In the UK, suicide is the leading cause of direct deaths 6 weeks to a year after the end of pregnancy. In 2020, women were three times more likely to die by suicide during or up to six weeks after the end of pregnancy compared with 2017 to 2019. At least one in five women experiences poor maternal mental health, with hidden levels of isolation, loneliness and anxiety or depression costing the UK millions per year and with unknown longer term effects on children and families. At Mothers Uncovered, we believe the true number is higher, but many women do not report their feelings, so they are undocumented.
The reasons they don’t speak up are many and varied. The overriding ones are guilt and shame at not being able to cope; fear that they must be a bad mother; a greater fear that they must be such a bad mother that social services will take their baby away; frustration because mothers have been looking after children for centuries so why can’t they cope? When mothers do speak up in media articles, the responses can often be savage and unforgiving. They are told to stop moaning, to be grateful they have a child. Comments, which come from all ages and demographics, certainly include ‘we didn’t have all this help in my day,’ ‘What about the dads/partners?’ and the one that stops all thoughts of speaking up – ‘What about the women who are not able to be mothers?’
The process of becoming a mother, known as matrescence, is a social and biological period of transition with enduring changes to women’s sense of self, identity and social status. This disruption is biological, leading to a loss of continuity with a previous life, leaving women needing to make sense of their experiences and the impact of those on their mental health and wellbeing. The mothers I’ve encountered are very mindful of how lucky they are to have a child. They also tend to put any of their own needs to one side in those first few months, often leading them to a state of desperation. Mothers Uncovered runs several groups a year and while there would be many tears shed in the groups, we only occasionally felt very concerned about a mother’s wellbeing. Now that has escalated worryingly, from about one woman every eighteen months, to almost one per group.
It’s a far worse scenario than the isolation I felt after giving birth in 2004. I felt invisible, lonely and like I was failing, but not failing enough to be flagged up as having post-natal depression. What would that mean anyway? Would my much loved baby be taken away from me? But at least I had groups to go to, eventually finding one that did more than scratch the surface, where mothers talked openly and honestly about the joys and challenges they were facing. The pandemic certainly worsened the situation. It was not just the birth that was traumatic, it’s the fact that many had to give birth alone. What were once routine appointments with health professionals to assess a woman’s wellbeing, both physical and mental, have been slashed to the bare minimum and we see a procession of broken new mothers.
No-one seems to be properly joining the dots. There are reports about ‘birth trauma’ and ‘post-natal depression’ as if the two things are separate. Whereas sadly, this is part of what has become more evident: the continuum of women’s health routinely not being given the right attention. Their pain needs are often dismissed by medics; research is focused on the male experience (heart attack signs, crash test dummies); Merope Mills felt that she was dismissed both as a ‘lay’ person AND as a woman when she expressed concerns about her daughter Martha. In pregnancy and birth, women’s wishes are almost always overridden by health professionals, silenced by the implication ‘you don’t want any harm to come to your baby, do you?’ No, mothers don’t want any harm to come to their baby. But we should care more about the harm that might come to them.