ISSUE : Maternal depression is a significant risk factor
affecting the healthy development of babies, children and youth.
The relationship between maternal mental health and
child health outcomes is well documented and research is continually
demonstrating the importance of early detection and treatment of maternal
mental illness in early childhood developments1,2,3. Maternal depression
can impair the maternal/child bond and result in delayed physical, social and
cognitive development with long term implications for physical and mental
wellbeing and related health outcomes2,3,4. Mothers who are
struggling with their own mental health concerns may find interaction with
their child in this capacity more difficult and thus delay or impair this vital
component of early brain development.
The World Health Organization (WHO) defines maternal
mental health as “a state of well-being in which a mother realizes her own
abilities, can cope with normal stresses of life, can work productively and
fruitfully and is able to make a contribution to her community”2. When
confronted with mental illness, many women are unable to function in a way that
allows them to contribute at a level that is consistent with WHO definitions.
Maternal depression is the second leading cause of disability among women globally2
and estimates suggest that up to one in five women will struggle with a mental
health complication during the perinatal period.
It may surprise you to learn that:
● It is estimated that up to one in five perinatal
women will suffer from a maternal mental illness. This prevalence makes mental illness the most common
complication of the perinatal period, and a significant public health concern.
● Not only are women affected by poor mental health
but impacts are felt directly by their partners, family, friends and community. When left untreated,
mental illness can have a direct impact on early childhood development outcomes.
● Exposure to Adverse Childhood Experiences (ACEs), of
which parental depression is one, can result in high levels of toxic stress on a child’s
developing brain that can result in a greater likelihood of poor mental and physical health outcomes
later in life5.
Many mothers experience a perinatal mood and anxiety
disorder. In 2017, a study in the Canadian Medical association journal looked
at suicide among new mothers and found that 1 in 19 maternal deaths in Ontario
is attributed to suicide6,7. Making suicide the fourth leading cause of death for
perinatal women in Canada7. 1 in 19!!!
Because of stigma and leaving the onus on the mothers
to reach out for help, only 15% of mothers who experience a perinatal mood or
anxiety disorder (PMAD) receive professional treatment 8. Some
countries, such as the UK, Australia, USA, all have a Maternal Mental Health
Strategy & screening program in place. Canada instead leaves the responsibility
on new mothers to reach out for help. They may not know to reach out for help
if they do not know they are experiencing a PMAD, or they may be afraid of the stigma
associated with a PMAD.
If we want to support children and youth, we must
start with mothers and ensure that they are healthy. When moms thrive, babies
thrive. If we want to turn the tide on some of our biggest challenges with
children and youth we need to focus on preventing them by having a strategy for
supporting Canadian mothers and increase maternal mental health.
Based on research, current trends, and new knowledge,
we need to act now and put a plan in place to screen mothers for PMADs to prevent
the loss of life, lessen the effect on children and youth, and decrease the
high economical costs for something that can be prevented by early detection,
and simple interventions. We need a plan in place to identify the mothers who
are at risk and get them into treatment whether that is peer based support
groups, medication, counselling, or hospitalization.
- Maternal depression
and anxiety is a stronger risk factor for child behavioral problems than
smoking, binge drinking, and emotional or physical domestic abuse9.
- More women will suffer
PMAD than there are new cases of breast cancer diagnosed annually 10.
- More women will suffer from Postpartum
Anxiety and Depression in a year than the combined number of new cases for men
and women of Tuberculosis, Leukemia, Multiple Sclerosis, Parkinson’s Disease,
Alzheimer’s Disease, Lupus, and Epilepsy.
- Depression during pregnancy and the
immediate postpartum period is the most concerning time and has the biggest
effect on the developing brain5.
has been estimated that the cost for untreated mother/child unit is up to
$150,000 with 72% of the cost allocated to the child11.
- It is
estimated 85% of mothers do not receive treatment, so the economic cost to
Canada is approximately $11 billion dollars. This can be reduced to approximately
$5,000 if we screen and treat.
This is an excerpt from the brief presented at the Great Canadian Health Care Debate at the National Health Leaders Conference, June 2018. See the full brief here.
1. Evans, J., Melotti,
R., Heron, J., Ramchandani, P., Wiles, N., Murray, L. and Stein, A. (2011). The
timing of maternal depressive symptoms and child cognitive development: a
longitudinal study. Journal of Child Psychology and Psychiatry, 53(6),
A., Surkan, P., Cayetano, C., Rwagatare, P. and Dickson, K. (2013). Grand
Challenges: Integrating Maternal Mental Health into Maternal and Child Health
Programmes. PLoS Medicine, 10(5), p. e1001442.
3. Sohr-Preston, S.and Scaramella, L. (2006). Implications of Timing of Maternal
Depressive Symptoms for Early Cognitive and Language Development. Clinical
Child and Family Psychology Review, 9(1), pp.65-83.
C., Jomeen, J. and Hayter, M. (2014). The impact of peer support in the context
of perinatal mental illness: A meta-ethnography. Midwifery, 30(5), pp.491-498.
5. Lebel, C.,
Walton, M., Letourneau, N., Giesbrecht, G., Kaplan, B. and Dewey, D. (2016).
Prepartum and Postpartum Maternal Depressive Symptoms Are Related to Children’s
Brain Structure in Preschool. Biological Psychiatry, 80(11), pp.859-868.
S. (2017) 1 in 19: New study shines light on reality of suicide among new
Ontario moms, moms-to-be. CBC news.
7. Grigoriadis, S., Wilton, A. S., Kurdyak, P. A., Rhodes, A. E., VonderPorten, E.
H., Levitt, A., … Vigod, S. N. (2017). Perinatal suicide in Ontario, Canada: a
15-year population-based study. CMAJ : Canadian Medical Association Journal =
Journal de l’Association Medicale
8. Patterns of
Depression and Treatment in Pregnant and Postpartum Women Angela Bowen, RN,
PhD1 ; Rudy Bowen, MD, CM, FRCP2 ; Peter Butt, MD, CCFP3 ; Kazi Rahman, MBBS,
MS (PhD Candidate)4 ; Nazeem Muhajarine, PhD5, 2012
9. Knitzer, J.,
Theberge, S., & Johnson, K. (2008). Reducing Maternal Depression and Its
Impact on Young Children. Retrieved from
10. Stone, K. (2010). How Many Women Get Postpartum
Depression? The Statistics on PPD | POSTPARTUM PROGRESS. Retrieved May 17,
11. Bauer, A., Parsonage, M., Knapp, M.,
Iemmi, V., Adelaja, B., & Hogg, S. (2014). The costs of perinatal mental
health problems. Centre for Mental Health. /doi.org/10.13140/2.1.4731.61