About 10% of births – that’s about 15 million babies – are born prematurely worldwide each year, making preterm births a major global health concern. The World Health Organization (WHO) defines preterm birth as delivery before 37 completed weeks of gestation.
Estimates suggest that the preterm figure is much higher in low-income countries. Preterm births are a danger to the infant’s survival and long-term health. And according to the WHO, the level of socioeconomic development in the country where a preterm baby is born often plays a crucial role in their survival.
In high-income countries, over 90% of extremely preterm newborns survive. In low-income countries, survival rates can be as low as 10%.
The survival rates of preterm babies depend heavily on healthcare accessibility and socioeconomic factors. Those include organisational support like maternity leave and consideration for the needs of working mothers. Even in high-income countries with advanced healthcare services, racial and socioeconomic disparities lead to disproportionate rates of preterm birth and adverse maternal outcomes.
While attention is rightly placed on the survival and long-term health of the babies, a silent crisis often unfolds alongside it: the mental health of mothers.
Preterm birth is frequently sudden and unexpected, bringing intense stress and psychological trauma, uncertainty, and emotional disruption for mothers. For many women, the experience is not only medical but also deeply psychological. Also, mothers’ mental health challenges not only affect maternal well-being but can also influence bonding, caregiving practices, and long-term child development.
Our work sits at the intersection of maternal mental health, public health systems, and research translation. We conducted a study which highlights how preterm birth can trigger profound psychological distress in mothers. We explored the complex intersections of preterm motherhood and maternal mental health in a low-resource context, in this case Ghana. The study used a qualitative approach and centred on understanding mothers’ personal experiences.
Our findings reveal the complex experiences mothers of preterm children go through, such as shielding themselves from negative comments until their babies gained weight. The findings further revealed the complex interplay between mothers’ subjective experiences and their perceptions during their premature infants’ conception, birth and care-giving journey.
These are not isolated experiences. For example, a study found that 17.2% of the world’s population suffers from postpartum depression and the highest prevalence rate is in southern Africa – 39.96%.
But the findings underscore the importance of addressing both personal and systemic issues when providing support to mothers of preterm babies. They also highlight how stigma adds to the emotional challenges mothers with preterm babies experience.
Read more: Young mothers in Kenya face a higher risk of giving birth early: study explores why
Giving birth too soon
We conducted in-depth interviews with 22 mothers of preterm infants in the eastern region of Ghana. Few studies have observed the interplay of preterm birth, sociocultural issues and psychological outcomes among mothers in this country.
Our analytical approach aimed to capture the sense that participants made of their experiences – to explore the complex emotional, psychological and social realities surrounding preterm birth from the mothers’ perspectives. The method allowed us to understand how mothers interpret, cope with and are affected by their experiences.
One of the women told us:
I was like, is all my struggle going to be wasted? I was extremely sad throughout the period … I didn’t expect him to be small like that at seven months. I was scared about his size.
Another shared her experience:
I was always indoors with the baby when he was small. Even if I’m going out, say to the hospital, I will wrap the baby in a cloth so that no one sees the child for them to make bad comments about him.
A third woman said:
It was so stressful because you will be sleeping somewhere while your baby too will be staying somewhere (else). I was always thinking about my baby and asking myself what was wrong with him at every point.
Challenges like these can be compounded by limited access to mental health services, especially in resource-constrained settings. The implications are far-reaching. For example, poor maternal mental health can affect infant development, breastfeeding and caregiving practices, mother-child bonding, and overall family well-being.
Supporting maternal mental health is essential to improving outcomes for both mother and child.
What should be done?
Mental health must be integrated into maternal and neonatal care.
Mental health screening should be a routine part of care for mothers, especially those with preterm infants.
There is a need to expand access to support services through community-based counselling, peer support networks, and affordable psychological care.
Public and private health institutions, academics and communities need to address obstetric violence and stigma through public education and further research. Obstetric violence is violence experienced by women during facility-based childbirth.
Interventions and policies should be developed to help normalise maternal mental health challenges and encourage women to seek help without fear.
Healthcare providers should be trained to recognise and respond to maternal mental health needs, particularly in neonatal care settings.
It’s also important to invest in context-specific research to quantify the burden and to design effective interventions.
Puleng Segalo receives funding from the University of South Africa.
Jacob Owusu Sarfo receives funding from the University of South Africa, University of Cape Coast, and Grand Challenges Canada.
This article was originally published on The Conversation. Read the original article.
