Maternal Mental Health Challenges in Urban India: Causes and Solutions Case Study

Empowering Communities to Support Pregnant Women's Mental Wellbeing

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Introduction: Maternal Mental Health Challenges in Urban India: Causes and Solutions

Mental health for a person is extremely important. For a woman who is pregnant,, it is necessary to take care of her physical and mental health. In India, it has been observed that many women are mentally unwell during pregnancy, which affects the growth of the child. A proper approach needs to be taken to take care of the physical and mental health of the pregnant (Tarusina et al. 2023). In India, most of the women suffer from different mental issues and live in urban areas. As per the views of Goyal et al. (2020), neonatal health and growth in India are significantly affected by the perinatal health issues of the mother. The mental health of a pregnant woman depends on different factors like marriage life, economic background, social factors, and also the issues she has faced. Women need to provide proper mental support during the pregnancy. Every person in the family needs to take care of the emotions of the woman and also needs to motivate her.

Recent studies have shown that, in India, perinatal depression among women was found to be approximately. between 14 and 24%. The mental health problems that are co-related to the "perinatal period" are "perinatal anxiety," "perinatal OCD," "postpartum psychosis" " and "postpartum PTSD.". Almost 1 out of every 5 women would experience a mental health disorder during pregnancy or maybe after birth. 20% of the women face suicidal conditions or thoughts during this period. Many psychiatric problems have been observed to be influenced by various factors like burnout or stress due to working excessively. Financial problems, inadequate education, conflicts among generations living together, etc. are extremely common occurrences in a country like India, which contribute greatly to the situation (Goyal et al., 2020). Such mental conditions could have a great negative impact on pregnant women, certainly making their health disorders more acute (Sokolovskaya, 2019). Due to incidents like miscarriage, the stillbirth of the baby, and neonatal death of the child, up to 60% of the parents face the symptoms of depression, post-traumatic stress disorder, anxiety, and other disorders. Despite the prevalence of a higher rate of stress symptoms or posttraumatic symptoms, the perinatal loss is not pictured as the trauma, or the situation is not considered to be traumatic (Niemi et al. 2019). These situations could be said to have an impact on pregnant women. Certain social actions have also been taken by the organisations for the betterment of public health, and their practitioners would help in addressing the consequences.

Main Discussion

Social Determinants of Health

Tackling social determinants of health of the common mental disorders and the sub-threshold mental disorders that are common is the major centre of the paper. According to the opinions of Ghosh and Bhat, (2022), almost 30% of Indian women experienced blues, and half of them went on to fall into “post-partum depression.". This indicates that post-partum blues need proper attention to manage so that the development of such depression can be prevented. The inequalities of systematic between the social class that are being judged to be preventable are unfair and inequitable, so the systematic differences in the health mentally by age, gender, income, ethnicity, geographic area, and education of residence are unfair and can be decreased by the implementation on the social risk factors (Niemi et al. 2019). There is very good proof, for example, that common, mental disorders, such as anxiety and depression, are being issued under the gradient of disadvantage economically across society, and disadvantaged and poor women suffer disproportionately from very common mental disorders and their unfavourable consequences (Sokolovskaya, 2019).

The dominant hypothesis, which links status social and mental disorders, mainly focusses on the frequency, level, and duration of the stressful experience and the extent to which the hypothesis is being buffered by the support socially in the manifestation of informational, emotional, or instrumental resources that are provided by or even shared with others, and by the capabilities of the individual and the method of coping (Novkunskaya 202). As opined by Rahman et al. (2022), intimate partner violence can lead to low birth weight and increased risks of mental health issues. Those who are lower on the hierarchy socially are mostly likely to experience very less favourable social, economic, and environmental conditions all over life and experience lesser access to support and buffers (Niemi et al. 2019). The disadvantages in the life of pregnant women start from birth and tend to accumulate all over life, even though not all individuals with the exposures are similar and have the same vulnerabilities, and some are stronger or have access to buffering and supporting mitigating the effects of the possible mental health of poverty and disadvantage (Sokolovskaya 2019).

The multilevel framework for the consideration of the social determinants of mental disorders can be applied to the interventions and strategies for reducing mental disorders and promoting the mental well-being of pregnant women in urban India (Tarusinaet al. 2023). The important zone is given. The areas are very important for two reasons: they impact the threats of mental disorders and they represent the opportunities for intervening in reducing the risk of mental disorders for pregnant women.

