Speaker
Description
Introduction
In South Africa, it is estimated the 1 in 3 women experience a common mental health disorder in the perinatal period . Despite supportive national policy to integrate mental health into maternal care pathways, the wellbeing of mothers is often overlooked, particularly in rural mining communities where mothers face a confluence of socio-economic hardships, cultural pressures, and inadequate support systems.
Through a strategic partnership between The Healthy Brains Global Initiative, Right to Care, and Anglo American we have started to transform this environment to one where mothers and their babies can thrive. Our Mma wa Nnete (Real mothers) programme leverages outcome-based contracting and performance management to improve the mental wellbeing of mothers driven by the needs and outcomes that they have identified as most meaningful to them.
Methodology
We started our pilot with a discovery phase into the mental wellbeing needs of mothers and the ecosystem around them. The insights were gathered using a human-centered design approach through immersion interviews and focus groups with 54 mothers, healthcare workers, and community leaders.
Results
The main influencers on maternal mental wellbeing in these communities was found to be:
1. People: A mother’s wellbeing is heavily influenced by their immediate social environment. Dysfunctional family dynamics and problematic partner relationships emerged as significant stressors, contributing to feelings of rejection, abandonment, and neglect.
2. Preparedness: Many mothers felt unprepared for the emotional, financial, and practical challenges of motherhood. This heightened their vulnerability to stress and anxiety.
3. Loss: Mothers frequently reported experiencing a loss of identity, freedom, and connection to their former selves. The loss of educational and career opportunities deepened their sense of despair.
4. Isolation: Isolation was both a symptom and a cause of distress. This isolation frequently escalated into loneliness, despair, and even suicidal thoughts. Limited isolation was sometimes used as a healthy coping mechanism.
5. Emotional Awareness: Mothers struggled to articulate their emotions, often defaulting to English terms instead of their mother tongue. A sense of vulnerability and mistrust in discussing dark emotions was pervasive, partly due to fear of gossip or judgment.
6. Lack of Emotional Inquiry: A significant finding was the lack of emotional inquiry by healthcare providers, with full focus being on the baby. This lack of curiosity and individualized care contributed to feelings of being misunderstood and unsupported.
Conclusion
In these communities in Limpopo, a mother’s wellbeing is predominantly influenced by family dynamics, partner relationships, and social circumstances. Most mothers felt stressed and helpless around the time of childbirth. A programme to support the mental wellbeing needs of mothers in these communities would need to cover the key aspects of; 1) better connected relationships – with family, partners, and healthcare providers. 2) Supporting the mother to feel prepared – financially, emotionally, and with health knowledge and 3) helping mothers retain and regain their freedom, dreams and sense of self.
