Perinatal Mental Health and Well-being of Mothers, Babies, Families, and Communities

Perinatal mental health. Scientific research has shown that mental health problems such as mental distress, and mental disorders / illnesses are common during the perinatal period and can have devastating effects on the mother, baby and the family in general. Maternal mental health is a global public health concern and also a human rights issue – all women and their families deserve maternal mental health and well-being. It is one of the most undermined issues the world over, including in countries such as Zimbabwe. Of note is the fact that globally every nation is a “developing country” in terms mental health care services.

The World Health Organisation (WHO) defines maternal mental health as “a state of well-being in which a mother realizes her own abilities, can cope with normal stresses of life, can work productively and fruitfully and is able to contribute in her community.  Most people struggle to identify the difference between mental illness and mental health. This is attributable to the fact that the first voice mainly focuses on mental illnesses but not taking into consideration the three components of mental health namely; mental distress, mental health problems, and mental disorders / illnesses. According to the Ministry of Health and Child Care, Maternal Mortality Report, (2019) Zimbabwe is one of the countries where women suffer from depression and yet very little effort has been directed towards addressing the issue. This includes antenatal depression, post-natal depression, anxiety, perinatal obsessive-compulsive disorder, postpartum psychosis and post-traumatic stress disorder (PTSD). These illnesses can sometimes be mild, moderate or severe. In most countries mental health is allocated less than 1% of the total health budget. This has left a huge gap in the accessibility of mental health care services. WHO (2020) notes that “Zimbabwe has a severe shortage of human resources of mental health, with an estimated 18 psychiatrists (17 of them in Harare) or approximately 0.1 per 100000 people. There are 917 psychiatrist nurses (6.5 per 100 000) and 6 clinical psychologists (0.4 per 100 000).”  This reinforces the view that Africans generally perceive mental health problems as a “white man’s disease”. Consequently, most mothers fail to access mental health services resulting in prenatal and traumas which again they will not look for help.

Apparently, some people do not believe that the mental health of the mother is directly linked to the fetus’ well-being hence there is need to note and address the false myths that people hold on to in relation to mental disorders in the perinatal and post-natal period. In addition, African myths on maternal mental health are still causing low therapy seeking behavior as some illnesses are believed to be spiritual rather than mental thus people tend to resort to religious help. For example, postpartum psychosis is widely believed to be as a result of witchcraft and not a mental health problem. Another myth is that mental suffering does not affect the pregnancy, the fetus, or the newborn baby. However, stress has been associated with worse gestational and neonatal outcomes. Furthermore, some people believe that pregnancy is a period of well-being and it protects the expecting mother from psychological unease but in reality, it is estimated that about 20% of expecting mothers have a psychiatric disorder during pregnancy or in the postnatal period.

In a bid to promote maternal mental health in Zimbabwe, the government enacted the Mental Health Act (Chapter 15:12) which is under the administration of the Ministry of Health and Child Care. In terms of this Act every citizen should get 30 minutes of health education, including mental health information before they receive any physical medical attention. Other stakeholders  play a complimentary role to the government efforts, for instance the Society for Pre and Post Natal Services (SPANS) which is conducting massive maternal mental health literacy/education sessions. In the same vein, SPANS introduced the International Conference on Maternal Mental Health in Africa (ICAMMHA) so as to provide a platform to share ideas on Maternal Mental Health. SPANS is also offering a Diploma in Systematic Family Therapy and Development Counselling in Maternal, Paternal and Child Mental Health which is centred on the promotion of sound mental health for all because there is no health without mental health.

Efforts to promote maternal mental health are slowly yielding results according to SPANS as they witness people interested to be part of the mental health movement. However, successful implementation of mental health care services will take time due to lack of funding and the gap in mental health professionals. Additionally, a lot still needs to be done in terms of awareness raising so as to dislodge established norms and beliefs of the greater society towards maternal mental health and mental health in general. The coming out of survivors of maternal mental distress, mental health problems and mental disorder/illnesses to share their experiences could provide invaluable lessons on the consequences of maternal mental illnesses to communities. Finally, governments should allocate specific resources in adequate amounts towards mental health care and maternal mental health care to facilitate availability for all.  

In short take care of people pre and post-natal as their mental health will be at stake. Taking a look back in the nineteen nighties, our culture used to have support system to help relieve pressure from the person who just gave birth. However, this 21^st century is each man for himself but God for us all. Mental Balance urges people to love and support each other always.