According to the Iranian Journal of Psychiatry, “The prevalence of psychological birth trauma has been reported at a rate between 20% to 30%,” which can result in mental health complications in new mothers. Often, these complications go untreated. In Iran, the majority of the population is Muslim and views birthing as a sacred and noble act. Over recent decades, infant and maternal mortality during childbirth has decreased significantly, with 95% of births taking place at the hospital.

Despite these positive advancements, the act of giving birth is seen as a practice that only women can witness. Therefore, fathers and male doctors do not partake or aid the mother while she is in labor. Midwives are present at some hospitals, but not enough to attend to every mother. Often, the mothers are left to give birth alone. This instills significant anxiety in new mothers: “According to a study in a health care center in Tehran, 46.5%, 12.1% and 11.1% of mothers experience post-trauma stress disorders, anxiety and depression respectively four to six weeks after a traumatic birth.”

Attitudes Around Mental Health in Iranian Women

Roughly a quarter of Iranian women suffer from mental health complications, such as depression and anxiety. Based on a study in the Iranian Journal of Public Health, women in Iran conceptualize mental health as emotional stability and the ability to function in day-to-day life with a sense of fulfillment. Mental health also includes sound decision-making, a lack of behavioral problems and a healthy family dynamic.

The journal notes, “According to participants’ views, people with high self-esteem, realistic beliefs, sense of control, essence or spirituality are satisfied.” Key concerns regarding mental health include poverty, marital issues, parental divorce, patriarchal attitudes, social stigmas and lack of religion/faith. Many women also believe that personal failings, such as jealousy or egoism, contribute to mental dysregulation.

Demographics and Maternal Mental Health

In terms of maternal mental health in Iran, especially in new mothers, a large theme is a sense of helplessness. In a study by the Iranian Journal of Psychiatry, many new mothers explain that, despite calling for help, they were not given attention. This experience resulted in them feeling alone and afraid. Additionally, they felt that if a birth complication should arise, they would not be assisted, resulting in their death or the death of their child. Many conceptualize this feeling as a “loss of control.”

They also note that the hospitals are not a comforting or suitable environment for childbirth. Some mothers note that this experience dissuades them from wanting to give birth again, resulting in a sense of insecurity. The journal notes that this experience is prevalent across demographics: “Regardless of their education, knowledge, socioeconomic status and place of delivery, they expressed their fear.”

Resources for Iranian Mothers Through Midwifery

Increasing and supporting access to reproductive health resources is the most direct way to accommodate maternal mental health in Iran. A study conducted by the World Health Organization (WHO) urges developing the roles of midwives beyond aiding women in hospitals during labor: “Midwives are well placed within communities; therefore, defining and expanding their roles will result in better accessibility and availability of sexual and reproductive health care.”

Midwives need to be accessible beyond the hospital context and be more engaged on a community level. This can be done through house visits, general education and skill-sharing. The study notes that midwives could also be used as a source of information and education. This would prepare new mothers for labor and inform them of the process prior to their due date. The study also explains that many midwives are given training that they do not implement in the hospital sphere. Ultimately, this results in the loss of these skills. WHO suggests that additional training courses be provided to these midwives, specifically to better deal with pregnancy complications and stressors surrounding labor.

While poor maternal mental health in Iran is a concern, there are accessible modes of combating these complications through education and community. Midwives are a staple in the birthing process. With advancements in the roles of Iranian midwives, new mothers will be better prepared and can avoid unnecessary stressors during childbirth.

– Anna Williams
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