Motherhood can be one of the most rewarding roles in life. Unfortunately, there is a pressure-cooker of challenges which contribute to high rates of mental health problems. Statistics may not be entirely accurate, perhaps due to stigma and missed diagnosis, but they indicate that approximately 10-15% of mothers have perinatal depression and 15-20% have perinatal anxiety. Although the focus is on mothers in this article, some of these challenges are also prevalent in fathers, with rates of approximately 10% reporting that they experience postnatal depression. Here, five common challenges will be discussed.
CHALLENGE 1: ROLE TRANSITION
First, we must acknowledge the transition to the role of ‘mother’ itself. Society often expects mothers to make a quick physical recovery from the stress and possible trauma of pregnancy, labour and birth (each of these can be a marathon in themselves). Then, mothers must dive headfirst, often blind-folded, into being responsible for a totally dependent little person. This can be a big psychological adjustment from the freedom, control and predictability in previous life. Effort, which was previously rewarded with financial bonuses and high performance reviews, must now be valued in other non-tangible ways. This challenge is particularly common with the modern trend for delayed motherhood after longer, successful careers. If this is a second child, then there is another rapid transition to become an expert multi-tasker.
How to overcome the ‘role transition’ challenge: Ideally, females would psychologically prepare before pregnancy and throughout the antenatal period. This would involve honest yet balanced conversations among friends and family and in antenatal classes. Then comes the balancing act of acceptance (i.e. normalising that this transition is difficult for most new mothers) and change (i.e., taking action rather than feeling helpless). Change may involve being organised and requesting practical help to make the recovery more humane and the overall adjustment easier.
CHALLENGE 2: CONFLICTING ADVICE
A second challenge is that mothers often can get pummelled by conflicting advice regarding pain relief during labour, feeding options, sleep routines, and many other topics, thanks to technological advances. These sources may include books, google, social media, support/coffee groups, health professionals, and general media. This can cause a whirlwind of confusion, anxiety and guilt.
How to overcome the ‘conflicting advice’ challenge: Acknowledge that there is such thing as too much information. Mothers need to come back to basics and trust their own instincts. This includes trialling what feels most sensible for their child in his/her situation. It also includes respecting the family and cultural values and customs. If there is still doubt or there is cause for medical concern, then that is where specialists are indicated.
CHALLENGE 3. LACK OF SOCIAL SUPPORT
The much talked about ‘lack of village’. Obviously, there are cultural differences but there is common frustration about the minimal practical hands-on support in western culture. That is, communities are not tight-knit like in the olden days when there were transport limitations. Humans are social beings and yet modern day mothers can be forced into an autonomous role, which can make them feel disconnected. Lack of support must be taken seriously as it is one of the biggest predictors of depression and anxiety.
How to overcome the ‘lack of social support’ challenge: Connection via social media groups can take the edge off loneliness but real life contact is preferable to combat this problem. Wherever possible, family, friends, neighbours and colleagues must reach out to mothers… and not just new mothers. Support is needed throughout the process of raising babies, toddlers, school-aged children, teenagers and in the years beyond. Ideally, there should be clear, assertive communication about the specific needs that need to be met – whether that be practical (e.g., meals, holding a baby, playing with a child or shared grocery shopping) or emotional. Support does not always involve advice – a patient, listening ear can be enough.
CHALLENGE 4. LIFE BALANCE
After many years of strong gender inequality in the workforce and stereotypical male ‘bread-winner’ and female ‘housewife’ roles, there should be some gratitude for the increased opportunities and choices in modern society. Inequality still exists but we are making progress. Unfortunately, many woman now describe feeling overwhelmed by the choices – staying at home, working part-time, working full-time, or freelancing for flexible hours. Some talk of the underlying pressure to continue advancing their career immediately. Assumptive questions are commonly asked, “when are you going back to work?”, which can make woman contemplate whether there is a bigger, more important job than child-rearing. Of course, there is also the enormous financial pressure to return to work to pay the increasingly expensive rent or mortgage in the current property market.
