“I felt useless as a mother.”
“I started spending days in bed.”
“I felt so ashamed.”
These are the testimonies from some of the many women in South Africa who experienced some form of mental disorder after becoming mothers.
Though pregnancy and childbirth is usually a source of joy, for as many as one in three South African women it is a source of depression and other mental disorders.
On Wednesday countries around the world recognised World Maternal Mental Health Day.
The day aims to spread awareness about mental disorders that are prevalent in one in five women worldwide from conception, through pregnancy, to the postpartum period, including the first 1000 days - known as the perinatal period - of the infant’s life, in order to ensure women have access to mental health care during this time.
Though these disorders are common, Dr Lavinia Lumu, a psychiatrist at the Akeso Crescent Clinic in Randburg, said many women do not seek treatment which can have harmful effects on the infant.
“Approximately one in five new mothers worldwide and up to one in three in South Africa may experience symptoms without even realising it,” Lumu said.
“Psychiatric disorders in the perinatal period, such as anxiety or depression, are often missed or left untreated to the detriment of mother and baby.”
Women are more likely to develop disorders during the perinatal period because the body experiences physiological changes such as levels of hormones during pregnancy.
“External factors also play a role, such as poverty, migration, stress and low social support.
“Most of the women in South Africa who experience maternal mental illness are poor, from disadvantaged communities and face many challenges in accessing services and care,” the Perinatal Mental Health Project (PMHP) writes in a report.
It is also believed that women are more likely to experience domestic abuse during and after giving birth, which can contribute to the high prevalence in countries like South Africa.
Christine, a mother who moved to South Africa from Congo shortly before giving birth, told the PMHP that she became depressed after her husband began abusing her.
“When I became pregnant for the second time, my partner did not want the child.
“He became verbally and emotionally abusive and was controlling with finances. Feeling despondent, isolated and helpless, I found it difficult to bond with my new baby and had no energy to meet the demands of my two-year-old daughter.”
Christine received support after her friends saw that she was struggling and referred her to PMHP, who connected her with a French-speaking counsellor.
Lumu said that like in Christine’s case, it was often family members and partners who begin noticing symptoms in a mother and for this reason having days to raise awareness about maternal mental health was important.
Referring mothers to places that can help with screening and intervention, as well as offering more informal sources of support such as caring for the baby or helping with household duties, can help women overcome these problems.
“If a family member suspects that a new or expectant mother has a mental health problem, it is important to encourage her to seek help urgently from a healthcare professional, such as a psychologist, psychiatrist, midwife, GP, or obstetrician,” Lumu said.
Lumu said that more mild depression and anxiety could be treated with therapy, but more severe conditions such as bipolar disorder and OCD may require treatment with medications. Often, using a combination of both methods of treatment ensures the best outcomes for the mother and the baby.
“Babies of mothers who have had untreated psychiatric disorders are also at high risk of developing behavioural, emotional, and mental health problems later on in life,” said Dr Bavi Vythilingum, a psychiatrist at the Akeso Kenilworth Clinic in Cape Town.
“Treatment can ensure that these risks disappear.”