Maternal Mental Health
Becoming a parent is an individual and unique experience whether you are a first-time parent or have more than one child. Men and women can end up navigating their way through such transitions differently. This is sometimes reflective of the meaning they attach to the role of "motherhood" or fatherhood". One thing is commonly accepted, the process of parenthood, whether one is a mother or father, can be a complex and challenging journey. Women experience large-scale biological, emotional and social changes through pregnancy and birth. The physicality of carrying an unborn child and the multi-dimensional changes a woman experiences are often underestimated. Roles change, mothers will often have longer maternity leave, whereas fathers return to work much quicker. As a mother you may be facing the sometimes-overwhelming task of caring for a vulnerable and dependent new born, whilst your partner is at work and seen as very much still part of a social community.
With increasing nuclear family structures and extended families often living far apart, women may lack strong social support systems and may end up feeling isolated, anxious and depressed. As a mother, you may experience attachment difficulties with your baby. The new identity and role of mother and/or parent, can bring up unresolved past traumas or difficult feelings associated with one's own parenting. In addition, the complexity of parenthood can be compounded by other unique experiences, such as:
Having endured fertility problems and/or IVF treatment
Having a donor conceived baby
Creating a family through surrogacy
Experiences of pregnancy/infant loss (e.g. miscarriages or still birth)
Sexual trauma (recent or historical)
Essentially, what we are saying is, the road to parenthood can be diverse, vast and multi-layered and with this often comes a complex range of emotions and psychological processes.
Below are examples of some of the difficulties that might occur for some women:
The medical model will often pathologise a woman's difficulties as part of her perinatal journey. One may hear terms such as antenatal depression (AND) or postnatal depression (PND), but many perinatal specialists argue this difficult emotional response can be expected when we consider the context of a life-changing role combined with sleep deprivation, exhaustion, hormonal changes, constant care for a small infant and lack of social support. Regardless of whether something like PND is a normal human condition or a medical condition, the evidence suggests that early help and support is key as ongoing PND can have a devastating impact on the individual woman, her partner, the infant and the wider family. PND can go on to have inter-generational effects too, as studies indicate that female children of postnatally depressed women, go on to develop PND themselves. Accessing psychological help early, whether it be during pregnancy and/or after, can bring changes and improvements in one’s psychological state; but very importantly it can prevent the development of other, sometimes, chronic mental health difficulties.
Tokophobia: Fear of Childbirth and/or Pregnancy
Tokophobia is often an overlooked phenomenon that can be deeply concerning for many women. Now, some fear of childbirth and/or pregnancy can be quite normal. Many women worry about their body changing through pregnancy, feel scared about pregnancy and experience fear about what happens during childbirth. However, tokophobia can effect as many as 1 in 5 women and is more of an intense and even debilitating fear of pregnancy and/or childbirth, in which reassurances may have little impact. This fear can be so intense, that one may prevent their body from conceiving, and may even undergo termination if pregnancy is achieved. It is important to stress that some women experiencing tokophobia may still have a strong desire for a child, but can't bring themselves to physically have a baby due to this complex phobia.
There are two types of this phenomena, one is 'primary tokophobia' which is anxiety and fear associated with childbirth and sometimes pregnancy, having never lived through such experiences.
The other is secondary tokophobia', which is the same type of fear, but tends to be experienced after a woman has experienced childbirth. This type of presentation can be a result of a difficult or traumatic childbirth.
Tokophobia can lead to feelings of not only fear but also guilt, shame, anger and disgust. It may even shape how you view yourself as a woman and also impact your relationship with your partner as there may be avoidance of intimacy as a way to prevent pregnancy. Those women who have had a baby, may even struggle to bond with the baby. So this is an experience that can have a wider impact on family relationships. Some women may even go through life remaining childless due to the intensity of this fear.
Birth trauma can significantly impact a woman's life, her relationships (with partner and/or family) and her attachment and bond with a baby. You may experience intrusive memories, flashbacks and lose focus on where you are now to the point that it feels like you are re-experiencing the whole trauma all again as if you are in the delivery suite. You may even feel that previous traumas in your life have re-emerged, which can feel particularly painful and even debilitating. You may swing from periods of complete numbness and dissociation to experiencing floods of emotions and images. In such circumstances, many women feel they are losing control of themselves, their mind and everything else. Birth trauma can become a serious and complex presentation if a person does not access psychological support and treatment.
Birth trauma may alter how you experience and view yourself as a person and can change how you approach things. You may avoid anything which reminds you of the traumatic incident; such as - pregnant women, the clothes you were wearing at the time of the incident, the hospital site and location, doctors, medical examinations and interventions and even contacting and interacting with your infant. If left untreated, you may even go on to develop a fear of childbirth and avoid having further children. Psychology sessions are aimed at helping you create a safe space, exploring the trauma and its significance and slowly integrating the experience into your psyche in a healthy way.
Perinatal loss is regarded as anything from miscarriage, ectopic pregnancy, stillbirth, termination of pregnancy, neonatal death, sudden or unexpected death in infancy, fetal reduction (usually when its a multiple pregnancy, e.g. twins or triplets) and having a baby removed due to care/legal proceedings. Perinatal loss comes with an array of complex psychological difficulties, which impacts a woman and her partner. Perinatal loss often comes with couple conflict and intimacy problems, anger, PTSD or trauma symptoms, anxiety, loneliness, helplessness and loss of control, depression, grief, loss and also shame and guilt. You or your partner may individually or even collectively be searching for answers to a range of questions, some which have answers and some which remain as an unknown, which can add to the already difficult complexity of emotions you're experiencing. You may be navigating yourself through such painful and difficult terrain, which can feel like a deeply isolating journey. Perinatal loss may go on to become complicated grief and it is vital that you're able to access emotional and psychological support which allows a space to explore and process the tragic loss you have gone through.
Blue River Psychology is committed to helping women navigating themselves through the complex journey of motherhood. We also work closely with women who are contemplating starting a family but struggling with what this picture might look like, due to unresolved childhood difficulties, traumas or attachment struggles. If you are struggling with emotional and psychological difficulties before, during pregnancy and/or after birth, please contact us to take a step towards self-discovery, empowerment and healthy change.