If there is some financial flexibility, some mothers describe feeling judged for their personal choices. In addition, they commonly feel guilty for their desire for independence and to achieve goals external to the family. The challenge is to gain insight and confidence to trial what makes them a well-rounded mother for the benefit of their children also.
Once the mother has decided which path to take, they must juggle. Juggle as much and as effectively as they can. Juggle career, housework, cooking, educating and caring for their children. Then there is also all the behind-the-scenes decision-making and planning for the future – all while ensuring their relationships aren’t neglected and their physique is well-maintained. In addition, there are common worries about children meeting developmental milestones, achieving academically, being healthy, and not bullied nor exposed to unsafe internet practices. Exhausting. No wonder the physiological ‘fight-or-flight’ stress response is activated. Research shows that a high level of chronic stress can increase risk of chronic illness and therefore, it is crucial to make positive lifestyle and psychological changes.
How to overcome the ‘life balance’ challenge: On a wider societal level, there must be empathic validation that it is difficult to be a mother in modern society. Every community member should respect differing personal choices rather than judging without awareness of the full story. When faced with criticism from others, mothers must try to externalise, rather than personalise, the unhelpful comments and discard them to the mental rubbish bin.
Next, increased workplace support should be implemented when possible. This may include offering flexible hours and compassionately enabling family to be prioritised when necessary (for example, during child sickness). Mother-employees’ morale and motivation will likely increase with these positive employment conditions.
On an individual cognitive level, one must attempt to tolerate imperfection, tolerate a lack of full control, and tolerate some uncertainty about the future. Common unhelpful thinking patterns that mothers ought to monitor and challenge are high-pressured ‘should’ statements, self-criticism, and unfair comparisons with others. Goals and expectations must realistically reflect their specific temperament, background, opportunities, support system and current coping ability.
Finally, on a practical level, mothers must attempt to simplify life and slow down. This involves a process of delegating tasks when (or ideally before) feeling overwhelmed and then reviewing obligations regularly so they are not spread too thin. Self-care must be prioritised. That is, frequent relaxing, non-stimulating breaks away from the relentless busyness and technology. Self-care preferences are personal but research emphasises exercise, sleep and healthy nutrition to fuel the body and mind for starters. This balance will benefit the whole family. It’s not hard to understand how the research demonstrates that reducing maternal stress/anxiety and depression improves their children’s behaviour, cognitive and physical development. The aim is for collective calm.
CHALLENGE 5. LIMITED MENTAL HEALTH EDUCATION AND SERVICES
As mentioned, there are high rates of perinatal depression and anxiety. Unfortunately, there is limited government funding and community resources available to mothers, especially those with mild to moderate severity of difficulties. Furthermore, there is uncertainty about when and where to access professional help, above and beyond prescription medication.
How to overcome the ‘limited mental health education and services’ challenge: It would be beneficial to first take a preventative approach. ALL antenatal and postnatal education classes should comprehensively cover how to psychological prepare for, and cope with the challenges of motherhood. These classes, preferably taught by trained mental health professionals, would reduce stigma and provide clear, practical tips. An important tip to emphasise is not waiting until problems are severe before accessing treatment. Treatment should be subsidised by government and should use evidence-based techniques such as cognitive-behavioural therapy for quick and effective recovery.
Overall, motherhood is complex and influenced by various factors. Some of these factors are internal and within an individual’s control. However, others are external and seemingly unchangeable. By spreading the word about these unhelpful pressures, we can only hope that societal expectations and practical support will improve and contribute to a more positive experience.
Thank you to all the amazing mothers who have contributed to this article by sharing their personal struggles.
If you or someone you know is struggling with stress, anxiety or depression, I am happy to help. I offer evidence-based treatment for reduced rates, either in face-to-face sessions or via Skype.