Motherhood can be a source of joy, but it can also pose difficulties and challenges – particularly, in the postnatal period. It is a time when some mothers’ emotional and physical endurance is pushed to the limit.
About 10% of pregnant women and 13% of women who have just given birth experience a mental illness, primarily depression and anxiety. In developing countries 20% of mothers experience clinical depression after childbirth.
Mothers who have mental health problems after giving birth, face the dual challenges of managing motherhood alongside their health issue. This balancing act can cause an internal conflict – but fears of being judged and shame around what they are experiencing can act as a barrier, which stops many women from seeking help.
There is an expectation that having a baby will result in the rosy glow of motherhood. But postnatal depression can leave many women with a persistent feeling of deep sadness, and a loss of interest in life. This may reduce their ability to care for their baby, or may leave them with thoughts of self-harm or even suicide.
A mother’s mask
We conducted interviews with mothers with mental health problems during the postnatal period. These were gathered as part of a larger study, which explored the family focused practice of health visitors who work with these women.
We found that while mothers wanted support, there were barriers to accepting it. The mothers we spoke to felt fear, shame and guilt about being a mother with poor mental health. These feelings led to the mothers covering up their deteriorating mental health, from family, friends and professionals.
And with an expectation of happiness, the reality of parenthood mixed with suffering from postnatal depression can be a hard one to accept – as one of the mothers we spoke to explained:
I didn’t feel a connection to the baby, and that was stressing me out even more. I was thinking I need to feel something here; I need to feel like fireworks going off here. (Mother of one, age 37)
With this internal conflict, mothers describe feelings of guilt and shame about their mental health problems, coupled with a belief that they were not deserving of motherhood:
I truly at times looked at these two kids and thought, you deserve better than me who is sitting here and can’t get dressed for days. What sort of life am I giving you?. (Mother of two, age 34)
The mothers in our study also spoke about fearing the judgement of society, believing that society equates mental health problems with bad parenting:
I was getting more and more anxious. They’re looking at me, they’re thinking I’m a terrible mother, I am a terrible mother. (Mother of three, age 38)
One of the mother spoke about the fears that her children would be taken away from her if she told people how she was really feeling – believing that people would view her as “not being a fit mummy”. Many of the mothers we spoke to talked about going to great lengths to hide their struggles with their mental health – from both their family, friends and the outside world:
You have that mask that you put on for society. And then you have days where you just don’t want to wear that mask so you just stay in the house. (Mother of two, age 32)
The mothers also felt they are judged more harshly than fathers, due to widely held assumptions that women have instinctual love for their children.
The reality of motherhood
To some extent, western society has moved beyond traditional gender roles, yet mothers still predominately take on the bulk of care giving responsibilities for children. And as our research shows mothers feel stigmatised and fear judgement – which can result in them covering up their deteriorating mental health.
Our research also highlights how a lack of openness around mental health problems, can mean these women will not be identified and cannot receive appropriate support. Without support there is a risk that their mental health will deteriorate further, potentially resulting in negative outcomes for all the family.
Services need to develop a deeper understanding of the impact of poor mental health on mothers and provide opportunities for mums to openly discuss parenting and mental health, in a judgement free environment.
Assumptions and expectations of motherhood, also need to be re-examined, and discussed more openly with the general public, as the rosy glow of motherhood does not reflect the universal experience of all mothers.
Rachel Leonard, Postgraduate research student in the School of Nursing and Midwifery, Queen's University Belfast; Anne Grant, Lecturer in the School of Nursing and Midwifery, Queen's University Belfast, and Mark Linden, Lecturer School of Nursing and Midwifery, Queen's University Belfast