This week is Mental Health Awareness Week, which is focussing on stress and its detrimental consequences on mental health.
Here Sally Hogg, Strategic Lead for Mums and Babies in Mind, writes about how managing stress isn’t just a responsibility for individual mums – society needs to think about how we reduce stress on mothers.
At the Maternal Mental Health Alliance we recognise how stress can negatively affect parents’ wellbeing and increase the risk of mental illness. When parents are feeling stressed, it also makes it harder for them to consider, reflect on and respond to their babies’ needs. And a huge body of research tells us that sensitive and responsive care is an essential ingredient in babies’ healthy brain development.
Stress in pregnancy is associated with premature birth and low birth weight. We now know that maternal stress affects babies’ development antenatally too: Research found that babies whose mums had higher levels of stress in pregnancy were more likely to have mental health problems themselves in adolescence.
The research carries positive messages too. The results of stress are not inevitable and there are things we can all do to manage stress and reduced its impact. Furthermore, evidence shows that a good quality relationship between parents and babies after birth can mitigate the impact of early stress on babies’ development, which is why services that support healthy parent-infant relationships are so critically important.
Discussing the importance of reducing stress in the perinatal period can feel like we are adding to the long list of unrealistic expectations on new mothers: not only should they bounce back from birth, look fab and be wonderful mothers, but they must feel relaxed about it all too!
But none of us chooses to feel stress. Often stress is caused by factors outside of our control. And we must challenge the view that it is mums’ responsibility alone to look after their mental health. Of course, mums can do things to take care of themselves. But maternal mental health must be everyone’s business. Part of this includes providing high quality maternity, health visiting and mental health services. We know that there is some great progress in the provision of these services – particularly for specialist mental health services – but huge gaps still exist. But it goes beyond that. As a society, all of us can do more to nurture expectant women and new mums. If we want to improve mothers’ wellbeing and give children the best start in life, we need to consider wider sources of stress and adversity.
Aside from sometimes grudgingly giving up a seat on the bus, we do very little to look after pregnant women in the UK today. For example, although we have pretty good maternity leave, working women are often expected to ‘lean in’ and continue working as normal until late in their pregnancy.
Our treatment of pregnant women is particularly stark if we focus on the most disadvantaged members of society, those already facing multiple adversities. Sadly, we live in times when poverty, homelessness and food bank use are increasing, and public sector and community support is declining. Poverty is stressful: the constant shortage of money, food, and a safe place to live, the inability to live healthy or feel in control of one’s life. These challenges are not unique to pregnant women. But it is perhaps harder to face such adversity and uncertainty, whilst at the same time wanting to one’s baby the best start in life. And we do very little to protect pregnant women from this stress, despite the increasing evidence – already discussed – about its impact on them and their babies.
The NSPCC conducted research into the experiences of some of the most vulnerable mums and babies– those experiencing homelessness, and in the criminal justice system. Their reports – An Unstable Start and An Unfair Sentence revealed how public policy exacerbates the stress that these women face. For example, whilst pregnant women are recognised as a category of ‘priority need’ in terms of receiving accommodation, in many parts of the country services can be slow to react to a pregnancy and resistant to move women from single person hostels into family accommodation until they are sure that the pregnancy is viable. This can mean that pregnant women are left in unsuitable housing and then have the upheaval of moving late in their pregnancy.
Investigations into the experiences of pregnant women prisoners have found that they generally receive minimal antenatal care and education, do not get adequate food and nutrition, experience feelings of isolation and powerlessness, and feel high levels of anxiety as they anticipate separation from their babies and await the result of sometimes lengthy decision-making processes.
Nelson Mandela once said that the “true character of society in revealed in how it treats its children”, and that “each of us, as citizens, has a role to play in creating a better world for our children”. As a society, we must do more to protect our children from the damaging impacts of stress and adversity. This starts at the moment of conception. Communities, employers, public services and policy makers can all review and improve how they care for pregnant women to create a more nurturing environment for them and their babies. The evidence shows us that reducing the stress these women experience would bring benefits for generations to come.