Postpartum Depression (PPD) is essentially depression occurring during the period after delivery of a child; this period extends to a year after delivery. It can affect up to 20% of women within 1 year of delivery and it can occur even if the child does not survive. It is different from Maternal Blues which resolves without treatment.
The birth of a child should be a thing of joy, but it is also highly stressful for some women; the baby suffers as a result. A number of women with PPD are not even aware they have it.
PPD cannot be passed to the baby through breastmilk as it is not a communicable disease. PPD cannot be passed to the husband either. However, some men have left their wives due to ignorance, fear, shame and stigma; they basically pack u understanding of what the condition is about. The condition is spiritualized and the woman is labelled with a “bad leg".
Sometimes, the mother is prevented from attending the naming ceremony due to fear of disgracing family members, and mainly stigmatization.
How does the baby suffer?
He could be neglected while relatives care for the mother, or over-protected by relatives who do not allow the mother; this would cause malnutrition and failure to thrive. A woman with psychotic symptoms can still breastfeed her baby under supervision. This can be done in hospital with mother-baby units.
The mother may also have false beliefs about the baby, and in the extreme, could harm the baby. Some of these false beliefs include thinking the baby is responsible for their problems etc. If the illness is serious and prompt action is not taken, the mother might feel the child would be better off being out of this world.
What are the causes of PPD?
Risk factors for depression after childbirth include unhappy marriage, stressful pregnancy, prolonged labour, problems with breastfeeding, deformity /illness in the child, high expectations for a particular gender, previous mental disorder, hormonal changes after pregnancy, insufficient sleep.
Is there a strong link between hormonal changes and PPD?
Yes, a sudden drop in the hormones supporting pregnancy is one of the identifiable causes of postpartum disorders.
How does PPD manifest?
Low or anxious mood, undue sadness, loss of interest in previously-pleasurable activities, hopelessness, poor sleep, lack of concentration.
In all of these, is the man affected?
Yes he is. Some men might feel neglected by their wives due to a lack of understanding of their illness, they often feel the woman is just being lazy. If the woman is admitted in the hospital, he is usually stressed trying to care for her and the baby at the same time.
The concept of Paternal Post Partum Depression has also been described, where men experience similar symptoms as their wives.
Men generally need more information about PPD and they should be encouraged to attend ANC with their wives so the can be enlightened.
Is it possible for PPD to recur after a first episode?
Yes it is. Some women have it during every pregnancy.
Can PPD be prevented?
To some extent, yes. Optimum social support is key, both during and after pregnancy. Good family support is important in preventing and managing PPD. However, some women still develop the condition despite adequate support; prompt diagnosis and treatment is important in these cases.
How is PPD treated?
Usually with a combination of psychotherapy and medication. There are drugs available now that have little or no risk to the baby’s growth and wellbeing.
For women whose babies do not survive and still have PPD, they need to be helped with the grief process.