Closing the gap in care for mothers experiencing mental health issues after childbirth

Society generally considers childbirth to be one of the happiest events in a woman’s life. But for some women, it is not possible to enjoy their newborn or their new role as a mother.

No less than twenty percent of new mothers exhibit symptoms of mental health disorders. The condition is generally referred to as ‘postpartum depression’, although the term also covers other disorders.

Untreated symptoms can have a lasting adverse effect on the health of both mother and child. Yet, treatment centres that accept mothers accompanied by their child are rare in Switzerland.

Difficult conditions

A research project on home-based aftercare for women who experience mental health issues after giving birth addresses this issue. The aim is to develop a care model and evaluate how women can receive treatment adapted to their personal situation in the comfort of their homes after their discharge from hospital.

“There is a gap in the healthcare supply chain,” stresses Eva Cignacco Müller, who manages the research project on behalf of BFH with several organisations (see box). “Finding a service that accepts a mother with her child is often a matter of chance.”

According to her, there are barely twenty clinics in Switzerland that offer a few places for mothers accompanied by their newborns, and their rules can have an aggravating impact: “If the mother is unable to care for her child because of her illness, she will not be accepted in the clinic.”

Familiar surroundings create security

The researcher sees great potential in a model that allows women to be treated in their homes. The familiar surroundings help the mother feel safe and stable, explains Eva Cignacco Müller.

This in turn enables her to train the daily tasks that mothers carry out and strengthen the bond with her child. For example, specialists can show her how to respond to her newborn and their needs.

Changing a baby’s nappy, for example, can be so much more than just replacing it with a clean one, says Eva Cignacco Müller: “It is a wonderful opportunity to communicate with the newborn.”

A mother who has perinatal mental health issues can learn to maintain eye contact and consciously babble with her baby. These primal interactions strengthen the bond between mother and child.

No round-the-clock support

Home-based therapy also offers patients a form of mental relief. It reduces the risk of stigmatisation that is often associated with hospitalisation due to mental health issues, explains Eva Cignacco Müller: “As a result, the agonising feeling of failing as a mother right from the start may be lessened.” Last but not least, the mother’s relatives can help her settle into her new role.

Nevertheless, Eva Cignacco Müller also expects challenges in implementing a home-based therapy. Unlike in a clinic, mothers who receive treatment in their homes do not have round-the-clock access to specialist care.

This in turn could increase the pressure and the expectations placed on their relatives. Furthermore, home-based therapy offers no opportunity for group therapy or for discussions with other affected women. It is therefore important to ensure that this form of therapy does not isolate patients, stresses Eva Cignacco Müller.

Test run planned in 2027

The study aims to build the ground for an integrated care model for women who are discharged from hospital with a diagnosis of acute psychological stress after childbirth.

The outline is as follows: a team consisting of specialists in psychiatry, nursing and obstetrics visits the woman regularly in her home while consulting closely with the hospital. The team assesses the woman’s health situation and implements therapeutic measures if required.

In a first sub-study, the researchers have gathered experiences from professionals who currently support postpartum mothers in their homes. Preliminary findings indicate that professionals deal regularly with women with mental health disorders following childbirth and that they encounter challenges in providing adequate care, according to Eva Cignacco Müller.

One reason for this is that the baby’s safety must always be considered. Another key consideration is the point of view of the women affected and their partners. The researchers aim to compile these viewpoints in a second sub-study.

Based on the results of the two sub-studies, the researchers plan to develop a model of care for women facing mental health issues after childbirth and subject it to a test run. Eva Cignacco Müller is confident that a trial could take place in 2027, provided that external funding can be secured.