Maternal Mental Health: It’s Time We Talk About the Whole Story
Medically reviewed by Paul Hornsey
Janine McNab, COO
The view of motherhood and maternal mental health is so often one of joy and gratitude. But the truth is, for many women, it’s also a time of deep emotional vulnerability. It’s a side of the experience that’s seldom spoken about, and even more rarely seen. While maternal mental health has come into sharper focus in recent years, the reality remains: many women continue to live their experiences in silence, unsure whether what they’re feeling is ‘normal’, or even if they’re allowed to speak up at all.
My own journey into motherhood was as beautiful, complicated, and confusing as anyone else’s. When I found out I was pregnant with my daughter, it felt like a miracle. I was 39, living with endometriosis, and in a new relationship. I hadn’t expected it to happen, and my pregnancy was genuinely lovely – I felt good, I loved the bump, and I really leaned into the magic of it all.
But midway through, life took a turn. My grandfather – who was more like a father to me – became seriously unwell. He passed away the night before my daughter was born. And so, I found myself completely disoriented in the days that followed; suspended between life and death, joy and grief. I didn’t know how to celebrate, or how to mourn. I just felt numb. And my word was it lonely and terrifying.
It wasn’t until my best friend suggested I see my GP that I realised something wasn’t quite right. That quiet moment of quiet support was the first step on a very long journey of understanding maternal mental health – and just how fragile that early period can be.
But, more importantly, I know that I’m far from alone in my experiences. Here in the UK, maternal mental health challenges are the leading cause of maternal morbidity, affecting more than 1 in 5 women during pregnancy or the year after birth. Yet around half of those who are struggling don’t get a diagnosis or the support they need.
The global picture is just as sobering. It is estimated that around 1 in 7 women worldwide experience postnatal depression – a figure that’s much higher in low- and middle-income countries where health services are stretched and stigma runs deep.
Even in our own UK health system – one of the most developed in the world – not everyone is getting fair access. Women from Black, Asian and Minority Ethnic backgrounds are:
This isn’t just about gaps in care, but rather the wider, structural factors that shape mental health. Racism, poverty, housing insecurity, trauma all aren’t external to mental health. They are mental health.
We also can’t ignore the cultural dynamics that affect how distress shows up. In some cultures, people might express emotional pain physically. Others may turn inward, or towards spirituality. Silence doesn’t necessarily mean that someone is okay. It just goes to show that we need to listen differently.
The NHS Race & Health Observatory has made it clear: cultural competence in perinatal care isn’t a ‘nice to have’. It’s essential. And it goes way beyond translating leaflets. It means building systems that truly reflect the lives, languages, values and needs of the people using them.
So, what needs to change?
We’re making progress, but it’s not consistent and it’s not enough. If we’re serious about supporting maternal mental health in a meaningful way, we need to:
This is not a niche issue. It’s not just a women’s issue, either. Maternal mental health affects children, families, workplaces, communities, and whole generations to come.
The way we approach this at Harbor is to curate a treatment plan solely around the individual and the family in our care, bringing in the right experts at the right time to not only treat the symptoms but help mothers find their hope again and enjoy the miracle of motherhood in a nurturing and safe environment.
So if you’re a clinician, policymaker, commissioner, researcher or advocate – or even just someone who cares – the question is: how can we show up better? How can we build a system that mothers can actually trust?
Because when we get this right – when we support mothers properly, with care that’s inclusive, trauma-informed and culturally responsive – we aren’t just saving lives
