Perinatal mental health and its impact on the family

Abstract

Perinatal mental health is a key issue in midwifery, and one that has received increasing media attention. The Royal College of Psychiatrists (RCP) (2000) stated that psychiatric problems— both new episodes of psychiatric illness and relapses of pre-existing psychiatric conditions—are common postnatally and are often serious (RCP, 2000). This is why it is so important for midwives to have a good understanding of the perinatal mental health issues that affect women and the impact that they can have on the woman and her family. Maternal depression and psychiatric illness can have a significant effect on the family unit (Cohen and Nonacs, 2005). Hanley (2009) stated that new mothers rely mainly on support from their partner rather than their wider family or health professionals. However, if the partner themselves become distressed, it can be detrimental to the woman’s wellbeing. It has been acknowledged that up to 30% of new fathers suffer some form of depression (Huang and Warner, 2005) and puerperal mental illness in a wife may severely affect the husband (Brockington, 1996). Men whose partners are admitted to mother and baby units are more likely to suffer psychiatric complaints (Harvey and McGrath, 1988; Lovestone and Kumar, 1993). The effect of postpartum illness on family life and on the emotional atmosphere in which children are reared is one of the main concerns of professionals working in this area—the effects depend on the degree and duration of the disorder and on the extent to which it involves the child (Brockington, 1996). If both parents are depressed, there may be further detrimental consequences for the families; studies have shown that emotional and behavioural problems in children were associated with an earlier episode of depression in fathers (Ramchandani et al, 2005). Additionally, impaired maternal mental health may effect the infant socially, emotionally, behaviourally and cognitively (Kurstjens and Wolke, 2001). Perinatal mental illnesses may disrupt the mother–child interaction and attachment, which could subsequently impact the infant’s development (Cohen and Nonacs, 2005). In a small minority of cases, mothers have rejected their child (Brockington, 1998) or even inflicted harm on the infant (Hanley, 2009). Midwives must be aware of the signs of mental health issues in women or their partners as it can have a great impact on the family. Research shows that women are least likely to come to health professionals for help and support, thus midwives need to ensure that women are being adequately cared for in the community postnatally, so that cases where perinatal health issues are present, they can be identified and treated appropriately. BJM