How New Mothers Can Overcome Postpartum Depression, By ChiNna Okoroafor

Postpartum depression (PPD) is a form of major depression that begins about four weeks after child birth, according to the DSM-5, a manual used to diagnose mental disorders. PPD is a significant public health problem which affects approximately 15 percent of new mothers due to a rapid drop in the levels of the female reproductive hormones (estrogen and progesterone) after delivery and other major life changes, such as the responsibilities towards a newborn baby, expectations of families, and so on. Its symptoms may start earlier, during pregnancy or later, up to a year after childbirth.

The lack of awareness of postpartum depression (PPD) in African societies is very problematic. In actual sense, every married man or life partner should be informed about postpartum depression so that if it happens, they will know how to handle it. This is a very important issue that should be taught in marriage counselling. Unfortunately, many don’t even know when their wives go into postpartum depression and as such do not know what to do to help, because they detach themselves from the pregnancy process.

It is important that men see the need to accompany their wives and/or partners to antenatal or prenatal care appointments, because this is the period during which they can ask questions and learn what it takes to provide emotional support to their wives. The early period of childbirth could sometimes be very stressful to both the new mother and the father. Understanding the emotional challenges involved would be very beneficial to the entire household.

One of the issues that stress new mothers is forced sex right after childbirth. During doctors’ visits, the obstetricians and/or midwives usually instruct new mothers to abstain from sex until at least after the six-week postnatal check-up. But this is when some insensitive husbands choose to complain, become violent and/or rape their wives, because it is impossible for them to control their sexual urges. Such actions make it easier for the wives to become prone to depression. When men engage in dangerous acts against their wives who just gave birth, they perpetrate a mental health challenge that may affect both their wives and children for their lifetimes.

PPD is characterised by long term disturbance in the emotional, behavioural, and physical states, which includes depressive symptoms like disturbed sleep, low appetite, memory loss, fatigue, suicidal thoughts, decreased concentration and lack of interest in pleasurable activities. It does not only affect the mother, but the wellbeing of the infants and may affect their cognition, behaviours and emotions. Research shows that it disturbs the development of children during toddlerhood, school age and adolescence.

A woman who has recently had a new baby is prone to so many different emotions (baby blues, postpartum depression and in an extreme case, psychosis). So, if one sees or knows a new mother, it is safe not to assume that she’s now happy and fulfilled by asking the generic question: How are you? You know for the majority of people that the answer is, ‘I’m fine.’ But is the new mother really fine? Often, people also ignore the mother and jump into asking about the baby. The truth is that some of these new mothers are walking advertisements for what real life postpartum depression looks like.

There are many risk factors involved in PPD that include poor marital relationships, early pregnancy, childcare stress, sleep deprivation and high societal expectations. While the intentions of well-wishers may be good, the generic approach of just asking a new mother how she’s feeling is not effective, because she would likely cover her true feelings. This is because if she is honest and tells a well-wisher that she is exhausted, the advice would be “make sure you sleep when the baby sleeps” or “welcome to motherhood” and these responses do not help in any way. Becoming a mother comes with a lot of worry, stress, and feelings that can be overwhelming. People should not expect that she is enjoying every moment of things. If she is truthful and says that she is depressed, she would be reminded of the miracle she just created, which is having a new baby. They would also reemphasize how having a baby is the joy of every woman. In a society where a woman is the face of infertility, she may have been under pressure to prove that her husband is not living with a “fellow man”, as it is often said when couples face fertility challenges.

Some women are advised by their doctors to go through the cesarean section, when it’s medically determined they cannot push after being 48 hours in labour; yet some of them still insist on undergoing a natural delivery. They end up putting their lives and those of their babies at risk. Research has shown that women who became pregnant on their own terms are happier mothers. So, motherhood brings joy if a mother was ready, planned for her pregnancy and designed her own future.

It is a thing of joy if a woman is not coerced into having a baby. Some new mothers have no idea what having a baby entails. Some were raised for the sole purpose of being wives and bearing children. So, they end up getting married to men who they are not compatible with or share aspirations, values, beliefs and even communication with. Since they lack self-worth, they remain in abusive marriages or relationships where they are reminded by their husbands that their sole purpose is to bear children and be at their beck and call. The men do not care about the women’s mental health and their overall wellbeing. So, the fact that these women may have been under pressure to bear children and be exposed to certain stressors specific to motherhood, increases their risk of postpartum depression.

Most new mothers are unable to get the rest that they need in order to fully recover from giving birth. Constant sleep deprivation can interfere with their abilities to care for the newborn and handle other daily tasks. So, instead of asking her how she’s feeling, listen to her, volunteer your time by offering to babysit, while she rests/naps or indulges in her choice of self-care. Many women are married to men who would not render the simplest of assistance, even if they are able to do so. During a stay or conversation with a new mother, if she opens up about her struggles, one should provide a listening ear and validate her feelings. There might be the urge to ask why the husband or partner is not helping. However, this is not the right time to do so. It is better to allow her to recover first!

Solution

It is important to understand that PPD can affect any woman, regardless of age or socioeconomic status. Therefore, in order to decrease its morbidity, it is vital to create awareness among individuals and families, so that they can step in and support a new mother mentally, as well as physically. The good news is that there are pharmacological (including medications that are selective serotonin reuptake inhibitors (SSRIs) and serotonin-norepinephrine reuptake inhibitors (SNRIs)) and nonpharmacological treatments (psychotherapy) available. However, the nonpharmacological intervention must include any and/or all of the following: psychodynamic therapy (PDT), individual/family therapy.

– ChiNna Okoroafor, a Licensed Psychotherapist and Certified Telemental Health Provider, writes from Colorado Springs, Colorado, U.S.A.

Disclaimer: This article is entirely the opinion of the writer and does not represent the views of The Whistler.