Postpartum or peripartum depression is a type of depression that mothers may experience after childbirth.  WHO (2009) defines postpartum depression as a mild mental and behavioral disorder that begins 6 weeks after delivery. It not only affects mothers but also fathers.

According to the CDC, 1 in every 10 women may experience postpartum depression within 1 year after giving birth. Recent reports have also indicated that new mothers (10-15 %) do suffer from postnatal depression within 3 months after delivery. 19.2 % and 7.1% of these mothers do experience mild and severe forms of depression respectively.

Also,

The chances of women suffering from other psychiatric disorders particularly anxiety disorder, who abuse drugs, and those with unmet needs experiencing postpartum depression are higher than their counterparts compared to those without mental disorders.

What are baby blues?

Giving birth to your newest member of the family elicits a mix of emotions in mothers: happiness, excitement, love, fear, anxiety, or frustration.  These emotive episodes are popularly called ‘baby blues.’

Are you experiencing a ton of mood swings as a new mom?

Hey, don’t freak out!

Reelaaaaax…..!

Inhale and exhale!

It is a normal thing that nearly 50-85% of mothers go through after delivery. It isn’t a red flag on your mental health, your fault, or a sign of weakness.

‘Baby blues are common to mothers within the first three days of giving birth.  Mothers may present varied symptoms of emotions including:

• Crying spells with no definite reason
• Sadness
• Sleeplessness
• Joy
• Pleasure
• Irritability
• Exhaustion

 

The good news with baby blues is that it eventually resolves after two weeks.

Signs and Symptoms

You may have come across horrific and saddening media stories of mothers killing their newborns or cases of infant abandonment in dumpsites, right? These are examples of the extreme impacts of postpartum depression.

Unlike baby blues, postpartum depression does last for more than two weeks. The emotions tend to be more strong and more intense severely impacting your bonding to your newborn. It also affects your relationship with your family and friends.

Other signs and symptoms are:

• Failure to breastfeed
• Poor parenting practices to your other children
• Feelings of worthlessness, shame, or guilt
• Social withdrawal from close family members or friends
• Loss of interest or enjoyment in the things once loved or the wider world
• Excessive fatigue
• Gaining or losing weight
• Intense irritability and anger
• Insomnia or sleeping a lot
• Suicidal thoughts of either harming oneself or your baby/ suicide attempt of harming oneself or the baby
• Indecisiveness
• Lack of concentration
• Having feelings or fear of being a bad mother

How does postpartum depression affect mothers?

Affected mothers may also fail to attend regular post-partum care checkups, child care immunization medical programs, and breastfeed the baby properly or for the recommended 6 months. In the long run, postnatal depression adversely hampers the health and well-being of both the mother and the newborn.

If you suspect that you have depression post-delivery, don’t be afraid to seek help right away:

• Ask for support from your partner or close family member to help in baby care
• Speak with your obstetrician or perinatal nurse about your condition. It’s their role to ensure that the baby’s and your health and well-being are in check.
• If you are a new mom and you are afraid of seeking help or the postpartum depression stigma, muster up the courage to confide in your supportive partner or closest family member to help you seek medical support.

Risk factors for peripartum depression

Several factors may increase your chances of suffering from depression after delivery.  Examples are:

• Family history of depression or other mental health conditions
• Cases of depressive disorder or mood disorder during pregnancy or earlier life
• New mothers
• Young mothers under 25 years old
• Lack of your spouse or family support after childbirth
• Physical or psychological trauma due to domestic violence or intimate partner violence
• Pregnancy complications- emergency cesarean section, giving birth to a preterm, low birth weight infant or infant with birth defects, pregnancy loss, hemorrhoids, stress incontinence, low hemoglobin levels
• Substance abuse- smoking, alcohol, or other hard drugs like cocaine
• The occurrence of pre-existing or gestational diabetes: this is diabetes that women may suffer from before and during pregnancy respectively.
• Usage of methyldopa as a treatment for pre-eclampsia and gestational hypertension
• Cases of unplanned or unwanted pregnancies especially in teen moms
• Low level of education
• Instances of stressful life events like job loss, unemployment, divorce, bereavement, and spousal abandonment
• Cultural beliefs and values

Treatment

Treatment varies from one person to another.

Your health provider will also provide treatment depending on:

•  Severity of your depression
• Underlying health conditions
• Breastfeeding status

The main treatment is psychotherapy (talk therapy) for mild and moderate cases.  Interpersonal therapy (IPT) and Cognitive talk therapy (CBT) are the two main types of talk therapies that are currently available.

Is interpersonal therapy and cognitive talk therapy the same?

