Reproductive risk to maternal mental health: international perspectives

Despite the emphasis placed, in international comparisons of obstetric management, on the perinatal mortality rate as a measure of excellence of care (or otherwise), there has been relatively little discussion of the impact of birth on maternal mental health. When thinking about this issue, we need to consider both the mental state of the mother during the antenatal period as well as the subsequent impact of the birth on her mood and risk of major mental illness. According to the authors contributing to the theme discussed here, that risk is much higher than we might have predicted, in diverse communities in Pakistan, Nigeria and India. None of these communities has access to the professional support services that might ameliorate the consequences of reproductive risk.