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Science
Holly Walker

Let's prioritise perinatal mental wellbeing

‘After birth, parental distress can negatively affect parent-child attachment.’ Photo: Ana Tablas/Unsplash

Up to half of all birthing parents in New Zealand experience symptoms of depression, anxiety, and stress in the perinatal period. Government needs to support and enable all new parents to access the support they need

Comment: As any parent will tell you, having a new baby is a joyful, challenging, but sometimes overwhelming experience. All new parents and pēpi should be surrounded with aroha and support at what is a crucial time for any whānau.

But many new parents in Aotearoa are struggling.

This week is Perinatal Mental Health Awareness week. On Saturday, Mahi a Rongo | The Helen Clark Foundation released a major new report on perinatal mental health policy. Āhurutia Te Rito | It takes a village argues that better support for perinatal mental wellbeing could transform the future for whānau and communities in Aotearoa New Zealand.

An estimated 10%-20% of birthing parents in New Zealand are thought to experience clinical symptoms of mental illness during the important perinatal period (from conception until the baby’s first birthday).

An even bigger group, thought to be up to 30%, experience symptoms that, while below the clinical threshold for diagnosis, can still be very challenging.

There is a lack of robust data on this topic, but when we combine these two groups, we are confronted with the startling estimate that up to half of all birthing parents in Aotearoa experience symptoms of depression, anxiety, and stress in the perinatal period.

There’s also the stark fact that suicide is the lead cause of maternal death in New Zealand - a key finding from the report. Wāhine Māori are three times more likely than Pākehā to die by suicide during pregnancy or in the first six weeks after birth - arguably a breach of the Crown’s Te Tiriti o Waitangi obligation to ensure equitable health for Māori.

Easing the suffering of half the country’s birthing parents and reducing our terrible maternal suicide rate is reason enough for our leaders and decision-makers to take perinatal mental health seriously.

In case they still need persuading, there is another important reason to prioritise perinatal mental wellbeing: it is possibly the single most effective way to improve long term child and whānau outcomes.

Having a parent in distress can cause serious detrimental impacts for babies, and hinder their cognitive, emotional, and physiological development.

During pregnancy, parental distress can disrupt brain development, which results in impaired executive functioning throughout a child’s life.

After birth, parental distress can negatively affect parent-child attachment, limit important parenting practices such as talking, reading, and singing to babies, and disrupt the establishment of positive feeding and sleep routines.

Among other things, experiencing a period of parental distress during infancy can increase a family’s likelihood of experiencing unstable housing, financial hardship, food insecurity, and domestic abuse. This relationship flows two ways: structural factors such as these are also major causes of perinatal distress.

Currently, the support available to parents in distress is not adequate. A stocktake carried out by the Ministry of Health last year found that specialist perinatal mental health support is inadequate, uneven, and may be inequitable.

The good news is we know what we need to do. Making sure parents and whānau have access to the right kinds of support at the right time is the best way to protect perinatal mental health.

This has long been understood in te ao Māori. In many Māori and Pacific cultural traditions surrounding pregnancy and birth, māmā/birthing parents and pēpi are accorded special status, and tikanga and cultural practices uphold and surround new parents and babies with collective support.

Now we need Government policies and investments to support and enable all new parents to access the support they need.

This support may take the form of temporary hands-on assistance, or support for the wider whānau with adequate resources to care for their own. It could mean timely access to affordable, culturally appropriate therapy, even (or especially) when someone is presenting with ‘mild to moderate’ need.

Whatever form it takes, support for whānau works best when it comes from sources that parents already know and trust. Collaborative, strengths-based initiatives, including community-led and kaupapa Māori-driven initiatives, are often best placed to deliver this.

The Āhurutia Te Rito | It takes a village report recommends political leaders and those designing our new health system prioritise policies that:

* Alleviate or remove background stress for new parents.

* Make it easier for whānau to spend time with and support new parents and pēpi.

* Ensure birthing parents have access to continuous, holistic maternity care.

* Resource and empower kaupapa Māori and community-led initiatives.

* Assist whānau and those who work with them to recognise early signs of distress and act quickly to provide support.

* Provide fast access to affordable, culturally appropriate therapy and specialist help.

With the new Health New Zealand and Māori Health Agency starting on 1 July, we have a unique opportunity right now to prioritise perinatal mental wellbeing, embed policies such as these, and transform the future for parents, pēpi, whānau, and communities.

Let’s not mess it up.

Where to get help:
1737, Need to talk? Free call or text 1737 any time for support from a trained counsellor
Lifeline - 0800 543 354 or (09) 5222 999 within Auckland
Samaritans - 0800 726 666
Suicide Crisis Helpline - 0508 828 865 (0508 TAUTOKO)
thelowdown.co.nz - or email team@thelowdown.co.nz or free text 5626
Anxiety New Zealand - 0800 ANXIETY (0800 269 4389)
Supporting Families in Mental Illness - 0800 732 825

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