Mental health experts in the past three decades have emphasized the dangers of post-partum depression for mothers, but a University of Kansas researcher says expanding awareness of several other perinatal mental health conditions is important for all new parents, including fathers.
This awareness has become even more critical as "super mom" and "super dad" pressures continue to grow, said Carrie Wendel-Hummell, a KU doctoral candidate in sociology, who presented her study on perinatal mental health disorders at the 109th Annual Meeting of the American Sociological Association. Perinatal is a term that describes the several weeks before, during, and after birth.
"Both mothers and fathers need to pay attention to their mental health during the perinatal period, and they need to watch for these other types of conditions, not just depression," she said. "Anxiety, post-traumatic stress disorder, psychosis, and bi-polar disorder are all shaped by circumstances that surround having a baby."
As part of her research, Wendel-Hummell who is also a project manager at KU's Center for Research on Aging and Disability Options in the School of Social Welfare, conducted qualitative in-depth interviews with 17 new fathers and 30 new mothers primarily from Kansas and Missouri. The sample covered a range of low-income to middle-class parents. She did not require a diagnosis of a perinatal mental health condition, but all participants had experienced prolonged symptoms of at least one.
According to Wendel-Hummell, a major focus of her research is to bring together biological and sociological understandings of the problems that new parents face. Medical researchers for years had attributed post-partum depression in new mothers to hormonal changes, despite evidence to the contrary.
"It has been framed so much as being a hormonal disorder, but the evidence there is actually very limited," she said. "Child birth itself is a life change and a life stressor, so actually there's far more evidence that those risk factors are the cause, more so than hormones."
Distressed mothers and fathers in the interviews generally voiced concerns about social problems, including cultural expectations of parenting, relationship stress, family-work balance issues, and struggles with poverty.
At the root of their perinatal mental health issues, low-income parents in the interviews mentioned ongoing struggles to tend to their infant's basic needs in the face of low wages and job insecurity, as well as to secure affordable quality childcare, reliable transportation, and safe housing.
These parents were often unable to afford mental health treatment. Frequently, pregnancy-based Medicaid is cut off after a post birth appointment, which prevents coverage of treatment of post-partum depression or other post-pregnancy mental health disorders, Wendel-Hummell said.
"They aren't getting the support they need," she said.
In terms of middle-class parents, Wendel-Hummell said these people tend to put too much pressure on themselves to be perfect mothers and fathers.
"Middle-class mothers often try to do everything to balance work and home life, and fathers are increasingly attempting to do the same," she said. "This pressure can exacerbate mental health conditions. If everything is not perfect, they feel like failures - and mothers tend to internalize that guilt."
Fathers in her study often suffered stress from working in places that did not have family friendly leave policies and from generally lacking resources to prepare them for fatherhood, Wendel-Hummell said.
Most people also tend to focus on the mother and baby.
"Nobody is asking about the father and how he's doing," she said. "People typically focus on the mom and the infant, so not only is it more difficult for men to express their emotions, nobody is opening up that window for them either."
Wendel-Hummell believes we need to recognize the prevalence of these additional perinatal mental health conditions and, in addition, find ways to screen for them.
"We really only have a screening procedure for depression," she said. "There should be improved screening, and it should be done in the later stages of women's pregnancy and throughout that first year after the baby is born, for both mothers and fathers."
Wendel-Hummell said focusing on implementing social policies (e.g paid maternity and paternity leave, sick pay, and accessible health care coverage) that address the mental health challenges many new parents face is essential. She also emphasizes the need to adjust the cultural expectations around parenting, including reducing pressures to be the perfect parent who can do everything on his or her own, and encouraging parents to accept support from family, friends, and their community.
"We focus way too much on, 'how do we fix this individual,' but we really need to address the state of social and family policy," Wendel-Hummell said.