How to Save a Life – Why Maternal Mental Health Matters

Kerry Thomson - 14 Feb 17

At the end of 2016, I was privileged to be asked to speak at the MBRRACE-UK National Report Launch of the Confidential Enquiry in Maternal Deaths 2009-2013. I invited by Action on Pre-Eclampsia, an organisation who have been hugely supportive of me, to talk about my experience of HELLP Syndrome – a rare complication of pregnancy.

Indeed HELLP was one of the scenarios that claimed lives during the reporting period, along with heart disease, ectopic pregnancy and intracranial bleeds. But a cause of death that I hadn’t expected to feature so prominently, was suicide.

The report found that more than 100 women died from suicide during pregnancy or in the year after giving birth. Indeed mental health problems are such a leading cause of death for mothers and expectant mothers, that the World Health Organisation has recently reclassified suicide as a DIRECT case of maternal death.

I was shocked that I hadn’t seen this information reported anywhere in the media. Despite the awareness raising of mental health by high profile figures, such as Princes William and Harry and the inspiring  work being done by journalist Bryony Gordon and her Mental Health Mates, the mental health of mothers still seems largely a taboo subject.

Just one week after the report launch I saw what had previously been a scary statistic become a possible reality. Someone I had gone to school with went missing. Her car was found abandoned at a small harbour. She was suffering from post-natal depression. She has never been found.

Often the blame for such tragedies is fired squarely at the NHS. But is this really just about them?  Do we as a society do enough to support women during pregnancy and after birth? There are a plethora of classes for pre and post-natal women – yoga, active birth, baby massage –  but are there any that support women with what’s going on in their minds during one of the most intense times of their lives?  Do we as a society help women to feel less isolated as mothers, or do we prefer to cast judgement on them – whether it be for breastfeeding in public or failing to control a spirited toddler in the fruit and veg aisle?

In India new mums are treated like goddesses. They spend a 40 day period of confinement;  staying in bed to sleep, feed and bond with their baby. After my second and third children  I was back home within 24 hours loading the dishwasher and dealing with toddler tantrums. There was little room to process what may have been whirling around in my head. My community  midwife dashed in and out as quick as she could, ‘you’ll be an expert, she said, ‘you’ve done it all before’.  Yes I may have done it all before but not with other children in tow. When I told my health visitor I was finding things hard after my third baby she said she’d better come and see me but couldn’t fit me in for a month. Some women can’t wait a month and that’s when they may become one of those tragic statistics.

My eldest son was born at 38 weeks. I was induced after becoming unwell with HELLP syndrome. My husband was sent home and I laboured quickly through the night alone, catheterised and with a magnesium sulphate infusion coursing through my veins to stop me having a seizure. It’s fair to say this has been the only time in my life thus far, that I have experienced true fear.

I struggled hugely in the months after the birth. I hated being alone, particularly at night. I felt like the darkness enveloped me and I didn’t know what to do. Like some sort of reverse vampire, I dreaded the sun going down. My husband was often woken at a godforsaken hour of the morning with me shaking in terror and panic, unable to settle our gorgeous boy.  Sometimes I awoke on all fours scrabbling around our bed convinced I’d fallen asleep and squashed him, when actually he was safely asleep in his Moses basket right next to me.

After my son was born my GP, community midwife and Health Visitor all told me that because I had had a ‘birth trauma’, I was at a much increased risk of Post Natal Depression. It’s all very well to point this out to a new mum but no-one ever checked up on me – no-one ever asked me how I was feeling so it felt like a tick-box exercise just so they could be sure they had covered themselves should anything go wrong. Surely this isn’t good enough? Simply filling in the Edinburgh Post-Natal Depression Scale – the easiest ever test to cheat in – isn’t good enough.

After maternity leave I didn’t go back to the job I loved because I couldn’t bear to leave my son. I felt jangling anxiety at even the thought of being parted from him. But I didn’t feel depressed.  I was very sociable, I’d made new friends, I was coping. So I just ignored it and assumed this was what happened when you became a mum.

It wasn’t until I had my daughter 19 months later, that my Health Visitor told me she had always thought I had been suffering from Post-Natal Post-Traumatic Stress.  I wasn’t even aware such a thing existed but it made complete sense to me. My fear of being alone in the dark, just like I had been during labour; my constant reliving of my experience and desperate need to tell anyone who would listen.  But why, if she thought this, did she not try to help me?  Why did she just let me suffer?

So if we can’t always rely on good support from the NHS – and I should say that I have had some amazing support from the NHS – then surely we can rely on it from others, from fellow mums, from the sisterhood?  Yes in large part we can. I honestly couldn’t have got through the last five years of being a mum without the incredible friends I have made along the way. But on the flip side I have also been witness to mothers who sneer at others who they believe ‘aren’t coping’ with an attitude of, ‘what on earth has she got to find so hard?’

We need to drop the tough girl act around maternal mental health and start being more open with each other and support each other more in return. No-one asks for the ‘black dog’ to come knocking on their door. No-one asks to lie in bed at night unable to sleep because they’re terrified their baby might stop breathing if they don’t keep a permanent vigil. No-one asks to feel like a jack-hammer is needling at their brain due to the sheer intensity of noise their child/children can make. No-one asks to want to scream like their lungs might just burst because they feel like the walls are quite literally caving in on them.

We need to drop the expectation heaped on mothers. We aren’t superwomen, we cannot do it all.We need to pay heed to the famous African proverb, ‘It takes a village to raise a child’. We need to celebrate mothers and  stop the judging, stop the expectation and stop any other mother from becoming a tragic statistic.

Kerry Thomson

I'm Kerry, I live in the sticks in Scotland with one husband, three kids, one dog, six chickens, 200 cattle and 2500 sheep. You can read more about me and my gang on my blog www.postcardsfrommykitchentable.com

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