Hesperian Health Guides
Pregnancy and parenting newborns
HealthWiki > Promoting Community Mental Health > Chapter 7: Mental health during different times of life > Pregnancy and parenting newborns
Compared to countries where parents have access to care and paid leave from work, the US lacks support systems for people during pregnancy and after birth, making this time extra stressful. Some situations create even more stress and make mental health problems more likely, such as:
- having mixed feelings about having a child, health challenges during pregnancy, or a very difficult birth
- family problems, including substance use, violence, or lack of support for the pregnancy or parenting
- lack of housing, income, food, or transportation
- lack of access to quality health care because of the high cost, racism, or other types of discrimination
- a baby who is very hard to care for, is born with health problems, or dies at or soon after birth
Ways to make it easier:
- Listen to how the person feels, what they are going through, and any concerns they may have. Take care not to rush in with advice, especially if you havenât been asked to give it. Help people trust themselves and their abilities. Ask about and help them build on whatever strategies are already working for them.
- Make prenatal care and the birth experience as personalized, supportive, and culturally appropriate as possible. Midwives, doulas, and other birth workers may specialize in pregnancy, birth, or the time after birth. In some states, Medicaid will help cover the cost of hiring a doula.
- Organize friends or volunteers to help with meals, supplies, transportation, or childcare. Help for even a short time can reduce stress.
- Get new parents together to share feelings, problems, and ideas about solutions. Regular get-togethers help parents feel less alone, get practical support, and just laugh together.
- Arrange regular home visits and other ways to pay attention to parents struggling with anxiety, sadness, or a lack of energy that prevents them from asking for help or caring for their babies as best they can. In those situations, counseling, medication, or a combination of strategies may be needed to help a person find relief.
Contents
Better birth care
What if the process of bringing children into the world fully centered the health and wellbeing of the person giving birth? Changing Woman Initiative (CWI) is a Native American-led womenâs health collective working in Arizona and New Mexico. CWIâs founder, midwife Nicolle Gonzales, saw too many Native American women with bad birth experiences due to Western health care and bureaucracy. âWe learned from our relativesâ stories about feeling violated, unheard, and invisible to the world.â
To meet the needs of Native American women, CWI offers home birth and other care in ways that validate and renew Native American birth practices. CWIâs Corn Mother Easy Access Womenâs Health Clinic offers basic maternal and child health services while supporting mental health by affirming cultural identity. The clinic helps train Native American midwives and birth supporters and provides mother and baby with 6 weeks of personalized follow-up.
Black families experience more birthing complications and worse birth outcomes compared to other groups in the US. This holds true even for high-income families and regardless of the parentsâ education levels. It is glaring evidence of how historical and current racism damages the physical and mental health of Black people in the US. Committed to reversing these outcomes one family at a time, the non-profit The Black Doula Project (TBDP) began as an online movement to create awareness, provide maternal health education, and create support for Black womenâs maternal journeys. But the group wanted to increase their impact further given the seriousness of the problem: âBlack women dying due to maternal complications is not just a sad story; it is a public health emergency.â
Known by various names, doula support is a long-honored tradition in Black communities. But the extra cost of hiring a doula can put it out of reach for many families and adds to the perception that hiring a doula is somehow not common for women of color. To make an alternative birthing experience with positive outcomes available to Black women, TBDP began providing easy-toapply-for grants to any Black family living in Washington, DC, or Baltimore to cover the costs of birth and postpartum doula services. Better birth outcomes should be guaranteed for everyone.
Depression
Many people feel depression and anxiety during pregnancy and after birth, and creating spaces to talk about it can help a lot.
The hormonal changes that happen during pregnancy directly affect your mood and the physical changes of pregnancy can make your body feel unfamiliar. These are some of the reasons why prenatal care is so importantâtalking about these changes with an experienced health worker gives you a better understanding of how your body and baby are developing and what to expect.