Parental, perinatal periods, pregnancy, adolescence, early childhood, family-building years, working, and older ages are all related to gender and are the life-course social determinants (Niemi et al. 2019). The attitude and behaviours of parenting, material conditions such as income, resource access, nutrition/food, sanitation, water, employment, and housing; the conditions of employment and circumstances of unemployment, mental health and parental physical; care of pregnancy and maternal; and support socially are the activities that are social determinants of the parents, households, and parents (Tarusinaet al. 2023). The trust and safety of the neighbourhood, the participation of the community on the issue of the mental health of pregnant women, crime and violence, natural attributes and built environment, and deprivation of the neighbourhood are the social determinants of the community (Novkunskaya 2020). The provision of education and care in the early years, schools, services for youth or adolescents, care of health, clean water, social services, and sanitation are the social determinants of local services which help in the assistance of pregnant women (Leykinet al. 2022). The reduction in poverty, discrimination, inequality, human rights, governance, armed conflicts, policies of nations in promoting access to education, health care, employment, housing, and proportionate of the services needed, and policies of social protection that are proportionate and universal to the need are the social determinants factors that can assist in the betterment of mental disorders of pregnant women in urban India (Sokolovskaya 2019).

Community Development

Social Action Theory

The theory of social action in motivating the community to get involved in the action, which Max Webber discusses in his action theory, in which firstly he mentioned Aktuelles Verstehen as the understanding of direct observational, where you just need to observe what a person is doing (Novkunskaya, 2020). Like the emotional state of someone from the body language of the person in the paper in which the condition of mental disorders of pregnant women in urban India in accordance with the theory, someone can notice the body language of the pregnant women and can understand the issues of the pregnant women by observing their emotional state. Nevertheless, only observational understanding is not enough to explain social action.

The next theory of social action, whose understanding is from Eklarendes Verstehen, is mainly the empathetic understanding, which sociologists should try in understanding the action of the terms where motivation arises (Leykinet al. 2022). People surrounding them are doing their work in angry mode or enjoying it. To get this, Weber argued that in observing the empathetic understanding, people should get into the shoes of the people doing the work in the paper People surrounding the pregnant women should notice each and every action of the pregnant woman; only then can the issues of mental health be addressed (Leykinet al. 2022).

Diversity/ Values/ Cultural Considerations & Ethics/ Values

The theory of values or diversity or cultural considerations and ethics or the values in which the value theory given by Schwartz in the year 1992 relies on the conception of the values that specify the main features that are implicit in the work of many theorists. The values of beliefs are linked inextricably in affecting (Jaeger et al. 2022). When the values are activated, the values become suffused with feeling. In the paper, the pregnant women are addressing mental health issues being considered, in which the people's independence is the most important value that becomes aroused if the people's independence is being threatened; likewise, in the paper, the pregnant women of urban India are being threatened in different ways, so they are going through the phase of mental disorders (Romanelloet al. 2022). And the pregnant women are helpless in protecting it (Sokolovskaya 2019). Pregnant women must be treated in the right way so that they feel happy and can enjoy every moment of the period of pregnancy that the women going through and their mental disorders can be reduced.

The values refer to the desired goals of the action that motivates people (Romanelloet al. 2022). People following social order, helpfulness, and justice are very important values which motivate to pursue different goals of the people (Jaeger et al. 2022). In the paper, the issues regarding the mental health disorders of pregnant women in urban India have been similar to the situation of the values referring to the desired goals that they too have some desired goal for their life; they are going through the gestation period and for them ((Sokolovskaya, 2019). The social order, helpfulness, and justice from other people will motivate them very much in the way that their mental disorders can be reduced.

Asset-Based Approaches

Empowerment

The health issues that are related to mental issues affect women during their pregnancy period. It is observed in the process of relational factors that are inherited by the person in their personal life (Albahri et al2021). That is also reflected in the social context of resources. This involves a change in the structure of the healthcare goals. The principles involved in the empowerment of the asset approach include: it is a type of power that is empowered into the individual life and that goes on; it is a “relational process” that determines the relationship between the mutual expressive nature of the environment and the person; it is an “ongoing process” that takes place in the form of a change that goes on continuously; and the well-being is also involved in the empowerment (Barmania and Reiss, 2021). Pregnant women are at the stage of life where they have to face ups and downs that cause health issues as well as mental traumas. The at leads to anxiety, depression and nerve problems. Therefore,, the approach of empowerment helps women to encourage their lives during the stage of pregnancy (Harrison et al. 2019). The social actions that had taken place to find out the pregnancy stage of the women in India were mainly in the urban areas where people facing stress issues are common.

Social Capital

Another approach of the asset includes the social capital includes the revenue issues that lead to mental health problems in pregnant women. The maternal stage of a woman undergoes many treatments related to the pregnancy (Warburton and Bredin, 2019). The higher the social capital, the higher will be the access to facilities related to health issues in pregnant women. The more capital, the more will be the healthy pregnancy journey of the women. The women reported they undergo mental issues thinking of the loss of revenue (Albahri, et al2021). These happen in many urban places where the cost rises up to such an extent that one cannot afford such facilities of healthcare. Social capital had a very positive effect during their pregnancy (Omodanet al. 2019). It had been reported that the higher the social capital, the possibility of the decrease in the “post-partum depression scale” that was proved in “Edinburgh’s post-partum depression scale”. Social capital involves a bridge of communication that helps women to lead a healthy pregnancy. That comes from family, friends and social communities (Harrison et al. 2019). The social actions that take place within healthcare also help women to be motivated.

