Midwifery, Mental Health and Maternal Journal — an interview with Laura Godfrey-Isaacs
Given the success of the Maternal Journal project (which we have written about previously) as it expands more and more, now feels like the perfect time to catch-up with its creator, Laura Godfrey-Isaacs, to find out more about how the project has snowballed, why it resonates so much with mothers, and why you don’t need to be “good at art” to find value in journaling. This week is Maternal Mental Health week, and today, 4th May, is World Maternal Mental Health Day, the theme for which, this year, is “Stronger Together”. This theme recognises that our journey towards better maternal mental health care will only be productive through collaboration between everyone concerned, including all healthcare professionals who have contact with women in the perinatal period (the period including pregnancy and the first year post-birth). Unfortunately, as many as 1 in 5 women will suffer with a mental illness during this period, most commonly depression and anxiety, but other disorders such as post-traumatic stress disorder and postpartum psychosis are also present. Furthermore, it is likely that rates of mental illness during the perinatal period will have increased during the pandemic, so it has never been more important that appropriate resources and care are available to women. Midwives have a pivotal role to play in this, which is why it’s even more fitting that tomorrow, 5th May, is International Day of the Midwife: a day dedicated to observing the incredible work that midwives do in supporting and caring for women and birthing people, as well as their wider families, at such a pivotal time in their lives. As I reflect this week on the importance of these days, I am pleased to share with you an interview I had with one woman who connects all these things: Laura Godfrey-Isaacs, a midwife and birth activist, as well as an artist and a mother, who is making huge contributions to improving provision and resources for women experiencing mental health problems in the perinatal period. As a researcher in the field of perinatal psychiatry, in 2017, I was offered the opportunity to be included in the pilot phase of a project that she launched, which has now become global: Maternal Journal.
When I asked Laura why she felt Maternal Journal would be of benefit to women, she explained that unfortunately, mental health problems are relatively common in the perinatal period, and, in her practice as a midwife, Laura observes that there are many women who are either currently suffering with, or have a history of, mild to moderate mental health challenges, but who don’t meet the threshold for referral to formal perinatal mental health services. They are therefore cared-for primarily by midwives, with signposting to other support which might be available in their communities.
Laura isn’t the only one who has observed this, and as such, in this area of mental health, as well as across healthcare more generally, there has been a movement towards the inclusion of “social prescribing”, or community referrals, where healthcare professionals may point people in the direction of community groups and interventions to help them with their symptoms, as an addition or alternative to more formal psychological therapies or medication, where it is appropriate for them.
This is where Maternal Journal comes in — the project was first designed as a group set up in South London, where women were brought together to learn journaling techniques, and use these as a basis to explore and share their feelings and experiences around motherhood.
“It seemed like a bit of a no-brainer to me”, Laura said, “because it is building on this legacy of women’s journaling and women’s diary keeping, of which there’s a really strong history. It was an acceptable form for women to write, explore their creativity and express social and political views at a time historically when they didn’t have access to being professional artists, journalists, or poets, so there is a strong tradition, and I think it is rooted in that as a practice for women.”
Inspire the Mind has featured blogs about this project before, but now is an important time to revisit the project, as since then it has expanded greatly, and last year the ‘Maternal Journal’ book was born.
The book has allowed the project to diversify, and while the community element of coming together to be creative and share experiences still remains important, the book, along with the freely-available resources on their website, can act as a companion to women who might want to have a go at journaling themselves, and perhaps even take it on as a lifelong practice after the perinatal period.
I was keen to find out how the project transitioned from being community- and group-based, to include a large element of personal journaling. Laura explained that during the pandemic, as the social isolation of lockdowns made pregnancy and early motherhood even more challenging, her and Samantha McGowan (who took part in the first ever Maternal Journal group) were active in producing resources to help women to find an outlet for their feelings in the form of creative journaling. Calls were put out for artists to produce and share journaling guides, which were then shared for free on social media and their website.
Soon, the team realised that they had curated a large number of resources, and began to consider making a book. With the help of money obtained from arts councils, additional artists were commissioned to create guides which covered a range of styles and genres of artistic practice, from poetry to cartooning and visual art to writing. The aim? To create a collection that was diverse and inclusive, where people could open the book and see people who look and sound like themselves.
The book now contains over 80 contributions from amazing artists, not all of whom are mothers themselves, but who represent a range of voices and experiences of motherhood in all its forms.
As with many “social prescribing” interventions, an important part is ensuring that the activities are accessible to anyone who might get benefit from them. In the case of ‘Maternal Journal’, some mothers may feel reluctant to try activities like this if they are not used to creating visual art or writing. I asked Laura how the project’s ethos of inclusivity had tried to combat this.
“That can be a barrier for people”, she said. “People have been told, maybe at school, that they aren’t artistic, or can’t write, or can’t draw, and they carry that around with them and feel like art is for artists. We don’t believe that — we believe that art is for everyone, it’s a fundamental part of being a human being, and everyone is creative, they just need to find the way that suits them, they need to be supported, and to find a way that’s enjoyable. This isn’t really about making art either, it’s about being creative and exploring your creativity, as we say in the book: ‘this book is for everyone’.”
It is clear from the book that a lot of care has been taken to make the guides user-friendly. Each guide is laid out simply, and accompanied by information on the time needed, the materials required and easy step-by-step instructions. There is artwork from other journals for inspiration, and the book showcases the wide variety of different modalities in which journaling can be done, even including some photography, sewing, collage and a piece from InSPIre the Mind on blogging. The activities are grouped into 5 main themes: beginnings, connection, identity, kindness and moments, so that different aspects of motherhood can be explored.
The fact that the Maternal Journal movement has expanded from being a small group in South London to having groups meeting across the world and a published book, is testament to the importance of offering women and people who birth opportunities to explore and reflect upon not just the medical and physical aspects of becoming a mother and parent, for which our maternity services are generally well-equipped, but also the psychological shifts and challenges of parenthood. As Laura told me, “During pregnancy and the first few years of motherhood and parenting, you go through such enormous physical mental, and social changes. So, it’s a good thing to try and document that, to note what’s going on and have a way in which you can explore it and reflect on it. It’s also a time when you’re often reflecting back on your own childhood and how you were parented, and projecting forward to thinking about what kind of parent you want to be, so there’s an enormous amount going on and it’s great to have a space where you can unpack a lot of that.”
This Maternal Mental Health Awareness Week, perhaps we should be reflecting on what more can be done not just to support women with severe and debilitating mental health problems, although of course that’s incredibly important, but also to normalise the idea that all parents will experience challenges in their journey of parenthood, and coming together to share stories, perhaps using creativity to explore experiences and emotions, can be of great benefit to mental wellness for everyone.