The Unspoken Struggles of Motherhood: A Call for Perinatal Mental Health Reform - July 9, 2010

Motherhood is often painted as a time of radiant joy and tender connection, with glowing mothers and cooing babies gracing baby shower cards and social media feeds. But for thousands of women like Karis from Basingstoke, Hampshire, the reality is far more complex. Her story, recently covered by the BBC, offers a raw and courageous glimpse into the rarely discussed world of perinatal mental health—the emotional and psychological challenges women face before and after giving birth. Her experience is not an anomaly. It is a testament to a mental health crisis hiding in plain sight, one that demands a deeper cultural reckoning and systemic reform.

Karis’s journey began like many others—with the birth of a child. But instead of joy, she was overwhelmed by confusion, fear, and intrusive thoughts. She described feelings of detachment from her newborn, Noah, even stating that she "didn't want to be his mum." These aren’t words you hear often, because most women who feel them are too afraid to say them. The stigma surrounding maternal mental health is so strong that even acknowledging the struggle can feel dangerous. Karis feared that if she opened up, her child might be taken away. And that fear, sadly, is not uncommon.

Intrusive thoughts, such as imagining harm coming to your baby—or even that you might be the source of harm—are terrifying symptoms of disorders like postpartum depression (PPD) and postpartum obsessive-compulsive disorder (OCD). These thoughts do not mean a mother is dangerous or evil. Rather, they are distressing signs of an overwhelmed, suffering mind in desperate need of care and support. And yet, too often, women endure in silence. The shame is deafening. The fear is paralyzing. And the cost is staggering.

According to Dr. Alain Gregoire, consultant perinatal psychiatrist and president of the Maternal Mental Health Alliance, up to 25% of women experience perinatal mental health problems, yet half go undiagnosed. Why? Because our healthcare systems, even when well-intentioned, still prioritize physical over psychological care. Routine prenatal checkups monitor fetal growth and maternal blood pressure, but they rarely include consistent, empathetic conversations about mental health. Karis said that if someone had simply asked her at every appointment how she was feeling, she might have opened up sooner. That one change—embedding emotional check-ins into routine care—could be the key to saving lives and restoring families.

The NHS has made significant strides in expanding access to perinatal mental health services, with over 64,000 women accessing specialist care in the past year alone—a 112% increase over five years. This is heartening progress. Multidisciplinary teams now include psychologists, peer support workers, and midwives dedicated to supporting a wide range of mental health concerns, from prenatal anxiety to postpartum psychosis. But while access is improving, early identification remains a massive hurdle. Many women, like Karis, don't seek help until they are in crisis. They are too ashamed to speak. Too afraid to be misunderstood. Too alone to reach out.

That’s why stories like Karis’s matter so deeply. They not only break the silence but also build a bridge for others to find their voices. When she speaks about thinking her baby was the devil or wanting to harm him, it is not a confession of danger—it is a cry for help that was finally answered when she connected with a perinatal mental health team. The courage to share her truth is part of her healing, and also a lifeline to other mothers quietly enduring the same.

There is also a crucial gendered element here. Women are socially conditioned to equate motherhood with unconditional love and endless self-sacrifice. When those emotions don’t show up on schedule—or when darker thoughts take their place—many women internalize that something must be broken within them. But mental health disorders do not discriminate, and hormonal shifts, trauma during childbirth, lack of sleep, and identity transitions all converge to create the perfect storm for psychological distress. In fact, the perinatal period is one of the most vulnerable times for a woman’s mental health.

Karen Sims, a clinical nurse specialist in perinatal mental health, pointed out that pregnancy and early parenthood can be “overwhelming”—a word that might feel like an understatement to those who have lived it. The overwhelming moments don’t just come from dirty diapers and sleepless nights. They come from losing touch with yourself, from grieving your former identity, from carrying the enormous and invisible weight of being everything to someone else while feeling completely alone.

The loneliness Karis describes—despite having a supportive partner—is particularly telling. Mental illness isolates. It whispers, "You're the only one who feels this way. You're failing. You're unfit." But the truth is that Karis is one of thousands, and she didn’t fail—her system did. Society failed her by not normalizing these conversations. Healthcare systems failed her by not checking in often enough. And stigma failed her by wrapping shame around her very human, very treatable experience.

So where do we go from here?

First, we must embed mental health screenings into every prenatal and postnatal visit—not as an afterthought but as a standard part of care. Every midwife, OB-GYN, and primary care provider should be trained not only to ask the right questions but also to listen without judgment. Second, we must amplify stories like Karis’s to dismantle stigma and replace shame with solidarity. When women hear, “You’re not alone,” from someone who’s walked through the darkness and come out the other side, it can be life-saving. Third, we must create easily accessible, visible paths to care. No one should have to find support; it should find them.

Lastly, we need to collectively redefine what it means to be a “good mother.” A good mother is not someone who never struggles. A good mother is someone who seeks help when she needs it, who endures despite pain, who learns to love through the fog. Karis didn’t fail as a mother when she had those thoughts—she triumphed when she spoke them aloud.

Motherhood, like mental health, is full of contradictions: joy and grief, connection and detachment, strength and vulnerability. It’s time we allowed all of those truths to coexist. It’s time we stopped expecting perfection and started building systems that honor the complexity of the perinatal journey.

Because no woman should have to whisper her pain in fear. She should be heard—loudly, clearly, and compassionately. Just like Karis.