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Durban - A case of a month-old baby found dead in a dustbin in Johannesburg on Monday comes just days after the case of a toddler who was nearly killed by a truck after being abandoned on the N1 highway in Gauteng.
These come shortly after a case in the Western Cape where a teenage mother is being probed for the alleged murder of her two children, while a baby boy is still recovering from exposure to extreme heat in Durban after being dumped on the side of a road in February when he was a week old.
But, while justice takes its course, mental health practitioners have said adequate screening and treating of mental health issues among pregnant women and mothers could prevent such incidents.
The Perinatal Mental Health Project (PMHP) says nearly 40 percent of women living in poverty in South Africa will experience a mental illness during or after pregnancy, and that this prevalence is higher than in other developing countries. In Uganda prevalence stands at six percent, while in Zimbabwe and Malawi it is just over 30 percent.
“If mental health problems are picked up and there is therapeutic as well as psychiatric support, it could have an impact,” said a counsellor from the PMHP. “Obviously there are those who decline, but those who do take up treatment benefit from it very positively. If there were more screening and more referrals and more services to accommodate it, it could have an impact.”
She said antenatal and postnatal distress was not always recognised as being serious and as something that can be treated. This could be because of lack of knowledge, the stigma of mental health issues, and the notion that pregnancy is supposed to be a positive experience.
People did not realise “how vulnerable some women are during the perinatal period” and that mental ill-health was exacerbated by factors like HIV, traumatic personal histories, lack of support, and violence in communities, particularly sexual violence which in some cases resulted in the pregnancy.
While prevalence might be higher in South Africa, the risk factors were common in other developing countries too.
A study by the World Health Organisation found that social determinants were an important cause of mental health problems in pregnant women and mothers and that women, especially those living in developing countries, were more exposed to risk factors.
A Cape Town domestic worker, who first suffered from perinatal depression after she had a child at age 14 and then again as a married woman in her twenties, said: “The clinic I went to in the township did not know anything about depression. So I was unable to get help from them. My husband was supportive but he didn’t always understand what I was going through.”
She later got the help she needed because her employer, a psychologist, was able to recognise it. “This was the first time I heard about perinatal or postnatal depression. I had suffered from depression all these years, but I didn’t really know what it was. Finally, I had some help.”
The counsellor said routine screening of mental health in obstetrics was lacking in public health.
“Just like urine and blood are tested for physical problems, we should routinely screen for mental health problems, but up to this point in South Africa, we don’t have that type of screening, and unless people are informed and actively seek help, there is not easy access.”
She said many communities in South Africa were in distress due to the levels of poverty and violence and substance misuse they are exposed to.
While a few organisations offered support at different sites, it was hoped that “the government will take it up and roll it out nationally for routine screening and efficient treatment”.