Partnership Working

Community participation & mobilisation

The health issues are further explained in the form of approaches that involve the partnership working procedure (Omodanet al.2019). That will encourage mental health issues. An important feature of the participation of the community through mobilisation in the procedure helps in the empowerment of the actions (Cassetti et al. 2020). That helps in the promotion of change in healthcare, the shaping of the service provisioned as stated by the “Scottish Health Council, 2019,” that helps to gather people for improving the quality of the treatment, and also the confidence of the public in reinforcing the health services (Ahumadaet al. 2021). Community participation leads to a huge geographical area that helps to gather a huge group of people. The approach of community development aims to achieve the voices of the members to make the people aware of the need for change (Harrison et al. 2019). This also helps in tackling any sort of social problems that arise in the process (Albahri, et al2021). According to Fisher, the definition given by him of community development is an approach that helps in the imbalance of power and tackling of the powers that get together in the form of a community.

Public Involvement

The participation of the public in as working participation that helps in the improvement of healthcare services. The public factors help in the change promotion of the service (Kim and Lee, 2021). Public involvement helps in the improvement of the quality of healthcare services, mainly in the case of pregnant women (Ahumadaet al. 2021). The participation of the public in the approach is illustrated in various ways. That includes the involvement of the partnership in the work, control of the citizens, etc.; all these factors were involved in “Amstein’s model” (Cassetti et al. 2020). The key to public involvement is the communication that builds up a strong bridge network to many people. One such barrier that is faced by the socialists in their way of involvement is “health literacy” (Barmania and Reiss, 2021). The barrier is not that important in the urban context of the study of India’s pregnant women (Omodanet al. 2019). However many such high innovations have not reached many people, Public involvement, where the participation of the girls and women of the young generation is highly required in the awareness process (Tan et al. 2021). As this is the case of women, girls of this generation would be the most preferable to perform the task.

Communication

Communication is the bridge that connects numerous people who need help (Britten et al. 2020). Women in urban areas have been found to be very stressed, and the work during the first stage of the pregnancy period becomes a headache for women to handle (Bergerumet al. 2019). Involvement in the community and the people around the women who are responsible for recreating a positive environment (Hassen, et al. 2021). Communication among family members helps one to understand the mental health condition of the women (Kim and Lee, 2021). The bond must be there with the community so that the work they are performing should involve the well-being of the women.

Health Promotion

Health literacy among urban people is higher than among the rural population (Gordon et al. 2020). But the rapid innovation often lacks the knowledge of the female population to know everything, which is why the promotion of healthcare-related promotions is important (Tabvumaet al. 2023). These promotions take place with the help of methods such as medical studies and organisations that take the initiative to publish such articles (Hassen, et al. 2021). Education is the main and most important way of promoting healthcare possibilities and awareness among many people. The promotions are also held with the help of social media platforms where the majority of the population is active at that place. The empowerment approach, as mentioned in the context of the study, helps in the development of the process (Cassetti et al. 2020). The main approaches of the social factor help in the promotion of the study. The more the population is educated with knowledge of the medical issues, the more will the promotion and awareness of the facts (Omodanet al. 2019). The education policy had been given in the classes where the parents are also involved in teaching their children and meanwhile, they also come across the methods and get aware. Health communication helps the community to work smoothly, which helps to create awareness (Ahumadaet al. 2021). Pregnant women are the ones who need to get aware at the very least.

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Conclusion

The study talks about pregnant women in India who need to get aware of the healthcare factors. Mental issues are increasing in pregnant women due to the reason that occurs in urban areas. That might be from work pressure or household-related problems. The study had given a brief description of the topic in the introduction, where the issues had been explained thoroughly. The study had gone through detailed explanations in the form of discussions that included approaches that helped to understand the concept well. Under which the determinants of the social factors that are related to health issues are explained. The involvement of the community and the approaches related to it are mentioned. Mainly, the awareness factors get more importance in every stage.

The importance of the partnership working that helps in the working efficiency that leads to the development of the work in the healthcare centres. The involvement of the public in active participation will help in the growth of healthcare education. The study had given the importance of education related to healthcare awareness mainly for pregnant women in India. The importance of promotion involves various methods of interaction. The key importance of the study came up as communication importance, which is a concern to every field of study and when it comes to bringing awareness. The people who are involved in the participation of healthcare social work should maintain the aim of making women aware. The importance of building up a positive environment is required for pregnant women to lead a good pregnancy stage. The stage is crucial, and the participation of the people around the pregnant woman must be equally aware of the fact.

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