Human babies are born in a state of complete dependence. They are without language and many of their neural (brain) pathways have yet to be laid out. Alongside the joy of meeting a new little life can be the shock of being responsible for their care, development and future. When night falls, the midwives will come and shoo all the dads and partners home and the mums are literally left holding the babies in their hospital beds. Oh my goodness, what do I do now? What if I can’t …!
Mothering involves a great deal of mental and physical energy. Babies learn their first lessons from the expressions on their caregivers’ faces. They learn that their needs will be met. They learn that everything is OK, that they are OK. For a brief and special time, the mother is the infant’s sun, moon and stars. And mothers have to learn to nurture their babies without spoken language. This is all needed for those neural pathways to be laid down.
What makes it hard for mums to do this? Depression, exhaustion or anxiety are common culprits. And we now know that many (but by no means all) cases of post-natal depression start during the pregnancy itself. That’s why we call it perinatal (around the time of birth) depression, not post-natal depression.
A pregnant mum diagnosed with gestational diabetes will need to attend a special clinic, adapt her diet, and perhaps will need to use insulin. It’s no-one’s fault, it just happens sometimes. A pregnant mum with high blood pressure will need special monitoring and medication, and often those babies have to arrive early. It’s no-one’s fault, it just happens sometimes. But a pregnant woman with severe depression? Everyone tries to minimise any need for treatment. Many women feel that depression is something they can and should “fix themselves”.
Most of our public hospitals now screen women for signs of depression, but not all private clinics recognise that depression can occur in their soon-to-be mums. Even when depression is found, it may not be as assertively treated. Pregnant women (and their partners) worry about taking medicine for depression the way they would never worry about taking medicine for, say, gestational diabetes. But untreated depression has effects on mums and babies and partners. The effects can last a generation.
The cost of not treating mental illness during pregnancy (and after birth) is something we don’t talk about enough. Investing in the mental health of our mums is investing in their babies – the next generation.