CBT helps mothers and dads recognize the interplay between their emotions, behaviors, and thoughts. As a result, they may be able to identify the faulty thinking patterns that lead to negative emotions or behaviors.

On the contrary,

IPT helps you to identify and improve on your interpersonal challenges and roles. this translates to a better understanding of oneself and a healthier relationship with your family and friends.

Depending on your health care provider, psychologist, or psychiatrist, the therapy session may be face-to-face or virtual counseling sessions.

You can also choose individual or group/peer/support therapy counseling sessions.

A combination of talk therapy and antidepressants is suitable for mothers with severe postpartum depression.  Examples of the commonly prescribed antidepressants options include:

• Brexanolone(Zulresso)
• Fluoxetine(Prozac)
• Paroxetine (Paxil)
• Sertraline(Zoloft)
• Escitalopram (Cipralex, Lexapro)
• Citalopram ( Celexa)
• Fluvoxamine(Luvox)

Urgent hospitalization or institutionalization in Mental Health Centers comes in handy in postpartum psychosis.

 Management strategies

Postpartum depression is manageable and preventable. If you suspect that you are presenting any of the aforementioned signs and symptoms, you can engage in the following:

• Embrace the 5-5-5 postpartum rule for adequate bed rest and self-care routine: 5 days on the bed,5 days on the bed, and 5 days near the bed.
• Talk and confide in someone you trust about your situation for help
• Join a support group or network with other mothers
• Adopt healthy eating habits: Increase intake of water and fiber-rich foods in case of hemorrhoids complication
• Seek support with household chores and baby care
• Take a walk or engage in exercises like Kegel’s exercise to strengthen your pelvic muscles. Bladder training also aids with stress incontinence issues
• Find time to engage in the activities you enjoy like painting
• Creation of breastfeeding and baby diaper changing stations within public settings including bus stations and workplaces
• Keep in touch with your family and friends via video calls, phone calls, or go out occasionally

Where to get help in Kenya

You may get medical and counseling support from your local health provider depending on your hospital preference.

Majority, if not all of the Kenya and faith-based hospitals do have mental health departments with qualified psychologists.

 

Feel free to visit one within your locality for your mental health and well-being.

Alternatively, you can reach out to the following organizations for counseling services:

 

Organization Name	Contact	Location
Kenya Red Cross – Mental Heal and Psychosocial Support)	Toll-free hotline:1199 Telephone: 0703-037-000 Email: info@redcross.or.ke	Headquarters: South C Red Cross Road, Off  Popo Road, Nairobi There are Red Cross branches in all the 47 counties
Chiromo Hospital Group – Psychiatric and Mental Health Services	Toll-free hotline: 0800-220-000 Telephone: +(254)741-805-793 Email: clientsevices@chiromohg.co.ke	Chiromo Lane, Westlands Nairobi
Befrienders Kenya- Suicide Prevention and Depression Management	Telephone: +(254)722-178177 Email: befrienderskenya@gmail.com	La Colline Gardens,Masaba Road, Off Bunyala Road, Upper Hill
Postpartum Depression Kenya (PPD Kenya)	Website: www.ppdkenya.com	Nairobi
Still A Mum – Maternal Mental Health Pyschosocial Support	Email: helpline@stillamum.com Twitter: @StillAMumAfrica Facebook: Still A Mum Africa Page	Branton Court, Ndemi Lane, Ngong Road, P.O.Box 2119-00202, Nairobi Kenya
Cognitive Behavioural Therapy- Kenya(CBT- Kenya) Counselling Center	Telephone: +(254)739-935-333 or +(254)756-454-585 Email: info@cbtkenya.org	Kilimani Kenya
Emergency Medicine Kenya Foundation (EMKF)- Suicide Prevention and Medical Emergencies	Toll-Free Hotline: 0800-723-253 Email: emkf@emkfoundation.org	Park Place Business Center, Nairobi Kenya
Niskize  Counselling and Call Centre	Telephone: +(254)718-227-440 Email: info@niskize.co.ke or niskize@gmail.com	KMA Centre Upperhill, Block F, Apartment 1.1., Nairobi Kenya

 

NEVER  lose hope in your peripartum depression treatment and management journey!

We are there for you…

 

Bottom line

The mother’s and baby’s physical and psychosocial health and well-being are crucial for a healthy life.

Postpartum depression is treatable, preventable, and manageable.

New mothers may fail to recognize it as its clinical presentations develop gradually.

Due to the effects of post-COVID-19 on the economy, and rising cases of sexual and gender-based violence especially in developing countries, the advocacy against postpartum depression stigma is vital.

If you suspect that you or your loved one is struggling with postpartum depression, seek immediate help from your local health practitioner or depression call centers.

 

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