New study reveals mental health impact on new mothers

Almost 10% of new mothers in Ireland have experienced symptoms of moderate to severe anxiety, while 14% have experienced symptoms of moderate to severe depression, a new study has found.

International perinatal literature tends to focus on depression in the postpartum period. Prevalence and pathways of depression, anxiety and stress from pregnancy through to the first postpartum year are rarely investigated, so researchers at Trinity College’s School of Nursing and Midwifery decided to assess this further.

They looked at the prevalence of, and changes over time in, depression, anxiety and stress symptoms experienced by first-time mothers from pregnancy throughout the first postpartum year.

The study found that 9.5% of women had reported moderate to severe anxiety symptoms and 14.2% had reported moderate to severe depression symptoms. A further 19.2% had reported moderate to severe stress symptoms during the first year after having a baby.

Depression and stress symptoms measured the lowest during pregnancy, but increased after birth at three months. They were found to be at their highest at six months postpartum. They then dropped a little at nine months postpartum, before increasing again at 12 months postpartum.

Meanwhile, the study found that those most likely to report symptoms of depression, anxiety and stress postpartum were:-

-Younger

-Born in a non-EU country

-Did not live with a partner

-Did not have a postgraduate education

-Were unemployed during pregnancy.

The study also noted that women who reported experiencing occasional or frequent symptoms of anxiety or depression in the year before their pregnancy were more likely to experience depressive, anxiety or stress symptoms in the first year postpartum, regardless of their age, education and relationship status.

Some 69% of women who reported having symptoms of depression in the postpartum year did not have any symptoms of depression during pregnancy, while 71% who experienced symptoms of anxiety in the postpartum year, did not report anxiety during pregnancy.

Despite an increase in general conversations around mental health, which help to break the stigma and silence associated with this issue, the researchers pointed out that there are additional aspects of stigma for a mother who is experiencing mental health problem.

Women worry about how they will be perceived by their familes and communities for experiencing a mental health problem during a time which society largely regards as a period of happiness and joy. Some women also worry that their ability as a mother will be questioned. This creates an additional barrier to mothers reaching out for support.

Speaking about the implications for clinical care,  the study’s senior author and mental health researcher, Susan Hannon, noted that currently, maternal healthcare stops at six weeks postpartum.

“But our research shows that a substantial number of women are experiencing clinical-level symptoms of depression, anxiety and stress well beyond this period of service provision. This means that women are not supported by a maternity care system that can detect and offer timely treatment to those who need it.

“Women who experience mental health problems in motherhood have to seek out treatment for themselves and that can be a very difficult call for a woman to make. Women would really benefit from postpartum healthcare that can support them for longer,” Ms Hannon said.

The study’s co-author, associate professor in midwifery, Dr Deirdre Daly, acknowledged all the women who shared their information for this and other studies.

“Many of these women are suffering unnecessarily and often in silence,” she noted.

Ms Hannon said that she hopes this research “lets women know that they are not alone, that they too can have these conversations about mental health and motherhood with family and friends to lift the silence and share their experience”.

“Talking with healthcare professionals will help women get the support that they need,” she added.

This study incorporates findings from the mental health strand of the MAMMI (Maternal health And Maternal Morbidity in Ireland) study, a multi-strand, longitudinal study which has collected information on the health and health problems of more than 3,000 first-time mothers giving birth in Ireland. 

No national database currently exists to collect information about women’s mental health in pregnancy and postpartum in Ireland. The mental health data from the MAMMI study is invaluable as it covers pregnancy and the entire first postpartum year and it reports information about stress and anxiety as well as depression.

The study is published in the journal, Archives of Women’s Mental Health, and can be viewed here.