Innovation UnitMai te whai-ao ki te ao mārama
Submission # 48
Publication – Pukapuka
Impact – Social Good
Identity – People & Culture
Mothers' mental wellbeing during the perinatal period is a significant public health concern.
1 in 5 expecting or new mothers will experience mental distress, and, if left untreated, the impact on mothers, their pēpi/baby and whānau can be devastating. However, almost half of mothers won’t seek help due to fear of having their child taken away, and of those who seek help, two-thirds experience delayed diagnosis and treatment. New Zealand’s rate of maternal suicide is seven times that of the UK, with 57% of those who died by suicide in pregnancy or within 6 weeks after birth being wāhine Māori.
The Health Promotion Agency | Te Hiringa Hauora (HPA) embarked on a journey to understand how it might contribute to improving the social, emotional and mental wellbeing of mothers in Aotearoa. To start this journey, HPA asked Innovation Unit to help them hear from mothers who experienced mental distress during pregnancy and/or during the first year after their baby was born. In particular, they wanted to understand the experiences and perceptions of wāhine Māori māmā / Māori mothers.
This insights report is a reflection of the stories we heard from mothers across Aotearoa, and was foundational for HPA to consider how they could contribute to supporting mothers and their whānau during this significant period of change. We then supported them to use the insights and opportunities we identified to co-design and test new potential solutions alongside mothers and health professionals.
The intention was to share the diverse experiences of women in relation to mental distress, healing and wellbeing when becoming a mother.
We especially wanted to capture the experiences and mātauranga of wāhine Māori māmā which was not widely documented to date. It was important to honor mothers’ stories in relation to their identities as wāhine Māori, such as using their wisdom and words throughout instead of medical terminology, and including the intergenerational impact of colonisation on their experience of seeking help through an already challenging time. We also wove throughout the report what we had learnt at the hapū wānanga about kaupapa Māori birth and wellbeing concepts. This included comparing women’s experiences with the Māori creation story, which ultimately informed the name of the report.
We also wanted to portray the visceral experiences of the mothers, their vulnerability, and their resilience in a way they could be proud of, and that other mothers could relate to. One example of this was using a water motif throughout. Many of the ways mothers described their distress and healing was like navigating a stormy sea - from calm waters, to choppy waves and losing control, going under and feeling completely overwhelmed and hitting “rock bottom” before finally coming up for air.
Our hope was that by bringing mother’s stories to life in a human-centred, engaging and accessible way, the insights would be used by others in the perinatal sector to consider how they too might better support mothers and whānau through this time.
We interviewed 17 mothers across Aotearoa with diverse experiences of mental distress, and attended a hapū wānanga to learn about kaupapa Māori approaches and values around the birthing experience. We analysed common themes and differences between mothers' experiences, such as what helped or got in the way of them feeling well or seeking help throughout the perinatal period. Working with an illustrator, we created a highly visual report to share back what we had heard, including a set of personas and a help-seeking process map. After sharing the report back with the mums involved to check we had honoured their stories, we used these outputs to inform a co-design process with mums and health professionals.
The power of how the stories were communicated means it has become an important document for the perinatal health sector. It informed the Mental Health Commissioner’s 2020 report on New Zealand’s mental health services and addiction services, and has been used by HPA to prioritise women’s voices in decision making processes, including HPA’s COVID19 response, comms and marketing.
Having mothers involved as key partners throughout the process challenged assumptions of what might help mums and families through this time. With more than 100 individuals and organisations directly engaged in the project, the work set up Te Hiringa Hauora to explore new partnerships moving forward. The organisation is now working with mana wāhine across Aotearoa who are already supporting mothers and whānau in their communities, some of whom were involved in this original project.
"Good example of collaborative process-orientated design outcomes. Presents narrative and wānanga findings in a digestable way."
"Another great example of community-led design, condensed in a publication, to address the complex situation of perinatally.
To me, the lengthy process of collaboration through listening and responding is to be celebrated.
It highlights the fact that designers have a lot to learn from their audience and society. I personally feel that it is easy to be trapped in a design for designer bubble. These initiatives put us back in the role of transmission."
Credits & Collaborators: Copywriting - Rachel Knight, Kataraina Davis Illustrator - Fern Grant Designer - Rachel Knight Editor - Rachael Neumann, Daniella Radaelli, Emily Preston Studio Manager - Aimee Hadrup
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