2024-10-28 13:00:00
A mother and her baby in the parent-baby hospitalization unit, which cares for five women and their babies, at the Bichat-Claude-Bernard hospital, in Paris, September 18, 2024. JULIE BALAGUE POUR “LE MONDE »
Anne-Laure Sutter-Dallay, child psychiatrist at the Charles-Perrens hospital center in Bordeaux, professor of perinatal psychiatry, discusses the psychological suffering that can accompany motherhood. Although these affect a majority of women with a psychiatric history, the perinatal period and the brain mutations that accompany it make all women vulnerable. Hence the importance of screening and prevention.
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How were mother-child units developed in France?
In France, the provision of perinatal psychiatric care has been developing for ten years: mother-child units, which deal with the most serious situations, but also day hospitalization, mobile teams, etc. All these structures offer gradation of joint care, to the mother suffering psychologically, to the child who may have behavioral characteristics to be treated. And allow this link to be healed.
Do these systems primarily target women suffering from a psychiatric disorder?
There are different types of patients seen in these units. The majority have a psychiatric history, such as a psychiatric illness (bipolar disorder, schizophrenia, etc.). But these antecedents can also be mild, such as occasional episodes of depression, during adolescence, or repeated psychological follow-up, without treatment.
Some women will develop a disorder during pregnancy or birth. Finally, independently of any disorder, psychological suffering can also be the consequence of difficult external events, such as the loss of a job, bereavement, etc. All signs of vulnerability must therefore be viewed with great attention.
The perinatal period is a magnifying glass for psychological disorders, it is a time when the brain undergoes profound changes, to adapt and become extremely sensitive to all the signals, particularly emotional, from the baby. It therefore becomes more fragile and all women are vulnerable during this period.
Suicide has become the leading cause of maternal mortality, according to a Public Health France study published in April. Has perinatal psychological suffering worsened in recent years?
For forty years, the figures on perinatal depression have not changed. There is no worsening, just a stronger spotlight. Between 10% to 20% of women suffer from it. Maternal suicide is not new either, but in France it was not previously explored as a cause of maternal death.
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**Interview with Anne-Laure Sutter-Dallay, Child Psychiatrist and Professor of Perinatal Psychiatry**
**Interviewer:** Thank you for joining us, Dr. Sutter-Dallay. Can you start by explaining the psychological challenges many women face during the perinatal period?
**Anne-Laure Sutter-Dallay:** Thank you for having me. The perinatal period, which includes pregnancy and the first year postpartum, is a time of significant emotional and psychological change. Many women experience mental health challenges due to hormonal shifts, life stressors, and the physical demands of motherhood. For those with a psychiatric history, the risk of severe issues increases. However, it’s essential to recognize that even women without prior mental health issues can be vulnerable during this time.
**Interviewer:** That sounds concerning. How have mother-child units developed in France to address these issues?
**Anne-Laure Sutter-Dallay:** Over the past decade, France has made substantial strides in providing perinatal psychiatric care. We have developed specialized mother-child units that cater to the most serious psychological conditions, as well as offering day hospitalization and mobile support teams. These facilities are designed to provide gradual and integrated care, not only for mothers dealing with psychological distress but also for children showing behavioral difficulties. This approach is crucial for healing the mother-child bond.
**Interviewer:** Are these units primarily focused on women with known psychiatric disorders, or do they serve a broader population?
**Anne-Laure Sutter-Dallay:** Our units are equipped to handle a diverse range of cases. While we do see many women with diagnosed psychiatric disorders, we also support those experiencing more general emotional distress related to motherhood. Our goal is to create a safe environment where all mothers can receive the help they need, even if they don’t have a formal diagnosis. It’s about prevention and ensuring all women have access to the right resources during this vulnerable time.
**Interviewer:** Screening and prevention seem critical in this context. Can you elaborate on the importance of these measures?
**Anne-Laure Sutter-Dallay:** Absolutely. Early screening for mental health issues can significantly improve outcomes for mothers and their infants. By identifying those at risk, we can implement preventative measures that may alleviate the intensity or duration of suffering. Our approach is proactive, emphasizing the need for awareness and open conversations about maternal mental health, which can help reduce stigma and promote timely interventions.
**Interviewer:** Thank you for shedding light on this important topic, Dr. Sutter-Dallay. It’s vital to create supportive environments for mothers and their children.
**Anne-Laure Sutter-Dallay:** Thank you for bringing attention to maternal mental health. It’s a critical aspect of overall family well-being.
