The tragic reality faced by many families after childbirth is coming into sharper focus, with the latest research and high-profile personal accounts underscoring a crisis: the mental health of new mothers, particularly those facing postpartum psychosis, remains dangerously overlooked. A recent heartfelt piece in The Independent tells the story of Rich Baish, whose wife developed severe anxiety and exhaustion after the birth of their daughter. Despite noticing troubling changes, Rich and his wife—like so many parents—did not understand the signs of postpartum psychosis, a rare but life-threatening condition. Within a month of giving birth, she took her own life, leaving a family shattered by grief and questions about how such tragedies continue to happen despite being preventable.The Independent
This crisis is not limited to the UK. The phenomenon of postpartum mental illness—ranging from depression and anxiety to the most severe form, postpartum psychosis—kills mothers across the world. Suicide remains the leading cause of maternal death between six weeks and one year post-birth in the UK, accounting for nearly 39% of maternal deaths in this period. Startlingly, most of these women had no previous history of mental illness, and many families are unaware of early warning signals until it’s too late.ScienceDirect article PubMed review.
Why should Thai readers care? Thailand faces similar challenges. Research conducted by Thai scholars and published in local and international journals highlights that perinatal mental health disorders, including postpartum psychosis, can greatly affect Thai mothers. The consequences are twofold: the risk to the mother’s own life and well-being, and substantial emotional and developmental risks for the child. A cross-sectional survey during the COVID-19 lockdown found rising rates of depression and anxiety among Thai new mothers, with social isolation, economic stress, and stigma making matters worse.MDPI ThaiJO
Postpartum psychosis is often misunderstood, with public awareness lagging far behind the severity of the risk. Affecting around 1 in 1,000 new mothers, symptoms usually emerge within two weeks of childbirth and can include mania, delusions, hallucinations, confusion, and insomnia. The course of the illness is rapid, with declines sometimes taking place over just 72 hours, as in Rich Baish’s account. Cases cited in The Independent and by global maternal health organizations show how symptoms can be minimized or mistaken for “baby blues”—leading to fatal outcomes.
“I knew something was wrong, but I thought it was normal exhaustion,” Rich Baish told The Independent, echoing what many partners and family members have reflected after maternal suicides. Dr. Jess Heron, CEO of Action on Postpartum Psychosis (APP), notes, “The complete absence of women’s stories combined with sensationalist reporting of postpartum-related tragedies in the press has led to poor public understanding, insufficient medical knowledge, and women carrying shame and trauma for their lifetime.” Dr. Susan Hatters Friedman, a psychiatrist specializing in maternal mental health, has also warned that the lack of recognition, as seen in the US where postpartum psychosis is not even officially listed in the psychiatric manual, hinders rapid diagnosis and lifesaving interventions.The Independent
Thailand faces its own forms of stigma and a longstanding culture of “saving face,” which still prevents open conversations about mental health, especially postnatal mental illness. Many Thai mothers avoid reporting mood or behavioral disturbances for fear of being labeled as a “bad mother” or bringing shame to their families. Studies from the Thai Journal of Obstetrics and Gynaecology confirm that, locally, postpartum mental health screening is sporadic and often limited to overt depression, rarely including discussions of psychosis or suicidal thoughts.ThaiJO
Globally, the response to postpartum mental health is evolving, but gaps remain. In the UK, mother-and-baby psychiatric units (MBUs) provide specialized care that allows mothers with postpartum psychosis to remain with their infants during treatment—an evidence-based approach shown to improve outcomes. Unfortunately, such units are rare outside of Europe and even less accessible in Asia, including Thailand. Without such facilities, mothers are often separated from their infants during psychiatric admissions, increasing stigma and potentially impeding recovery.PubMed Central
Historical perceptions of women’s mental health also weigh heavily. Documentaries and films explored in the article, like “Witches” and “Wild Animal,” highlight that societies have long demonized or dismissed women’s suffering, labeling mothers with intrusive or delusional thoughts as “witches” or “unfit.” Contemporary Thai culture, while no longer steeped in literal witch-trials, still struggles to reconcile traditional notions of motherhood’s virtues with the reality of maternal mental illness. This generational silence compounds the isolation felt by afflicted mothers.
Thailand’s public health officials have made some progress, especially since the COVID-19 pandemic drew attention to maternal mental health strain. National campaigns now encourage postpartum home visits by nurses and health volunteers, and postpartum depression questionnaires (such as the Edinburgh Postnatal Depression Scale) are increasingly used in large hospitals.MDPI However, systemic barriers linger: primary care workers receive little training on severe postpartum mood disorders like psychosis; psychiatric services are frequently available only in major urban hospitals; and, due to shortages, public messaging still shies away from graphic risks for fear of scaring expectant mothers.
Expert recommendations converge on the need for better awareness, rapid intervention, and destigmatization. “It is a curable illness, but it’s also a medical emergency—one that should be taken as seriously as a heart attack,” Rich Baish urges. Psychiatric experts and advocacy groups like APP and the Maternal Mental Health Leadership Alliance call for integration of perinatal mental health screening into antenatal and postnatal care, public education campaigns, and investment in specialized mental health services for mothers.APP MMHLA
Practical steps for Thai readers, especially expectant families, include: educating oneself and loved ones about the range of postpartum mental health issues beyond “baby blues”; seeking help immediately if disturbing symptoms such as paranoia, hallucinations, or sustained insomnia appear; and pushing for greater openness in local communities and healthcare settings. If severe symptoms arise, same-day specialist psychiatric care is critical to prevent tragic outcomes.
Thailand’s Ministry of Public Health and public hospitals should prioritize development of mother-and-baby psychiatric units and integrate mental health assessments and counseling into universal postpartum care, particularly in the first few weeks post-birth when risks are highest. Community and religious leaders can help de-stigmatize maternal mental illness by sharing stories and supporting affected families—เปลี่ยนความเงียบเป็นความเข้าใจ (let’s turn silence into understanding).
As Thailand modernizes its healthcare system, we have a cultural and medical opportunity: increase public conversation about postpartum mental health, improve screening and access, and save lives. The pain of stories like Rich Baish’s must fuel policies that ensure no new mother suffers in silence and no family loses a loved one to a preventable tragedy.
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