This year World Health Day's theme is depression. Depression is one of the most common mental health problems in Europe: One in seven people may experience depression at some point in their lives.
On this day, we (Mental Health Europe, Make Mothers Matter the European Women's Lobby) have decided it was about time to break the silence around one particular form of depression, which happens after having a baby: post-partum depression. This may take the form of feelings of extreme sadness, anxiety, and exhaustion and may make it difficult for women to complete daily activities for themselves and/or for others - including their baby.
It should not be confused with the so-called "baby blues", a commonly used term to describe the worry and tiredness many women experience after giving birth, and must be taken seriously as it can be intense and very challenging for women, their baby and the entire family. Post-partum depression is a reality. The World Health Organisation estimates that 10-15 % of women suffer from postpartum depression in Europe and worldwide - although due to the taboo and stigma around the issue, data and figures remain limited.
Why is it a taboo? Why don't we speak more about it? Not only in the healthcare and maternity settings but also in the media, with our GPs and paediatric care professionals? The assumption that new mothers will just find their feet is insidious. As much as motherhood is natural, it can also be overwhelming and without the right support available, numerous factors may put the mental health of mothers at risk.
During pregnancy and after childbirth, we know that women are at a higher risk of experiencing mental health difficulties. There is no single cause of postpartum depression: it is no one's fault, there are no rules as to who it will hit and no woman should ever feel ashamed of experiencing it. It may happen to anyone and it is certainly not a sign of weakness.
Tackling postpartum depression must come with appropriate support for women during pregnancy and after childbirth, including a midwifery-led continuum of care, promoting access to safe, timely, respectful and dignified care during childbirth and gender sensitive healthcare systems ensuring that the human rights of women are always respected.
Our three organisations - all involved at different levels in advocating for the rights of women to access quality care and mental health care - have identified peer-to-peer support, educational programmes for future parents, work life balance friendly policies, institutional involvement in creating mother-friendly spaces and the mainstreaming of mental health in maternity services as essential to preventing post-partum depression and to allow for recovery.
I am a mother myself and my last pregnancy came with severe risks, months of hospitalisation, uncertain outcome for my health and life, a traumatic premature birth followed by surgery, difficult physical recovery and NICU stay for my baby. Thankfully, I was lucky enough to have access to quality, free, mental health support whenever I needed it, throughout the process, and my medical team understood and respected that mental and physical health are closely intertwined. I was able to actively take part in the medical decisions taken concerning my own body and life. I was surrounded and supported by family and friends, I had peer support from women who had faced similar pregnancy complications and I was able to take sufficient time to recover and finally enjoy life with my son before returning to work. To make a long story short: without all of this support, I don't know if I would have been able to cope. I realize I was extremely lucky, but unfortunately too many women have to go through similar - or different - challenges alone or with insufficient support and services.
This is why we need to address risk factors appropriately and women who experience these should be offered early psychosocial support. Such factors include high-risk, unplanned or unwanted pregnancies, traumatic and/or premature deliveries, difficult socio-economic realities, difficulties in balancing work and family life, family problems, stressful life events as well as obstetric violence - such violence exists but remains under reported, under researched and largely unaddressed within health systems.
Starting a frank discussion about the quality of care and psychological support for women, postpartum depression and obstetric violence should begin with the development of Europe-wide awareness raising initiatives and guidelines which acknowledge the link between mental and physical health and respect human rights including the right of all mothers and their families to access appropriate and quality care and support. These are avenues and ideas to explore together: civil society, policy makers, health and mental health professionals, women and men. "We can all contribute to promoting positive mental health for mothers and creating supportive environments to make maternity a truly beautiful - although not always easy- experience for all."