A few years ago, a very close friend of mine was pregnant for the first time, and she shared about her severe anxiety related to her pregnancy and childbirth. She mentioned having a very low mood and feeling isolated as she was a new immigrant and had no family or social support in Aotearoa. Today, she recalls this as one of the most difficult phases of her life. I had encouraged her to see her doctor when her symptoms of low mood had worsened after the baby’s birth. She was diagnosed with Post-Natal Depression and Perinatal Anxiety, common conditions which, when left untreated, can worsen over a period of time. Years later, now working in the field of hinengaro-well-being, I understand that these conditions are prevalent among many pregnant women and new mums. However, they are still unsure about what Post-Natal Depression or Perinatal Anxiety is, and that support is available through their doctors or in the community. Medication, individual psychology or counselling and group therapy including Mindfulness Courses are helpful to cope, heal and grow into motherhood confidently.
Wellbeing and mental health issues during the perinatal period (during pregnancy and following childbirth) are common throughout the world and adversely impact on maternal mobility, mortality and ultimately, the survival and development of children (WHO, 2021). The impact of mental illness at this critical time can be far reaching, affecting not only the mother but also her baby, family and the community. When a woman experiences untreated Perinatal Depression or Anxiety, her baby is more likely to develop emotional, cognitive and behavioural issues, and there is an increased risk of learning difficulties and mental health issues.
In Aotearoa, the largest cause of maternal death is suicide. In the period 2006-2018, suicide accounted for 30 maternal deaths and Māori women are 3.35 times more likely to die by suicide, according to the 2021 report from the Perinatal and Maternal Mortality Review Committee (PMMRC). The report highlights that even though the rates of maternal death in Aotearoa are higher than those in the UK, there is significantly less investment in maternal and perinatal mental health in NZ than in the UK (PMMRC, 2021). Around 11,000 women are estimated to experience Perinatal Depression/Anxiety in New Zealand every year. Maori, Pasifika and Asian communities are less likely to access health or mental health services. Asian and new migrant communities experience a higher rate of Perinatal Depression/Anxiety, and Maori experience a higher rate of maternal suicide than any other ethnicity (MMH Report, 2022). It is harder for new immigrant women to cope with perinatal issues due to lack of support from family, language barriers and lack of knowledge about Maternal Mental Health Services.
Mothers Helpers conducted a survey-Experiencing Perinatal Depression in NZ (2019/2021). Participants said their mental health is supported when they experience a service they can access easily with a short wait-time that genuinely listens to their concerns, treats them non-judgmentally with warmth, kindness and understanding, is attentive and informative. They want a mental health service that is consistent and reliable, a service that is sensitive and focused on their needs - checking in with them regularly. They want a service that helps them to identify contributing factors to their depression and anxiety and gives them tools to manage it, a service that helps them to make small, realistic, practical steps towards their goals. They want a relevant, inclusive, current and up-to-date service that provides or can access practical help or respite (MMH Report, 2022).
At Tamaki Health, we facilitate Mindfulness Courses to support our patients and their support people in their journey to overcome anxiety and depression and to cope with long-term physical health symptoms. We have been offering the six-week Aotearoa Mindfulness and Awareness Programme for over ten years. Additionally, for the last three years, we've been providing the enriched Te Ao Māori course, Mauri tau me te Māramatanga, and a Hindi Aotearoa Mindfulness and Awareness Programme. Systematic reviews conducted in recent years found preliminary evidence supporting the efficacy of the perinatal mindfulness-based intervention. Qualitative studies in these reviews included participants who found mindfulness strategies very useful while trying to cope with transitioning into parenthood (Dhillon et al., 2017; Hall et al., 2017; Matvienko-Sikar et al., 2016; Taylor et al., 2016).
Recently, we have developed a Maternal Aotearoa Mindfulness and Awareness Course for pregnant women, new mums, their family, and support people. This programme will assist participants in taking a deeper look at wellbeing through an integration of Mindfulness Meditation, Psychology and Medical Science. This programme is inspired by the gold standard Mindfulness-Based Stress Reduction Programme developed by Jon Kabat Zinn (2013). Research has shown that Mindfulness practices help increase women's wellbeing during their pregnancy and after childbirth. Our Maternal Mindfulness Course will assist expecting mums and new mums to cope with perinatal stress, depression and anxiety, increase self-awareness: physical, emotional, and behavioural, improve levels of energy, increase inner strength and resilience; learn self-regulation skills to manage thoughts, emotions and behaviour; improve the quality of rest and sleep, enhance communication and relationships, and overall wellbeing; cope with day-to-day challenges, transition into parenthood smoothly and recover from pain; regulate blood pressure, etc. This course is free for registered patients and their support people at Local Doctors and White Cross Clinics. For queries, you may contact Manjusha via email: firstname.lastname@example.org
Manjusha Mane has a Master’s Degree in Business Administration and a Master’s Degree in Counselling (UOA) and is the Clinical Lead and Educator for the Mindfulness Programmes at the Wellness Support Team, Tāmaki Health (Local Doctors and White Cross Clinics)
Dhillon, A., Sparkes, E., & Duarte, R. V. (2017). Mindfulness-based interventions during pregnancy: A systematic review and metaanalysis. Mindfulness, 8(6), 1421–1437.
Hall, H. G., Beattie, J., Lau, R., East, C., & Biro, M. A. (2016). Mindfulness and perinatal mental health: A systematic review. Women and Birth, 29(1), 62–71.
Kabat-Zinn, J. (2013). Full Catastrophe Living. Using the wisdom of your body and mind to face stress, pain and illness. Bantam Books.
Maternal Mental Health Report, (2022) https://www.productivity.govt.nz/assets/Submission-Documents/Sub-086-Maternal-Care-Action-Group-NZ.pdf
Matvienko-Sikar, K., Lee, L., Murphy, G., & Murphy, L. (2016). The effects of mindfulness interventions on prenatal well-being: A systematic review. Journal of Psychology & Health. 31(12), 1415–1434.
Te Tāhū Hauora-Health Quality and Safety Commission, (2021). Perinatal and Maternal Mortality Review Committee https://www.hqsc.govt.nz/news/update-from-the-perinatal-and-maternal-mortality-review-committee/
Taylor, B., Cavanagh, K., & Strauss, C. (2016). The effectiveness of mindfulness-based interventions in the perinatal period: A systematic review and meta-analysis. PloS ONE. 11(5), e0155720.