Editor’s note: In this weekly column addressing medical and health care issues, doctors from Mercer University’s medical school provide useful and timely information on a variety of topics. Readers with questions for the doctors can email them at firstname.lastname@example.org.
We live in a country where the primary focus in the first year postpartum is on the infant, and rightfully so as the baby needs nutrients, bonding, safe sleep and clinical oversight. Speaking of doctor’s appointments, the infant is the clear winner with seven standard appointments during the first 12 months of life. The mother, who may have recently delivered by cesarean section or had a difficult labor, gets one standard follow-up appointment six weeks after birth, one that traditionally is not focused on mental health. What message are we sending here and why is it so important to address this relative neglect?
The rate of postpartum depression, a mood state that can occur in the months after giving birth, is 1-in-7 new mothers in this country and is often higher in vulnerable populations. Symptoms of postpartum depression include sadness, anxiety, loss of enjoyment, feelings of self-blame or consideration of self-harm. What this rate means is that about 14 percent of new mothers are experiencing enough of these symptoms to raise concerns. We know that while harmful to the mother, postpartum depression also affects the infant. Children with a depressed mother may have cognitive or behavioral problems later in life and also have difficulty bonding. So, back to the question: Why is this relative lack of focus on the mother’s mental wellness important? The short answer is because it impacts the entire family.
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Which brings us to the topic of maternal self-care. What if we nurtured ourselves mentally, physically, and spiritually whenever possible? This may be challenging to commit to on a daily basis, given other responsibilities, but it has a high return on investment. Author Alan Cohen states, “There is virtue in work and there is virtue in rest. Use both and overlook neither.”
As mothers, and not just mothers with infants, we often overlook our own needs, and a lack of time is not always the culprit. Subtle and not-so-subtle messaging might be partially to blame, and this harkens back to that disparity in well-child to postpartum doctor’s appointments. As mothers, we are supposed to be completely focused on our children, right? Or wrong? During a focus group study of new mothers, Barkin and Wisner observed contradictory thinking in women regarding parenthood. Some of the women equated motherhood with extreme selflessness whereas others noted the importance of occasional “selfishness” in order to recharge. Others understood the importance of taking care of oneself, but weren’t sure how to do so while juggling life’s other obligations.
An extension of this work, conducted by faculty and students at the Mercer University medical school, revealed that not all types of self-care are practical for all types of women. It makes sense that the types of activities you can engage in for your own wellness are affected by your resources. Resources that affect women’s self-care practices are finances, available time and social support. Meaning that a woman with all three of these factors likely has a greater range of options in how she cares for herself. Obviously, a woman on a tight budget may not opt for a massage when things get stressful at home or at work. However, self-care is possible for all women and can be as simple as taking a break to read a book or taking a stroll on a sunny day. Self-care can be coloring alongside your child. It is anything that is restorative and provides a buffer against the daily demands of motherhood.
As members of society (or, “community helpers,” as my 5-year-old says) we need to convey the message that overall maternal wellness is essential to family health.
Jennifer L. Barkin, M.S., Ph.D., is an assistant professor of community medicine and obstetrics and gynecology at the Mercer University medical school.