30 April 2019
Looking after a women’s mental health during her pregnancy and after giving birth is a big part of the midwife’s role in midwifery. A woman face a lot of changes during this time and midwives must ensure she is cared for and that her needs are met.
As most of us know, whether we have been pregnant ourselves or been close to someone who has gone through the journey, a lot of hormonal changes occur during the child bearing period. There are numerous hormonal changes whilst pregnant which can effect a woman’s mental health, and this doesn’t change after giving birth! Indeed, women may also experience mental health issues after giving birth, in the postnatal period. At the start of their pregnancy women are asked a variety of questions in regards to their mental health to get an overview of how they are feeling. Some women may be overwhelmed, some may be in shock, some may have not been prepared for the pregnancy and others will have their anxiety heightened by the pregnancy. All are important factors relating to mental health. It is the role of the midwife to see the signs of deteriorating mental health and act on it appropriately. Women handle the hormonal changes differently and it is so important that women feel they can be honest with their midwife about how they feel.
Pregnancy is often perceived as a happy time but it is not always this straight forward. It is a big change for these women and their families and sometimes a little extra support and encouragement may be needed to assist the woman and family through the transition into parenthood. Women may not be able to explain their reasons for feeling down or upset over certain things so having good support is vital.
Mental health is being spoken about more than ever before but certain stereotypes are still there and breaking down these barriers is crucial! We still lose far too many people to mental health issues so healthcare professionals now have more training in recognising mental health illnesses and are a lot better at talking about it more openly. Some of the different conditions that can be diagnosed in pregnancy include; antepartum depression, tocophobia (the fear of labour), postnatal depression and post-traumatic stress disorder. Midwives must be aware of each condition, the signs and symptoms of the condition and how best to manage it.
I think the key to being a midwife and assisting with mental health issues is building the connection with the women who might not openly discuss an issue and seeing a decline in their attitudes, then assisting them along the journey to recovery. Many trusts will have specialist mental health teams that can intervene and provide the correct help for women if they need it.
Knowing the difference between hormonal impact on moods and mental health conditions is so important. It is discussed at the booking appointment and often midwives will speak with the partner, or relevant close relative/friend, to ensure they are aware to look out for changes in the woman’s mood and get them to seek help and support if needed. Midwives will then check in with the women throughout the pregnancy and after the birth to ensure they are still stable, both physically and mentally.
The fact that social media is highlighting the important of self-care and mental health issues should have a positive impact for women as it is more openly spoken about now. Midwifes will talk through issues, refer if relevant and give a support network to women who may be suffering with ill mental health throughout the child bearing period. In my eyes, talking so openly about mental health is essential in the long-term to encourage people to get help and no one should ever be ashamed of needing help!