Feeling the Connection: Healthy Mom, Healthy Child
A mother’s mental health can affect a child’s development in the womb and throughout their life.
Dr. Shanique Ampiah, MD '14, and Dr. Christine Armstrong, MD '14, are alumnae of the American University of the Caribbean School of Medicine, an Adtalem Global Education institution.
Dr. Christine Armstrong is an obstetrician-gynecologist in Connecticut. Dr. Shanique Ampiah is a pediatric psychiatrist in Florida. Different specialties. Different locations. Both share common ground when it comes to the mental health of moms.
They know that a healthy mom equals a healthy child.
Dr. Armstrong sees the signs of depression during and after the pregnancy. Dr. Ampiah sees the challenges mom face and the impact on the child.
says Dr. Armstrong. “It doesn’t get any easier as she goes through her pregnancy and when she has a new baby.”
How Mental Health Affects Mom and Baby During Pregnancy
A mother’s mental health can affect a developing fetus in a variety of ways, according to both doctors.
Dr. Ampiah notes that when pregnant women struggle to take care of themselves, their prenatal care suffers as well, which can then impact the developing fetus. They don’t see an OB-GYN. They don’t take prenatal vitamins or get diagnosed with diabetes or high blood pressure. That affects maternal mortality, according to Dr. Ampiah, and puts babies at risk for coming early, being underweight, and a host of other complications which can go on to have deleterious effects later in life. In her psychiatric practice, Dr. Ampiah sees children whose lives started this way.
She also emphasizes the impact of stress on mothers, such as access to healthy food or safe living conditions and other social determinants of health—barriers that affect maternal mental health, and therefore, her ability to care for her child during pregnancy and beyond.
says Dr. Ampiah about the effect of stress on the body. “There’s atrophy in the limbic system, which is where the emotions are processed in the amygdala, and in the memory systems of the brain."
To identify stressors, Dr. Armstrong uses depression scales and gets to know moms during their prenatal visits to monitor their mental health. “You have to ask, hey mom, how are you doing?” she says. “Do you have enough support at home? Do you have all the things that you may need to take care of this child once they’re born?”
Addressing Mental Health Stigma
“Obstetricians are the first line for the patient, mother and child, and you need to have an open mind and open arms,” says Dr. Armstrong. This is important because mothers worry about taking depression medications while pregnant or that if they show signs of depression, they’ll be considered unfit and have their child taken away.
Dr. Armstrong works to create an environment where pregnant women and new moms can just say “I’m not OK.” She wants to know if they don’t feel like eating or getting out of bed. Then she recommends resources, makes referrals to mental health providers, and lets them know there are medications that won’t affect their baby.
She recalls one patient who was bubbly and happy during her pregnancy, but admitted after delivery that anxiety and depression from her youth were returning.
“She had this feeling like, I’m a mom, I should be able to handle this. I’m a bad mom if I ask for help,” says Dr. Armstrong. “I told her, you carried a whole human for nine months, and then you birthed this human, and now you have to take care of this human. It’s a lot of work, and you have to give yourself grace.”
After a few weeks on antidepressants, she felt more like herself and was better able to be there for her baby.
‘Serve and Return’: Lasting Impacts on Children
Postpartum depression can isolate mothers from their babies. This disrupts the natural cycle of “serve and return” interactions that foster optimal brain development in babies. The serve-and-return interaction is the back and forth, like a tennis match, of responsive interactions between a baby and their caregiver, for example, a baby cooing and a mother responding with a smile and baby talk.
“That talk back helps to develop a baby’s learning centers and their language skills,” says Dr. Ampiah. If hindered, perhaps by a mother’s severe depression, “children may not receive the input they require and in severe cases, we see emotional development problems stemming from that, and over time, they’re not performing as well academically when they enter school. By the time they’re in adolescence, there’s increased risk of mental health concerns and substance abuse.”
Ultimately, children become adults and some become parents. If there is no intervention, a negative cycle can continue. Due to this, Dr. Ampiah is an advocate for early intervention and believes in having unconditional positive regard for her pediatric patients and their parents—believing that no matter how a child presents in her office, their parent is doing their best with the resources they have. She makes time to check in on her patients’ mothers.
“Sometimes moms need an extra 30 minutes where we just talk, giving her a safe space to vent, while I offer supportive therapy, discuss the importance of parental self-care, and then the next 30 minutes is with the child,” she says.
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