Mi discurso en el Parlamento Europeo con Make Mothers Matter

El pasado lunes 22 de septiembre participé en un evento en la sede del Parlamento Europeo en Bruselas organizado por la ONG Make Mothers Matter para presentar su informe sobre el estado de la maternidad en Europa. Estas fueron mis palabras:

Over recent years we have seen an amazing body of research regarding the maternal brain, the neurobiology of birth, breastfeeding and attachment, and the neuroscience of nurturing. It is beautiful!

Modern neurobiology shows us how all human beings are born in love with their mothers. This knowledge is crucial to understand and cover universal infant needs: all newborns expect to be close to their mother, with intimacy (skin to skin), and to be breastfed. They also need her loved one to be well. These are the foundations of our mental health: this ongoing attachment relationship as John Bowlby anticipated in his speech at WHO in 1952.

Pregnancy transforms women´s bodies and brains. Maternal brain transformation, also known as matrescence, implies an improvement in the areas involved in empathy and mentalization: mothers are wired to put their children’s needs first, to care for them, to protect, to enjoy and to love them.  LOVE is the most critical ingredient of human development.

Matrescence implies an increased vulnerability. Why? Although all mothers undergo this transformation to love their babies, many of them struggle and suffer as a consequence of not being able to fulfill their infant´s needs.

While human biology, through millions of years of evolution, has designed motherhood to be loving and joyful, our societies place mothers in an impossible dilemma, dictating rules and pressures that go in the opposite direction of our biological programming besides leaving the most vulnerable ones alone, or worst, blaming them for not being good enough mothers. This pressure is best illustrated by the numbers: at least one in 5 women will suffer a perinatal mental disorder and 7 in 10 will hide their symptoms. Depression and anxiety during pregnancy can cause obstetrical pathologies, such as prematurity or hemorrhage. Suicide is a leading cause of maternal death in the year that follows birth. Gender violence worsens during pregnancy. Pregnancy is such a precious time with a specific psychological process and increased sensitivity: ambivalence, psychic transparency require time to rest, to be creative…The arrival of a new member to a family is the best time to stop the intergenerational transmission of violence, that´s why we also need to listen to and include fathers from pregnancy.

These are critical times. The hypermedicalization of pregnancy and birth, together with job insecurity and the lack of proper emotional support, leaves many pregnant women excessively worried and facilitates anxiety and stress. 1 in 4 or 5 pregnancies end in miscarriage or stillbirth but the profound grief of many mothers often goes unseen. Furthermore, obstetric violence leaves many mothers traumatized. As a result of birth trauma, often caused by mistreatment, one in 3 mothers will develop PTSD symptoms. Their infants, partners and families will be impacted. Having a premature or sick infant increases stress, unfortunately most hospitals still do not apply optimal family centered models of care for babies in Neonatal Intensive Care Units (NICUs).  Most mothers want to breastfeed, but many don’t find the support they need and end up frustrated, which again creates guilt and sorrow. The industry of milk substitutes is a growing business and the IBFAN code (International Code of Marketing of Breast-milk Substitutes) is not always respected.

No wonder mothers are exhausted and overwhelmed! So many of them don’t even have the energy to ask for support as they are swallowed by a patriarchal system that does not value care nor honors motherhood.

To change this, mothers need to be supported, listened to, cared for, and celebrated from pregnancy on. All mothers and infants deserve exquisite, delicate, compassionate care from conception on. A care that gives mental health the same consideration as physical health.

We need to start asking mothers what they need, and make their voices be heard as MMM is doing today. We need to be very creative, to imagine a society where infants and children are welcomed everywhere, and their mothers and fathers supported. Where mothers can truly enjoy the gift of giving life and be valued for it. We need to think big and think of how the entire society can put the care of the most vulnerable ones at the very center.

1. The very first step towards change is a human rights issue: ensuring respectful maternity care, which means eradicating mistreatment and obstetric violence[1].
2. Prioritize respectful and compassionate care for the most vulnerable dyads: migrant and refugee mothers, for those living in poverty, for mothers of sick infants, for single and teenage mothers or those struggling with mental health problems.
3. We need to train mental health professionals and maternal health professionals, but not only, also social services and the whole society, in perinatal mental health, to make sure the most vulnerable mothers, often sexual abuse survivors and or victims of gender violence can access support without being criticized.
4. As the leading cause of late maternal death, perinatal mental illness must be front and center in maternity care. We have to make sure all women experiencing complex and severe mental health problems can access the right care at the right time.
5. Develop specialized perinatal mental health programs at all levels. This includes opening mother-baby units (MBU) in all European countries, so mothers who need an inpatient treatment can benefit from it without being separated from their infants.
6. Support motherhood from before conception. Young European women face critical decisions regarding their wish to become mothers, some will delay it or give up because of a scarcity of resources. (Others will try later facing difficult assisted reproduction processes, which in many cases are guided by profit driven companies that facilitate reproductive exploitation). Make educational centers and faculties mother and baby friendly so mothers can continue their studies and follow their dreams.
7. Improve breastfeeding support. Make IBFAN CODE (International Code of Marketing of Breast-milk Substitutes) mandatory. Develop policies at all levels that welcome breastfeeding moms and children, that ensure women can return to work and continue lactating as long as they wish. Find ways to thank mothers for the huge effort and investment implied in breastfeeding, that prevents so many diseases and reduces sanitary expenses. Train healthcare professionals starting on college levels (medical school, nursing school). Make sure fathers to understand their crucial role supporting breastfeeding.
8. Let´s not forget mothers who are grieving their stillborn babies of whose babies died. Let´s promote trauma informed guidelines for perinatal care that include perinatal loss.
9. Support and protect mother-infant dyads beyond infancy, specifically mothers and fathers of children with chronic illness and disabilities.
10. Abolish surrogacy and all forms of reproductive exploitation.

Promote always the most compassionate, exquisite, delicate care to all mothers, prioritizing the most vulnerable ones. Let´s this love between newborns and mothers happen, grow, and expand through our entire lives and societies.

[1] EU report ( Obstetric and gynaecological violence in the EU – Prevalence, legal frameworks and educational guidelines for prevention and elimination. Requested by FEMM COMMITTEE, APRIL 2024)