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Some new mothers who received free post-natal visits have admitted lying to the nurse about their own mental state and say it felt like an interrogation.
Well Child Tamariki Ora is a free service which developed out of Plunket, and is now run by Health New Zealand / Te Whatu Ora. Mothers are transferred to the care of the Wellchild service when their babies are six-weeks-old for between four and eight home visits.
Massey University public health academics Dr Angelique Reweti, Chrissy Severinsen and Mary Breheny collected 420 stories about families' experiences with the Well Child service around the country.
In an interview with Nine to Noon, Dr Reweti said the responses revealed a pattern of unmet needs.
Well Child / Plunket failing new mums' mental health: Research
"Many mothers felt the focus was really on the baby's physical health, so there was that check box, tick box, surveillance approach where they came and weighed and measured the baby, but didn't really connect with the māmā or their whānau."
Many mothers feared being judged as inadequate or unfit if they admitted struggling.
One mother explained: "I was scared that if I opened up about how I was feeling, that people would think I was incompetent or neglectful or a danger to my baby, so whenever my Well Child nurse visited, I would just say things were good … I wish I could've told her how much I was struggling."
Others felt it was hard to articulate their distress: "I wish my Plunket nurse had asked if I was okay. I was not coping at all, having terrible anxiety attacks, crying all the time, very highly strung. But both my babies were big chubby, happy babies so I just got showered with praise while inside, I was cringing, thinking how wrong she was. I just needed a chance to say how I was feeling, then maybe I would've got the help I needed when I needed it."
Others felt appointments were too rushed.
One mother explained she felt pressure to give the "correct" answers to the nurse's questions.
"It felt like a barrage of questions, rather than a conversation to develop a relationship. 'Are you depressed?' while I'm cowering on the couch, quietly crying. I was too ashamed to admit it, and that was that. That visit and every subsequent visit left me feeling even less supported than I did beforehand."
Reweti said it was apparent that a "one size fits all" monocultural model was not working for everyone.
For instance, when parents felt obliged to lie about co-sleeping, that was "a missed opportunity" to talk about safe ways to co-sleep with babies, which had been shown to help with attachment and bonding, she said.
It showed the importance of culturally appropriate services.
"We know up to 80 percent of mothers are likely to experience distress or anxiety and it's higher among Māori, Pasifika and Asian communities."
To give Health New Zealand / Te Whatu Ora credit, it had welcomed the feedback in the research, and was already implementing new programmes, such as Kahu Taurima, she said.
Kahu Taurima is the joint Te Aka Whai Ora and Health New Zealand / Te Whatu Ora approach to maternity and early years (pre-conception to 5 years old, or the First 2000 Days of life), which allows local communities to design wrap around services.
Health New Zealand / Te Whatu Ora director of Starting Well, Deborah Woodley, said the mental health and wellbeing of mothers was "a priority" for the agency.
"The research reflects changes that we are already making to our maternity and early years services. These are long-term system changes which will have a profound and long-lasting impact on how mama, pēpi and tamariki are cared for in Aotearoa."