must admit up front that I feel quite conflicted about celebrating the various global annual days. While they offer a chance to highlight key societal issues in a hope to shift policy and nudge systems change, often these occasions are relegated to check-box functions for both the individual and on organised platforms. I no longer want to be content or have a feel-good moment after creating a message for mental health day, nor do I want to sleep well at night because I spoke to a group of already inspired women on IWD. So, I generally hibernate these days off. World Health Day, with a focus on maternal and newborn health feels like an exception. Here I lose some of my male readers.

Just yesterday I got into a conversation with a young father who had sent off his two very young children with their mother to Germany because: “It’s amazing how the country is focused on investing in the children of tomorrow; yes, on science and technology and higher education, but more so on parenting and child development.” It isn’t rocket science nor a testament to their superior intellectual functioning that they wish to invest in the optimisation of their building blocks; if babies are born healthy, parenting is augmented and early development and schooling prioritised, societal prosperity and advancement will follow. But the long view is an endangered concept, held on to like dear life by only a few, and threatened by the capped capitalist glory.

I grew up in the late 1970s and early 1980s, hearing older women instruct families of expectant mothers to keep them happy and smiling. It’s inscribed in my mind, obviously picked up by informal chatter since I was less than 10 years of age, to stick pictures of beautiful children and other happy images in the room of pregnant women, so that they are surrounded by healthy happy thoughts. The 40-day chilla, where women are excused even from obligations of prayer, is meant to allow maximum healing of mind and body, reversing the complete physiological uphaul of pregnancy, while giving space to bond with the new born.

Scandinavian countries mandate pre-birth and up to 16 months of post-partum parental leave, to ensure enhanced maternal and newborn physical and emotional health indices. Paternity leave, a newer development, became a necessity as society moved towards nuclear setups, prime objective being to develop integral paternal bonds with infants and to support maternal wellbeing in their biological functions. In some cases, these leaves are highly paid; again, a clear understanding that this initial economic investment promises a surplus in the long term. From religion, to culture, to policy, anyone with a reasonable level of logic has prioritised maternal and infant mental health and emotional development since time immemorial.

So here’s the basic science: maternal mental and emotional health during pregnancy and post partum significantly impacts newborn development and outcomes. One of the standard questions in psychiatric history taking is details of mother’s pregnancy with the patient. Nine out of ten times in my clinic, mothers relate significant emotional stress during their pregnancies – financial, interpersonal, communal or physical; some relate post-partum blues, anxiety or depression as well. These stressors can negatively affect the infant’s cognitive, behavioural and psychomotor development. Untreated anxiety or depression may lead to pre-term birth, low birth weight, malnourishment or stunted growth. It may also increase the risk of neuropsychiatric disorders for the child in later life. Similarly, compromised mother-infant attachment may affect breast feeding and infant care. Some studies also report increased hospitalisations and risk of diarrhoeal and other infectious diseases. Post-partum depression is highly prevalent, with reported rates as high as 50 percent in Pakistan, and has significant adverse consequences for both mother and infant. Post-partum psychosis, while less frequent, poses a direct threat to life to both the mother and the infant. Again, plain as day.

My ceremonial recommendations must state that identification, prevention, treatment and raising awareness of maternal mental health disorders in the perinatal period need to be a priority. Comprehensive screening programmes are vital for early identification and intervention and women should have access to perinatal mental health care, involving both pharmacological and non-pharmacological interventions such as community support groups and therapy.

But, here’s the rub, how do you even begin to safeguard maternal mental health in a country where the gender equity index is second lowest in the world and where women lack access to reproductive decisions and rights? Healthcare professionals, policy makers and communities must act together to prioritise maternal mental health as a paramount public health challenge. That means first - and fiercely - advocating for gender parity, girls’ education, pubertal health, women’s empowerment and of-age marriages. A lack of each of these is among the top-most risk factors for maternal mental health disorders.

Taking stock of maternal mental health and wellness is not soft science. It is not even that women are vulnerable and weak—if you would only skim over the science of what happens to the body during pregnancy, you would be in awe; it is that infants, both girls and boys, will grow up to represent the future of your family, lineage, community, country and the world. They need the best the environment has to offer, and it starts with a healthy mother and a father who get it. Don’t mess it up.

The writer is a consultant child, adolescent and adult psychiatrist. She is the founder and CEO of Synapse Pakistan Neuroscience Institute.