Bad Mother: How Maladaptive Maternal Cognitions and Negative Self-Evaluation Contribute to Perinatal Mental Distress in Aotearoa New Zealand

The high rates of perinatal distress globally, and in Aotearoa New Zealand, are cause for concern. The numerous and substantive adverse outcomes of distress and depression on women, infants, and their families/whānau in the perinatal period make it imperative that we look beyond general risk factors that we may not be able to change, to identify modifiable factors, including psychological factors and mechanisms, that can help us predict and treat depression in pregnancy and after birth. Through two separate studies, one longitudinal and one cross-sectional, with community samples of postnatal mothers/birth parents aged over 18 years of age in New Zealand, we investigated the role maladaptive maternal cognitions, negative self-evaluations of the self as ‘mother’, and maternal shame play in postnatal distress. In Study One, we found maladaptive maternal attitudes were strongly associated, both concurrently and over time, with increased postnatal depression symptoms. Not unique to depression, this association between maladaptive maternal attitudes and postnatal distress partially extended to anxiety and suicidal ideation. In Study Two, we replicated the findings of Sonnenburg and Miller (2021) that a greater discrepancy between an individual’s maternal self-concept and ‘good mother’ ideals was associated with increased postnatal depression symptoms. This association was fully mediated by maternal shame. Cognitive therapies, including Cognitive Behavioural Therapy (CBT) and Acceptance and Commitment Therapy (ACT), and interventions focused on compassion and self-acceptance could prevent or treat perinatal depression and associated distress, by equipping mothers/birthing parents with psychological strategies and skills they can use to address unhelpful negative cognitions related to maternal self-concept and reduce associated shame.