Time to speak up about post-partum depression

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This year’s World Health Day sheds a light on depression, one of the most common mental health problems in Europe.  One in seven people may experience depression at some point in their lives and each of us may be affected. On World Health Day 2017 Mental Health Europe (MHE), Make Mothers Matter (MMM) and the European Women’s Lobby (EWL) join forces to break the silence around one specific form of depression: post-partum depression.

According to the World Health Organization, approximately 10-15% of women suffer from postpartum depression in Europe and worldwide, which occurs after having a baby. The impact on women and their families can be very challenging. The experience and feelings of postpartum depression are intense and should not be confused with the “baby blues”, a commonly used term to describe the worry and tiredness many women experience after giving birth.

Despite its prevalence, postpartum depression remains taboo with limited data, awareness, prevention and treatment programmes available. The assumption that new mothers will just find their feet is insidious. As much as motherhood is natural, it can also be overwhelming and without the right support available, numerous factors may put the mental health of the mother at risk.

During pregnancy and after childbirth, women are at a higher risk of experiencing mental health difficulties. There is no single cause of postpartum depression. However, the risk increases with the number of perinatal complications mothers experience. Tackling postpartum depression must come with appropriate psychological support for women during pregnancy and after childbirth, including midwifery-led and continuum of care, promoting access to safe, timely, respectful and dignified care during childbirth and gender sensitive healthcare systems ensuring that the human rights of women are always respected.

MHE, MMM and the EWL have identified peer-to-peer support, educational programs for mothers, partners and relatives; work-life balance friendly policies; institutional involvement in creating mother-friendly spaces and the mainstreaming of mental health in maternity services as essential to prevent postpartum depression. Addressing risk factors of postpartum depression appropriately is crucial and women who experience these should be offered early onset psychosocial support. Those include high-risk, unplanned or unwanted pregnancies, traumatic and/or premature deliveries, difficult socio-economic realities, difficulties in balancing work and family life, family problems, stressful life events as well as obstetric violence.

Obstetric violence may be defined as the appropriation of women’s body and reproductive processes during birth by health professionals which is expressed by dehumanising treatment, the medicalisation of natural processes including excessive use of c-sections, resulting in a loss of autonomy and ability to decide freely about their bodies and sexuality, negatively impacting their quality of life. It is a reality in Europe which remains under reported, under researched and largely unaddressed within health systems.

What can Europe do? Affordable, accessible, quality maternal health care varies greatly between Member States. Our respective organisations call on the European Commission to ensure that the upcoming package on work-life balance is ambitious including legislative proposals such as a longer maternity and parental leave and a new paternity and carer’s leave directiveaddressing the root causes of ill health in mothers.  We also suggest further research in the field of post-partum depression as well as the impact of obstetric violence on the psychological well-being of women as suggested by the WHO.  It is also important to look into developing European-wide awareness-raising initiatives and guidelines on respectful and non-abusive care during childbirth which acknowledges the link between mental and physical health, respects human rights including the right of all mothers and their families to access appropriate and quality care and support.

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