Lamaze (lamaze.org) and other childbirth classes, often provided at low cost or for free, allow a group of people to create community while building confidence about their pregnancies and giving birth. Classes like these can be especially helpful in communities where migration and social changes have disrupted the traditional ways in which knowledge and preparation for childbirth used to be passed down.
Depression is even more common after birth than it is during pregnancy. Because becoming a parent is supposed to be a joyous time, new mothers often feel ashamed about being depressed, thinking it shows they are unfit as parents or might harm their babies. Community workers can help families understand that depression after birth is common, ask how the person is feeling and what they think would be most helpful, and guide them to the support they need.
Depression can range from âbaby bluesâ (mood swings in the first days after childbirth) to moderate or severe depression. Any form of depression can be hard to get through but all can be treated with counseling, therapy that takes into account the needs of the baby, medication, or a combination of these.
There are many reasons people with a new baby or young children can end up isolated. Limited options for jobs and housing can make it hard to live near friends and family. Politicians talk about self-reliance but often cover up the lack of government-supported community support systems. Because isolation makes depression worse, support groups for new parents can help. So can making it easy to participate with a baby in all kinds of community activities, either by offering childcare or making space for babies and small children to be part of your event.
Anxiety
Someone may experience anxiety for the first time during or after pregnancy, or if they had anxiety before, it may become worse. The emotional and financial stresses around childcare are big sources of anxiety. Local resources like parentsâ networks that compile and share information about childcare and other concerns of new parents can help a lot. Sharing babysitting with another family or a group of families forming a babysitting cooperative are other ways to take turns watching each othersâ children.
Make breastfeeding easier
Not everyone is able or wants to breastfeed, but for many, breastfeeding helps protect against anxiety and depression. So why doesnât society make it easier to have the time, support, and places to breastfeed? Why isnât paid family leave available to everyone? Some places even have laws that make breastfeeding harder! Activists involved with âlactivismâ promote breastfeeding culture by challenging restrictions on public breastfeeding. âNurse-inâ events bring people together to breastfeed where someone has been shamed or hassled for breastfeeding, including in stores such as Whole Foods, Target, and Walmart.
In Pittsburgh, Pennsylvania, artist Jill Miller painted a colorful Milk Truck to create an eye-catching space for breastfeeding and drove it around to celebrate workplaces and businesses that support breastfeeding. Raising public awareness about the emotional and physical advantages of breastfeeding promotes mental health by undoing the stigma of shame and isolation.
Trauma
Some people experience trauma during pregnancy, childbirth, or the weeks after. Trauma can be caused by a very difficult birth, loss of the baby, other medical difficulties or poor medical care, poverty or racism, or violence from a partner or family member. Also, given the intense emotions related to pregnancy, giving birth, and caring for a baby, a personâs past trauma may be triggered.
People with traumatic responses during or after pregnancy need support. Help them get counseling, therapy that takes into account the needs of the child, medication, or a combination of these. Groups working to improve access to counseling and other services around pregnancy and birth can push the health system to recognize how much trauma there is in our communities and provide support.
Psychosis
People with psychosis experience a reality not shared by others. For example, someone may hear voices inside or outside their head that others do not hear, or see things that are not there.
A person may have experienced psychosis before or may experience it for the first time during pregnancy or early parenthood. Someone with a longstanding psychotic condition may be successfully treated with medication or another type of therapy that enables them to parent children successfully. They may need support and advocacy around their rights as parents, for example, the right to use medication to support their mental health during pregnancy even if the medicine poses a risk to the developing baby.
Psychosis that happens for the first time when a baby is born is rare. Postpartum psychosis is a serious condition that appears suddenly, usually 24 hours to 3 weeks after childbirth. The person may experience extreme mood swings, confusion, unexplained behavior, and insomnia, as well as see, hear, feel, and smell things that are not there. If their psychosis includes ideas about suicide or harming the baby or others, this is an emergency. Hospitalization may be needed to keep everyone safe.