by Kim Bartholdi
Clinical Psychologist

Mental Health in the Perinatal Period

When I got pregnant the first time, I realised that nobody had told me how challenging pregnancy can be. While everyone talks about the miracle of life and the glow that women experience during pregnancy, not many talk – at least not openly- about how hard it can be not just physically but also mentally. 

In the recent years, there has been an emerging field that focuses on the mental and emotional health of women during pregnancy and the postpartum period, as well as the psychological development of infants: perinatal psychology. This is an interdisciplinary approach that combines elements of psychology, obstetrics, developmental science, and social work, recognizing the profound impact that pregnancy and early parenthood have not just on mothers, but also on babies and families as a whole. The mental health of an expectant mother is linked to her baby's development, which is why understanding perinatal psychology is crucial for fostering healthy parent-infant relationships. 

Why is Mental Health in the Perinatal Period Important? 

The perinatal period encompasses the duration of pregnancy and the year following childbirth. This phase is marked by significant physical, emotional, and psychological changes. Hormones fluctuate, bodies change and adapt to new roles, and relationships transform. While many women experience joy and excitement, this period can also bring about anxiety, depression, and stress, affecting both the mother and child as well as partners. 

According to the World Health Organization (WHO), around 10-15% of women experience mental health issues during pregnancy, and this number can rise to 20% during the postpartum phase, which is sid by many women is harder than pregnancy itself. Your body feel different, you are responsible for another human’s life who constantly needs you, your hormones are still not back to normal and you have to deal with all of this while sleep deprived. 

Conditions such as prenatal and postpartum depression, anxiety disorders, and post-traumatic stress disorder (PTSD) are common but often underreported. Many women experience a feeling of shame if they report these conditions as they are afraid that people will judge them as bad mothers for not feeling happy about this period all of the time. Thus, educating parents and medical providers about the signs and symptoms, as well as the importance of addressing these concerns, is vital for the well-being of families. 

The Perinatal Period: Important also for Infants 

The effects of maternal mental health extend beyond pregnancy into the early years of a child's life. Infants are highly sensitive to their caregivers' emotional states. Research has shown that when mothers experience stress or mental health issues, it can affect their babies' brain development and emotional regulation. For instance, maternal depression can lead to difficulties in attachment, and infants may display behavioural issues such as irritability or withdrawal. 

The concept of the "Mother-Infant Dyad" highlights the interdependence of a mother's emotional health and her infant's development. Positive interactions, secure attachments, and continuous emotional availability are fundamental for healthy child development. Understanding the dynamics of this relationship can provide insights into childcare practices and the importance of nurturing a supportive environment during the perinatal period. 

Therapy and Support Services 

Therapy and counselling tailored to the perinatal period can provide substantial relief for mothers experiencing mental health challenges. Common therapeutic approaches include: 

• Cognitive Behavioral Therapy (CBT): This evidence-based approach helps individuals understand and change patterns of thinking that contribute to their emotional difficulties. CBT can equip mothers with strategies to manage anxiety and depressive symptoms. 

• Mindfulness and Acceptance-Based Therapies: These practices focus on fostering present-moment awareness and accepting emotions without judgment. Techniques such as meditation and guided imagery can help mothers cultivate a sense of calm and connection with their infant. 

• Group Therapy and Support: Connecting with other expectant or new mothers in a group setting can alleviate feelings of isolation. Support groups provide a space for sharing experiences, fostering camaraderie, and learning from one another. 

• Partner Involvement: Including partners in therapy can improve relationship dynamics and enhance support systems. Discussions surrounding shared responsibilities, communication, and emotional connection can strengthen relationships during a challenging time. 

Perinatal Therapy for Grief 

Unfortunately, not all expectant mothers become mothers. Miscarriages and stillbirths are profoundly painful experiences that can leave lasting emotional scars on parents. The loss of a pregnancy, whether in the first trimester or later, can elicit a complex array of feelings, including grief, guilt, anger, and despair. Parents often grapple with a sense of failure, questioning their bodies and the circumstances that led to the loss. This emotional turmoil can result in significant mental health difficulties, such as depression and anxiety. 

The silence surrounding pregnancy loss can exacerbate these feelings. Many parents report feeling isolated, as societal norms often discourage open discussions about miscarriages and stillbirths. This lack of acknowledgment can hinder the healing process, leaving parents feeling unsupported in their grief. 

Perinatal mental health support is crucial in navigating these challenging emotions. Perinatal mental health support can be things such as counselling and support groups. They can offer safe spaces for parents to share their experiences and feelings, fostering a sense of community. Recognizing the profound psychological impact of these losses is essential in providing compassionate care to those affected. Encouraging open conversations about pregnancy loss can help reduce stigma, promote healing, and ultimately support the mental health of grieving parents. 

Conclusion 

Perinatal psychology plays a critical role in the well-being of mothers and their children. Although expecting mothers can be very excited about becoming parents, it is often a transition that can come with challenges. By prioritizing mental health during pregnancy and the postpartum period, we can enhance parent-infant relationships and foster healthier family dynamics. Ultimately, integrating psychological support into comprehensive perinatal care will contribute to the long-term development and emotional health of the next generation. Recognizing the importance of perinatal mental health can help destigmatize mental health issues and create a culture that values mental well-being in the context of growing families. If you are thinking about conceiving soon or if you are an expecting mother, having mental health support during this period can help you cope with this beautiful and yet challenging period. 

About the author

Kim is a multilingual clinical psychologist at The Counselling Place Singapore. With expertise in CBT/REBT, Kim supports children, teens, and parents with behavioural issues, learning difficulties, and adjustment challenges. Her extensive international experience living in diverse countries has honed her cultural sensitivity, making her an ideal support for expatriates and individuals coping with life transitions.

Kim’s empathetic approach empowers clients to navigate life's changes, fostering self-confidence and independence, helping them find solutions to overcome present and future challenges.