HAJIYA Amina was excited to be pregnant, within a year of marriage. She read many articles around health and safety during pregnancy and she marked every milestone with pride. She duly registered for antenatal services after making enquiries for the best facility where her pregnancy could be supervised, and she could rest assured that she and her baby would be in safe hands.
Everything went smoothly and she was delivered of a bouncing baby boy. But she was just feeling tired and exhausted. There was no excitement or joy. She felt drained, tired and would burst into tears for no particular reason. She started feeling guilty for bringing the innocent baby into the world. She was not sure she could be a good mother. She didn’t want to take the baby or breastfeed him. She didn’t feel like eating or talking to anyone. She just felt miserable and wanted to be alone. Her husband and mother felt she was only tired and will snap out of it. But when these behaviours continued even after the naming ceremony, they became worried.
Her mother was getting irritated with her and tongue-lashed her without mincing words. ‘Are you the first to give birth to a child or what’s all this nonsense now?’ ‘You want us to be begging you to take care of your own baby?’ ‘Better stop being lazy,’ she concluded. Amina simply burst into tears again as she didn’t understand what was wrong too.
Eventually, her husband took her back to the hospital. The doctor informed them that she had postpartum depression and they will invite a psychiatrist to review. They became alarmed. Does that mean his wife is running mad? What is really happening?
Perinatal mental health
During pregnancy, and the aftermath of pregnancy, the rate of mental health problems in women is higher than at other times. In developing countries like Nigeria, one out of every five women (20 per cent) going through pregnancy and childbirth will experience a mental health problem – commonly anxiety and depression.
The term ‘Perinatal Mental Health’ covers the emotional and psychological health and wellbeing of a parent (mother) during the period from conception to 12 months after a baby is born (infancy). If attention is not paid to the emotional wellbeing of women during the perinatal period, the negative impact will be felt by everyone – new mother, the baby, father, other children and the entire society. In some tragic instances, it leads to suicide or the killing of the baby (infanticide).
Pregnancy: Anxiety and depression are commonly occur here, usually having a U-shaped frequency of occurrence across the three trimesters of pregnancy. Thus, levels are high during the first trimester, lowest during the mid-trimester and high again in the final trimester just before delivery. These fluctuations follow the expectant mother’s pattern of worry: first trimester – will the pregnancy stay, or will I suffer a miscarriage? Hope it is not a false alarm and that I am truly pregnant? And so on. But by mid-trimester, these worries are allayed, and she is calm. By the final trimester, anxiety and depression again increases, with concerns over the safety of delivery, will the child be normal or abnormal? And so on.
Immediate aftermath of delivery: Mental health challenges here may include depression (postpartum depression) or psychosis. In post-partum depression, it is characterized by excessive moodiness, crying for no specific reason, feeling tired and not being excited while everyone is celebrating the birth of a new child. This may be transient and last only for a few hours or days, in which case, it is simply called post-partum blues.
However, in some instances, such feelings may persist for weeks or months and the mother may even begin to question why she brought an innocent child into this miserable and sinful world. She may have suicidal ideas and entertain thoughts of harming the baby and herself.
The early warning signs include weepy spells, not being willing to nurse the baby or pay attention to the baby, refusing to eat and neglecting to take care of her personal hygiene. In such instances, coupled with the possibility of harming herself and her baby, immediate attention from a psychiatrist should be sought without delay.
Post-partum psychosis may also occur in the aftermath of childbirth. In this instance, the woman begins to talk abnormally and may be restless and agitated. Her behaviour may also be inappropriate. It should be clear to close family members that something is wrong, and she needs urgent medical attention.
Conclusion: Mental health conditions may be triggered by pregnancy and the aftermath of childbirth. Just like women developing high blood pressure or diabetes during pregnancy. They can be easily treated, and they will fully recover and return to normal functioning. It does not mean they are running mad.
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