In a new series of articles published in The Lancet, researchers highlight the importance of mental health care of parents during pregnancy and after childbirth.
More than 10% of women in high-income countries experience mental health disorders during the prenatal and postnatal periods.
The new articles do not have data on the rates of prenatal and postnatal mental health problems experienced by women in low and middle-income countries, but they hypothesize that the rates are likely even higher.
Louise Howard, professor of Women’s Mental Health at the Institute of Psychiatry, Psychology and Neuroscience at King’s College London in the UK, and lead author of one of The Lancet papers, says:
“For many parents, the arrival of a child is a challenging time. The stigma around [pre] and postnatal mental illnesses can prevent people from getting the help they need. It’s important that people seek treatment promptly to prevent suffering and distress for the whole family. We want the public to know that there are effective treatments out there.”
The authors point out that although postnatal depression has been the focus of research, further studies are required to fully understand the other disorders. For instance, one area that needs to be further explored is the extent of the risks for the fetus or infant of the parent taking medication.
However, Prof. Howard says that, as many of these prenatal mental illnesses can be treated effectively, the risks of leaving symptoms untreated could be more harmful to mother and child than the risks of treatment.
In the second paper, childbirth as a trigger for severe mood disorders – mania, severe depression, psychosis – is discussed.
“More research is crucial to understand what triggers psychotic episodes after childbirth so that we can predict women at risk and develop treatments that are safe to be administered for mother and baby,” says lead author Prof. Ian Jones from the Medical Research Council Centre for Neuropsychiatric Genetics and Genomics at Cardiff University, also in the UK.
Suicide attempts, the authors say, are one of the leading causes of maternal death in high-income countries. As such, they recommend that all women with a history of severe mental illness should receive proper counseling on risks and what care may be needed both during pregnancy and after childbirth.
The links between parental mental health disorders and risk of low birth weight, premature birth and later psychological problems are examined in the third paper.
Lead author Alan Stein, currently head of the Child and Adolescent Psychiatry Unit at the University of Oxford, describes the third paper:
“Adverse effects of [prenatal] mental health disorders on children are not inevitable and many children are not adversely affected. Early identification and intervention are critical in preventing them. We need to treat both the parents’ symptoms and help with caregiving difficulties. Parents at risk of mental health disorders during or after pregnancy need to be identified early to try to prevent symptoms from affecting offspring.”
The links between child development and prenatal health disorders are complex and poorly understood, the report says. The authors recommend that much more research needs to be done around developing appropriate interventions in low- and middle-income countries, especially.
Also, the researchers draw attention to depression in fathers – now understood to be more common than previously thought. Although research has primarily focused on psychological disorders in mothers, emerging evidence suggests paternal depression also influences child development.
Overall, the series emphasizes that adverse effects of prenatal disorders on children are not inevitable. Quality of parenting, social support and the length and severity of the parental disorder are the most important factors to take into consideration, the authors say. The researchers conclude that effective identification and early intervention are critical.