Bringing to light distress and healing in early motherhood


With Te Hiringa Hauora | Health Promotion Agency , New Zealand

A new report by Innovation Unit ANZ shares mothers’ experiences of distress and wellbeing during pregnancy and the first year of motherhood.

Becoming a mother – and a whānau/family – is a huge transition, and mums’ wellbeing during pregnancy and in the first year of baby’s life is a significant public health issue.

The problem

1 in 5

expecting or new mums will experience mental distress

Almost 1/2

of mums won’t seek help due to fear of their child being taken away


of those who seek help will experience a delayed diagnosis or treatment

x 7

New Zealand’s rate of maternal suicide is 7x that of the UK

10 to 20% of women will develop some form of mental distress during their pregnancy or within the first year after having a baby. Left untreated, these issues can have a devastating impact on mums, their pēpi/baby and their whānau. Mums’ mental distress has been shown to compromise the emotional, cognitive and even physical development of their pēpi, with serious long-term consequences. The good news is that, with the right support as well as improving their social and physical environments, women and their families can recover.

In April 2019, Te Hiringa Hauora | Health Promotion Agency embarked on a journey to understand how it might contribute to improving the social, emotional and mental wellbeing of mothers in Aotearoa, and commissioned the Innovation Unit to help them to ensure that mother’s voices were at the heart of this process.

Our approach

To first understand mums’ experiences of mental wellbeing and distress, we spoke with 17 māmā across Aotearoa, with a particular focus on wāhine Māori mums. We also attended a hapū wānanga/antenatal class in Kawakawa, where we spent time with mums, hapū wāhine and whānau to learn about kaupapa Māori approaches, values and concepts around the birthing experience.

We created a highly visual report to share back what we had heard, including a set of personas and a process map showing the barriers and enablers for mums to seek help when experiencing distress.

We then shared this back with the mums involved to get their feedback, and held a workshop with mums, health professionals and creative thinkers to share the research and come up with a range of new ideas for Te Hiringa Hauora to explore. We developed and quickly tested some promising ideas with mums, health professionals and potential partners, and consolidated their feedback along with recommendations for Te Hiringa Hauora to consider as part of their wider work with partners to support positive maternal mental health and wellbeing.

Mums and health professionals read through the research insights at a workshop in Wellington.

What we learnt

We learnt a lot about the realities and challenges of motherhood, including the following eight key insights, which are further explored in the research report:

  1. Becoming a mother amplifies existing anxieties, stress, and past trauma
  2. Assumptions – from self and others – stop mums from asking for or accepting help
  3. Reliable support people are key, but who that is can be different for everyone
  4. Loneliness can have many faces
  5. Mums can be deeply afraid of formal support services and spaces
  6. The invisible line between what is and isn’t normal means mums don’t know when to ask for help, and
  7. Seeking formal support can fundamentally challenge mothers’ identity as Māori

“[My] mum protected us from Māori culture and language because in her time it was frowned upon to be Māori... So when it came to getting help now, I didn't feel like I fit with kaupapa Māori or mainstream services. I was torn about where to put myself.” Māori māmā


Having mothers involved as key partners throughout the process helped challenge assumptions of what might help mums and families through this time. More than 100 individuals and organisations were directly engaged in this work through interviews, workshops, updates, and giving feedback on ideas, and it has set up Te Hiringa Hauora to explore new partnerships moving forward. Te Hiringa Hauora staff were also engaged at key stages in the project, which helped the wider team experience a new way of working and consider future opportunities for the organisation.

Click the image to download the full report.