ay is an important month for mothers and families. Not only is Mothers’ Day celebrated in several countries this month, but 15 May is the International Day of Families and 01 May is World Maternal Mental Health Day—with the whole month dedicated to Maternal Mental Health. However, maternal mental health is still regularly stigmatized and largely ignored—in both developed and developing countries. As new parents, we were shocked at how few mental health services were provided for expectant mothers. Even though screening for postpartum depression (PPD) has become a norm, these screenings are rarely administered by mental health professionals and deeply insufficient, as there is rarely any follow–up. In fact, after our screening, we were told, “Oh good, you don’t have the depression. That would be a longer conversation.” Well, maybe it's time we had that conversation.
Moving Beyond Physical Recovery
Globally, important instruments have been developed to support mothers and families. One key mechanism is the International Labour Organisation’s Convention 183 (ILO 183), which ensures maternity leave and labor protections. However, only 43 countries have ratified it. Furthermore, while there have been important strides, these are often based on labor protections and on the physical rather than mental health of the mother. This is most clear in the area of maternity leave itself. ILO 183 requires signatories to provide 14 weeks of guaranteed maternity leave. Globally 11 countries still do not provide maternity leave while an additional 50 provide less than the recommended 90 days. This length of time provides time for the physical recovery of the mother, but does little to support maternal mental health needs. Indeed, postpartum depression may be diagnosed up to one year after giving birth, with recent research suggesting a significant number of women exhibit symptoms of PPD later in the postpartum period. At the same time, only 16 countries around the world provide at least 180 days of guaranteed maternity leave.
While efforts to increase maternity leave protections are important and should be expanded, simply ensuring maternity leave is not enough to address the challenges of maternal mental health. New mothers may experience a range of perinatal mood and anxiety disorders, with PPD the most prevalent, affecting one in seven women. Personal or family history of mood disorders, inadequate social support, and high stress can increase the likelihood of experiencing PPD and other mental health challenges.
The transition into motherhood involves coping with physical healing, adjustment to the new role and its responsibilities, and sleep deprivation. Breastfeeding mothers must also adapt to the time commitment it requires, which is the equivalent of a full–time job on its own. While women have made great strides in breaking traditional gender norms to join the workforce, societal expectations still dictate that women pick up most of the child–rearing duties and care tasks in the home. New mothers who put their careers on hold to have a baby may experience a loss of their professional identity. All of these factors put maternal mental health at risk.
Furthermore, as fathers often have to return to work shortly after the baby is born and are traditionally viewed as the breadwinner, mothers tend to take on most or all the night wakings in order to protect their partners’ sleep. However, this lack of restorative maternal sleep can exacerbate mental health symptoms.
Strengthening Partners’ Roles
There are actions that governments can take to help partners help mothers. This includes providing paternity or parental leave and supporting mental health services for mothers as a standard part of both maternal and child health check–ups. These services should be guaranteed rather than dependent on one’s socio–economic status or employee benefits.
According to the World Bank, 123 countries around the world have paid paternity leave available—however almost all are extremely short, with only 18 countries providing paid paternity leave longer than 2 weeks. While fathers do not have to physically recover from the child bearing experience, their ability to support mothers is critical to mental health for mothers. Furthermore, while these benefits are important and should be expanded, similar policies must be ensured for LGBTQ+ and adoptive parents. These benefits are important regardless of the fact that these parents do not physically give birth. Given the prevalence of single mothers, allowing mothers to transfer leave benefits to other care providers—whether to friends, grandparents, or even to hire help—could provide support to new mothers.
In addition to paternity and parental benefits, ensuring that mental health services are available to mothers is necessary to both normalize and support the challenges that come along with this major life change. Parents—mothers, fathers, and other caregivers—should be offered mental health screenings and services throughout the entire perinatal period by those trained to do so. Those whose screenings indicate the presence of a perinatal mood and anxiety disorder should not have to suffer in silence due to the lack of access to information, services, and support.
It is often said that it takes a village to raise a child—and when it comes to supporting not only the child, but maternal mental health, this is absolutely true. Although efforts to expand maternity leave are critical, if we are serious about addressing maternal mental health, governments across the globe must enact policies that help mothers access their village—from fathers, to non-biological partners, to mental health providers.
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Partnering for maternal mental health
Photo by Alex Pasarelu on Unsplash
May 1, 2024
Maternal mental health is still largely stigmatized or ignored as we concentrate on maternal physical health. Women need labor protections based on their mental as well as physical health, and new fathers need time off to support their partners, write Ashley and Adam Ratzlaff.
