While conversations about mental health have increased over the last couple of years, the unique mental health challenges many people face during pregnancy and in the postnatal period have often been overlooked.
The reality, however, is that 10-20% of pregnant people experience mental health problems during pregnancy or in the first year after pregnancy – and suicide is one of the leading causes of maternal death in the UK within a year after childbirth.
This lack of awareness also contributes to the stigma and misunderstanding that continues to dominate these conditions; in a 2017 survey of over 2,300 women conducted by the Royal College of Obstetricians and Gynaecologists, 28% of women felt there was a stigma attached to their mental health conditions, with a further 28% saying they felt embarrassed.
However, things are changing – albeit slowly. This week marks the sixth ever Maternal Mental Health Awareness Week – a week-long campaign dedicated to raising awareness of the mental health problems experienced during and after pregnancy. And while one week isn’t going to fix such a long-standing problem, the work being done to raise the visibility of these experiences during this time is certainly making them harder to ignore.
One such project is Perinatal Voices – an on-going photographic project led by the London-based portrait and documentary photographer Susheel Schroeder, which aims to address the UK’s maternal mental health crisis and question “the role of visibility and representation in mitigating the stigma attached to perinatal mental health conditions”.
The project, which was launched to coincide with this week’s event, is made up of a variety of black and white portrait shots of women from different backgrounds, all of whom have their own individual experience of maternal mental health issues.
These include 35-year-old Gemma, who suffered with both perinatal anxiety and postnatal depression. “It wasn’t picked up by health professionals; it was my husband who suggested we go to the doctor, and even then it was brushed off,” she says of her experience.
“After getting help privately and with medication, over time I got better. But on reflection, I’m very sad for the woman I was then, who went through those many months without any help and worrying I just wasn’t a good enough mother, when it wasn’t that at all, of course. I strongly feel more support is needed on the frontline for all pregnant women and new mothers as a routine part of perinatal and postnatal care.”
Another of the women involved in the project, a 33-year-old mother of one called Charlotte, spoke about her experience with tokophobia – a severe fear of pregnancy and childbirth – and how it’s impacted her future plans.
“I’ve had a phobia of pregnancy and childbirth since I was shown a vaginal delivery video in sex education class,” she explains. “I wasn’t fully unaware of the affect it had on me until I was pregnant and experiencing intrusive thoughts about miscarriage, abortion and self-harm.
“My daughter’s delivery was a straightforward planned c-section, but my brain still cannot make sense of this. I found pregnancy and childbirth extremely traumatic, and I don’t think I will be able to have another child.”
For Schroeder, who was inspired to take on the project following a series of conversations with women she had photographed previously, the series is all about increasing the visibility of these kinds of experiences and making others feel less alone.
“A maternal mental health diagnosis can be very isolating, and I hoped that seeing women who looked like them talking openly about their experiences and challenges would make other women more comfortable with talking about their own,” she explains.
“Images used in articles about maternal mental health are often of women with their children with their faces partially obscured or hidden, and I wanted every woman I photographed to look directly at the camera in order to challenge the viewer to question what’s happened to them, make sure they are seen and their stories are heard.
“The louder the conversation can be around maternal mental health, the harder it will be to refuse women the support they need.”
In the future, Schroeder aims to expand both the size and reach of the project and work with organisations to make a real difference in maternity services across the UK.
“Access to care and support for women is different in each local health trust so my goal is to continue to create these portraits and turn the series into a touring exhibition that visits different regions in the UK to make maternal mental health more visible nationally,” Schroeder explains.
“Eventually I want to have photographed hundreds of women and I hope to create a platform where the project can be visible online and accessed by everyone.
“It’s a big goal, but I’m really committed to making this work impactful and hope this project can one day contribute to the huge efforts made by organisations like the Maternal Mental Health Alliance to improve maternity services and access to mental health care for women so that by the time our children have children, things will look very different for mothers.”
If you, or someone you know, is struggling with their mental health, you can find support and resources on the mental health charity Mind’s website and NHS Every Mind Matters or access the NHS’ list of mental health helplines and services.
If you are struggling with your mental health, you can also ask your GP for a referral to NHS Talking Therapies, or you can self-refer.
For confidential support, you can also call the Samaritans in the UK on 116 123 or email firstname.lastname@example.org. In a crisis, call 999.
For dedicated information about perinatal mental health issues and to seek support, you can visit the Maternal Mental Health Alliance’s website.
Images: Susheel Schroeder