Tilton Zertuche is doing a daily battle against losing herself.  A mother to two boys, a five-year-old and a three-month-old, Tilton recognizes that she is trying to combat a common fallacy - one that can consume mothers in the early months and years of their childrens’ lives.

 

Women experiencing pregnancy for the first time are often inundated with information about maternal and newborn health; suddenly time is measured in weeks instead of months, and abstract concepts calcify into pragmatic practices like taking prenatal supplements and learning which forms of exercise are safe to undertake.  This influx of new knowledge can be overwhelming… so much so that by focusing this intensely on her baby’s needs, a mother can find herself on a slippery slope in which her own needs are not met.

Mental health is an under-researched and under-advocated component of the maternal and newborn health agenda, largely because there are so many pressing physical health needs to address.  However, evidence increasingly shows a correlation between identity and self-care of the mother can influence outcomes during and after childbirth, and in the early stages of newborn life. 

The erasure of maternal identity sounds like an intangible thing, but it is not.  Simply put, a woman’s perception of self can shift abruptly from, for example, “Tilton, a poet and artist” to “Tilton, a mother”.  This is rarely deliberate, but because a new mother might not have the time nor the energy to maintain the previous components of her identity, she might experience an increased likelihood of suffering from mental health issues in the short, medium and long-term.

“When the kids finally fall asleep, all I want to do is stare into space and try not to get consumed with unfinished house work,” she says, “I have to pick myself up and make myself do art, or sing a song, or read or write.  Because these are the things that make me feel like myself, make me feel valid and whole.”

The practice of self-care is not always easy to maintain when there are multiple children to care for amidst a number of competing priorities, but Tilton’s practice is one strongly associated with better health and wellbeing.  Regardless of the hobby, it can be replicated by any new mother seeking to maintain a sense of self during the whirlwind of domestic labor and childrearing.

There is a lesson here: New mothers need to understand that their own wellbeing is not a by-product of successfully managing the elusive work-life balance.  Good maternal mental health is a necessity that requires conscious effort.  Post-partum depression is well-documented in mothers who may experience traumatic childbirth, sleep deprivation in the first months of a child’s life, or even feel guilt for resting outside of the baby’s sleep schedule.  Self-love and self-care can combat this.

“I think so many mothers just don’t make the time to do things for and of themselves,” Tilton says, “Their entire day is geared towards the needs and wants of others to the point where, even if by some miracle they do get time for and of themselves, they don’t even know how to use that time.  They feel awkward in their own skin if they aren’t serving their family.”

The United Nations Sustainable Development Goals (SDGs) have done a great deal to curb maternal mortality and morbidity around the world, and particularly in parts of Africa where resources are scant.  However, the SDGs must better recognize the importance of maternal mental health in reducing incidences of maternal mental health issues.

In countries equipped with well-resourced health frameworks, the leading cause of maternal death is suicide.  Whilst SDG 3.4 aims to reduce premature mortality from non-communicable diseases by one third through mental health initiatives, there are few civil society organizations or government partners working in the crucial work of ending suicide, and less still in maternal mental health.

As development partners around the world seek to improve the wellbeing of women and their families in a number of different spaces, it is my hope that mental health can be increasingly incorporated into programmatic strategies to create and maintain holistic health.  Appropriately briefing mothers on the ways in which hormonal, chemical, physical, and emotional changes incurred by pregnancy and childbirth will go a great distance in reducing post-partum depression and ameliorating risk of maternal suicide.

If doctors, nurses, and midwives working with expectant mothers place an emphasis on the importance of doing things for one’s own wellbeing – such as sleeping, leaving the baby with a trusted friend or family member for a few hours, or undertaking a hobby that makes the mother feel like her pre-motherhood self – the dark correlation between motherhood and mental illness can be combated more effectively.  New mothers must regard their own self-maintenance with the same diligence as a medical prescription: no negotiation, no neglect, it’s necessary to maintain good health.

But it is a choice.  A project.  For many women who struggle to justify the effort to themselves: it is work.

“I’m working so hard to fight that easy path to go down,” Tilton says, “I refuse to make my children an excuse for not living my dreams, because that is so unfair to them.  The birth of these boys will not be the death of my personality, dreams, self-love, or self-care.”

 

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