M
ay is an important month for mothers and families. Not only is Mothers’ Day celebrated in several countries this month, but 15 May is the International Day of Families and 01 May is World Maternal Mental Health Day—with the whole month dedicated to Maternal Mental Health. However, maternal mental health is still regularly stigmatized and largely ignored—in both developed and developing countries. As new parents, we were shocked at how few mental health services were provided for expectant mothers. Even though screening for postpartum depression (PPD) has become a norm, these screenings are rarely administered by mental health professionals and deeply insufficient, as there is rarely any follow–up. In fact, after our screening, we were told, “Oh good, you don’t have the depression. That would be a longer conversation.” Well, maybe it's time we had that conversation.
Moving Beyond Physical Recovery
Globally, important instruments have been developed to support mothers and families. One key mechanism is the International Labour Organisation’s Convention 183 (ILO 183), which ensures maternity leave and labor protections. However, only 43 countries have ratified it. Furthermore, while there have been important strides, these are often based on labor protections and on the physical rather than mental health of the mother. This is most clear in the area of maternity leave itself. ILO 183 requires signatories to provide 14 weeks of guaranteed maternity leave. Globally 11 countries still do not provide maternity leave while an additional 50 provide less than the recommended 90 days. This length of time provides time for the physical recovery of the mother, but does little to support maternal mental health needs. Indeed, postpartum depression may be diagnosed up to one year after giving birth, with recent research suggesting a significant number of women exhibit symptoms of PPD later in the postpartum period. At the same time, only 16 countries around the world provide at least 180 days of guaranteed maternity leave.
While efforts to increase maternity leave protections are important and should be expanded, simply ensuring maternity leave is not enough to address the challenges of maternal mental health. New mothers may experience a range of perinatal mood and anxiety disorders, with PPD the most prevalent, affecting one in seven women. Personal or family history of mood disorders, inadequate social support, and high stress can increase the likelihood of experiencing PPD and other mental health challenges.
The transition into motherhood involves coping with physical healing, adjustment to the new role and its responsibilities, and sleep deprivation. Breastfeeding mothers must also adapt to the time commitment it requires, which is the equivalent of a full–time job on its own. While women have made great strides in breaking traditional gender norms to join the workforce, societal expectations still dictate that women pick up most of the child–rearing duties and care tasks in the home. New mothers who put their careers on hold to have a baby may experience a loss of their professional identity. All of these factors put maternal mental health at risk.
Furthermore, as fathers often have to return to work shortly after the baby is born and are traditionally viewed as the breadwinner, mothers tend to take on most or all the night wakings in order to protect their partners’ sleep. However, this lack of restorative maternal sleep can exacerbate mental health symptoms.
Strengthening Partners’ Roles
There are actions that governments can take to help partners help mothers. This includes providing paternity or parental leave and supporting mental health services for mothers as a standard part of both maternal and child health check–ups. These services should be guaranteed rather than dependent on one’s socio–economic status or employee benefits.
According to the World Bank, 123 countries around the world have paid paternity leave available—however almost all are extremely short, with only 18 countries providing paid paternity leave longer than 2 weeks. While fathers do not have to physically recover from the child bearing experience, their ability to support mothers is critical to mental health for mothers. Furthermore, while these benefits are important and should be expanded, similar policies must be ensured for LGBTQ+ and adoptive parents. These benefits are important regardless of the fact that these parents do not physically give birth. Given the prevalence of single mothers, allowing mothers to transfer leave benefits to other care providers—whether to friends, grandparents, or even to hire help—could provide support to new mothers.
In addition to paternity and parental benefits, ensuring that mental health services are available to mothers is necessary to both normalize and support the challenges that come along with this major life change. Parents—mothers, fathers, and other caregivers—should be offered mental health screenings and services throughout the entire perinatal period by those trained to do so. Those whose screenings indicate the presence of a perinatal mood and anxiety disorder should not have to suffer in silence due to the lack of access to information, services, and support.
It is often said that it takes a village to raise a child—and when it comes to supporting not only the child, but maternal mental health, this is absolutely true. Although efforts to expand maternity leave are critical, if we are serious about addressing maternal mental health, governments across the globe must enact policies that help mothers access their village—from fathers, to non-biological partners, to mental health providers.
