health.economictimes.indiatimes.com | July 23, 2021
Brooke Shields, Gwyneth Paltrow, Sarah Michelle Gellar, Drew Barrymore, Mandira Bedi. What do all of these women have in common (apart from being mothers)? Each of them has spoken about their own personal battle with postpartum depression.
Postpartum depression refers to a major depressive episode with its onset in the first 4 weeks following child birth. It is common for women to experience ‘baby blues’ soon after their delivery – this refers to the feelings of overwhelm, irritability and low mood that a new mother may experience in the first 2 weeks following the birth of their child. If these symptoms continue to linger however, and the low spells persist, it may be an indication of postpartum or postnatal depression. This is a much more severe condition than the general wave of baby blues and one warranting medical attention.
Current estimates in the UK suggest that one in every 10 women will experience postnatal or postpartum depression. An Indian study from 2018 on the other hand suggests that 19% of new mothers experience postpartum depression. That is, just under one in five mothers will experience depression. Take a minute for this number to sink it. That means that in a mother’s group of 10-12 individuals, two are likely to be experiencing post-natal depression. In your group of 5-6 close friends, one is likely to have experienced a depressive episode after the birth of their child. In a society where mental illness tends to be swept under the carpet rather than be acknowledged, these numbers are concerning and if anything, is likely an under-estimate of the true prevalence.
Postnatal depression: The Indian context
Cultural scripts often equate motherhood with the experience of ultimate fulfilment. A period of unparalleled joy and ecstacy. Coming to terms with feelings of low mood and apathy experienced during this period, something that is completely out of keeping with the expected cultural script can make for an even more sinister disease experience. In a typical Indian family, a new mother has access to support from both her biological and marital family. Unfortunately though, for many new mothers, birth of a female child is associated with a significant drop in the level of support provided. While this may be especially true in rural parts of the country, urban India is not bereft of their preference for a male child.
Secondly, immediately after child-birth, there is a dramatic shift in the object of attention. It is common for mothers-to-be, to be waited on hand and foot and be the object of much pampering and indulgence. However, as soon as the child is born, the mother’s needs typically become insignificant, with all attention now focused on the newborn infant. As such, the myriad of changes the mother goes through – be it hormonal, weight or body image related, pain related – everything is ignored and many a times not even acknowledged. The child becomes the number one priority and the mother’s needs if considered, tend to be secondary. Many a time even new mothers may report feeling guilty if they focus on themselves rather than their newborn. Families typically prioritise the infant’s needs and health care facilities are also organised around the same. Care visits for the infant are regular, but the mental health of the mother is not given the same reverence. Similarly, anganwadi workers are focused on the newborn, with care needs of the mother largely ignored.
The commonly presented argument is that the child is completely dependent on the mother for all their needs and as such, it is only natural to expect the mother to place their needs aside and focus on the needs of their child. After all, a newborn is not really in a position to look after themselves. Certainly a logical argument, but there is one argument to counter this – a happy mother is key to a happy and healthy child. And there is overwhelming evidence to support this statement. It is thus imperative that we strike a balance between the needs of both these individuals.
Another commonly made argument is that women are aware of all the physiological changes they will experience with motherhood. They chose motherhood and hence signed up for sleepless nights, worrying about a young infant, the potential change in their role from breadwinner to caretaker etc. For starters, motherhood may be a forced choice for many Indian women. For those lucky enough to voluntarily choose to enter motherhood – knowing what will happen does not mean that they cannot find the experience challenging. And neither does a challenging experience mean that the mother does not love their child.
It is common for new mothers to experience significant exhaustion, waiting for the early days of constant care and supervision to be over and wanting some semblance of their old life back among other things. Importantly, none of these feelings mean that they do not love their child or that they are not caring for them. Mothers need not feel guilty about caring for themselves either. Rather they should be encouraged to take some time away from the role of a mother specifically for their self-care. This could be a short yoga class, going for a walk by themselves, being able to read a book without interruptions, taking a massage or a long bath, having a date night. Whatever they need to ensure their own mental well-being.
Postnatal depression in the pandemic
Just as other mental health conditions have seen a dramatic increase through the course of the pandemic owing to limited social support and restrictions on movement, postnatal depression has been no stranger to this rise in numbers. Documented cases in Canada have shown a huge spike and psychologists in India are reporting the same. The good news however is that the simple gesture of friends and family pitching in to assist can go a long way in improving outcomes for both the mother and the newborn.
Some ways of supporting a new mother could be volunteering to help out at night so that the mother can sleep through without disturbance. Bottle feeding the infant at night so that mum can rest could be one option. Taking care of meals and assisting with housework means that mum can sleep whenever baby sleeps, again allowing her to get some much needed rest. It is true when they say it takes a village to raise a child. Now more than ever, it is imperative that fathers step up and help out wherever possible – be it helping out around the house, changing diapers, feeding the baby or rocking them to sleep. Sharing the load will go a long way towards the wellbeing of the mother and the child and help lay the foundation for a happy family in the years to come. But in the event that this is not enough (and in some cases it won’t be), be sure to approach a mental health professional to seek some additional assistance.
-Prof. Deepa Bapat, Adjunct Faculty – Psychology