MHTF Quarterly, Issue 6: Maternal Mental Health
The MHTF Quarterly shares resources, research and news in key maternal health areas. This quarter, we’re focusing on maternal mental health: determinants, outcomes and solutions.
The World Health Organization defines health as “a complete state of physical, mental and social well-being, and not merely the absence of disease or infirmity.” Yet, mental health is often absent in maternal health programs, indicators and research.
Psychiatric disorders in women during and following pregnancy were first defined in 1858 by Louis-Victor Marcé, but these disorders were not formally evaluated or recognized until the 1960’s. Since then, the study of the relationship between pregnancy and mental health has grown into a discipline of its own, and yet we still have a lot of progress to make to understand, treat and quantify the prevalence of maternal mental health problems, especially in low-resource settings.
Today, mental health disorders, most commonly depression or anxiety, affect 10% of pregnant women and 13% of women who have given birth. However, these rates reflect data collected only in high-income countries. A dearth of maternal mental health research in low- and middle-income countries (LMICs) has made it difficult to assess disease prevalence and understand the complex factors that affect prevention and treatment of maternal mental health disorders in this vulnerable population.
As of 2012, only 34 studies on maternal mental health in the postpartum period had been conducted in LMICs, leaving 85% of LMICs with no data at all. From the few studies that exist, we know that the prevalence of common perinatal mental disorders (CPMDs) is as high as 33% during pregnancy and 59% after childbirth in LMICs, much higher than rates in high-income countries. In order to address the great inequalities of CPMD prevalence between LMICs and high-income countries, it is critical that researchers and program implementers bolster the evidence base and then tailor interventions appropriate for each setting.
The implications of effective prevention and treatment of maternal mental health disorders are far-reaching. Suicide during pregnancy and the postpartum period is not often counted in maternal mortality statistics even though in some areas it can account for 20-33% of maternal deaths. Also, mental health disturbances poorly affect a woman’s perinatal care attendance and her adherence to pregnancy care plans, such as daily iodine supplements, and thus have the potential to negatively impact both her health and the health of her baby.
In addition to her own health, a woman's mental health status affects the health of her newborn into childhood and beyond. Women with maternal mental health disorders are more likely than those with good mental health in pregnancy to have a premature and low birth weight baby, who then faces poor cognitive and motor development, stunting and behavioral and emotional problems.
In this edition of the MHTF Quarterly, we share several resources for learning more about this critical issue.
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