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Reflections Magazine : Reflections Magazine Issue 52
10 For the majority of people being pregnant and having a baby is an exciting and joyful time, but for some it is more challenging. Mood changes are normal in pregnancy and immediately after the birth of a baby. Hormonal changes that come with being pregnant, and the adjustment that is required as a woman learns to be a parent affects how a woman feels, and certainly can be worrying. This is perfectly normal. However too much anxiety, or persistent negative changes in feelings, behaviours and thoughts may indicate a mood disorder that requires assessment and treatment. Perinatal anxiety and depression are quite common. In fact research undertaken in Australia found that up to 9% of women will experience depression in pregnancy, with that number increasing to 16% in the year following childbirth. Anxiety, which can be just as debilitating, is probably even more common. Fathers also experience perinatal depression and anxiety at nearly the same rate. Many studies have determined a relationship between perinatal depression and anxiety and adverse outcomes in children. Young children of depressed mothers may be more impulsive and have more difficult peer interactions, and insecure attachment is more common. Cognitive, language and emotional development can also be affected. Women with less social support are more likely to become depressed, but Lee and colleagues found in their 2006 study that high levels of social support and child care protects against the effects of mild to moderate maternal depression on some child behaviour problems. An Australian study by Giles and colleagues from the University of Adelaide (2001: e1) found that "..as little as half a day of formal child care at the age of two years modified the effect of recurrent maternal depressive symptoms on total behaviour problems in children aged five years." It is important to note that depression or anxiety in a parent is not a confident predictor of unfavourable outcomes in children. In fact, we know that despite a parent's ill health, the majority of children will not be affected. Infants thrive when they have an expectation that their physical and emotional needs will be met. Even with some degree of depression or anxiety, many parents are able to provide "good enough" parenting - where the parent is attentive and responsive to the infant, and has empathy for and the ability to reflect the infant's feelings. In other cases, these needs may be met by a variety of people such as another parent, grandparent or regular caregiver. Johnston and Brinamen (2005: 270) discussed infant mental health principles in the context of child care and proposed that formal child care's primary purpose ".. is to provide children with experiences in adult-child relationships that instil a basically positive sense of self and the world." ECEC educators also have an increasing role in developing and affirming the parent's sense of self and supporting the parent-child relationship. Some Thoughts on Perinatal Mental Health in an Early Childhood Education and Care Environment Parts of Australia are experiencing a period of rapid growth, which attracts increasing numbers of families from interstate and overseas. Each time a family relocates they leave behind the family, friends and the community that would have supported them during the often testing time of pregnancy and raising small children. The African proverb, "it takes a village to raise a child" is still true, but what happens when that village is no longer accessible? The answer is that we have to create a new village. Early parenting groups run by child health nurses help new parents who live locally and have babies of similar ages to meet. Playgroups have provided substitute communities for many families across Australia for decades. Early Childhood Education and Care (ECEC) centres provide the respite and child care that once might have been provided by a grandmother. Author: Roslyn West Clinical Nurse Specialist -- Perinatal Mental Health Child and Adolescent Community Health Service, WA
Reflections Magazine Issue 51
Reflections Magazine Issue 53 Summer 2013