsyc.65.7.805
Wang, Z., Liu, J., Shuai, H., Cai, Z., Fu, X., Liu, Y., Xiong, X., Zhang, W., Krabbendam, E., Liu, S., Liu, Z., Li, Z., & Yang, B. X. (2021). Mapping global prevalence of depression among postpartum women. Translational Psychiatry, 11, 543-566. https://doi.org/10.1038/s41398-021-01663-6
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