Mothering with a serious mental illness in South Africa: A retrospective review

Background: Mothering may be an important role for some women, including those with serious mental illness (SMI), for whom mothering may motivate recovery while potentially increasing psychosocial burden. Children of mothers with SMI have an increased risk of academic and mental health challenges. Little is known about mothering with an SMI in South Africa. Aim: This study aims to identify the frequency of motherhood in women with SMI and to determine the characteristics of these mothers. Setting: This study was conducted at Tara H Moross Psychiatric Hospital in Johannesburg, South Africa. Methods: Demographic, clinical data and motherhood characteristics were collected retrospectively from the files of 118 female psychiatric inpatients with SMI. Results: The frequency of motherhood was 63%, with 38% of the sample having minor children. Mothers and non-mothers were similar, predominantly single, unemployed, with a high burden of substance use. The most common SMI in both groups was psychotic disorders (47%). The prevalence of human immunodeficiency virus (HIV) was six times higher in mothers (p = 0.0001). The extended family were caring for children (without mothers) in 43% of cases, while 25% of mothers provided childcare alone. Conclusion: Motherhood is common in women with SMI. Unemployment, single parenting, comorbid HIV infection and substance use are highlighted, as is the role of the extended family in childcare, in this setting. Further exploration of the impact of these factors on the mothering role, women’s mental health and child outcomes is suggested. Contribution: This study acknowledges the high frequency of motherhood in women with SMI, with implications for future policy planning, targeting intergenerational mental health.