(A couple of days ago I read a story in the UK-based Daily Mail about a UK woman suffering from post-partum depression (PPD) who killed her two young babies. She underwent treatment and is now back home with the husband who supported her through the tragedy. That got me thinking--how clued in are we about PPD? Do we even wonder why some new moms feel depressed or suicidal? Do we try to understand what makes a new mom harbour thoughts about harming herself or her baby? I think this is a subject all of us need to be aware about.)
This is an article I wrote for The Hindu in 2013
This is an article I wrote for The Hindu in 2013
M lives in Hyderabad. After her delivery, she underwent the traditional
40-day confinement. Being restricted to a room with just the baby
affected her. She began to feel suicidal; thoughts of harming both her
baby and herself filled her head.
S is from Delhi. After she had her baby, she experienced severe crying
bouts. Doctors at a premier mental health institute diagnosed her as
having Obsessive Compulsive Disorder (OCD). But treatment did not help.
She lost interest in her baby, her family and herself.
Neither M or S or their families, understood what was happening to them
post-delivery; that they were actually experiencing some form of
post-partum depression (PPD).
“M somehow got hold of my number. She called me to say she had a very
bad feeling towards her baby,” recalls Dr. Archana Nirula, a Delhi-based
gynaecologist and the India coordinator for Postpartum Support
International (PSI), a voluntary group that supports new moms and
creates awareness on post-partum disorders.
M’s husband was in the U.S. at the time. Dr. Nirula contacted him and
with his help, convinced M’s in-laws to let her, literally, step out of
the confinement room. The in-laws were told they had to help her care
for the newborn.
“S is my cousin’s wife,” says Dr. Nirula. “I told my cousin to
immediately hire help to care for the baby; that he must take S out
often, spend time with her. I impressed upon him that he too must share
the responsibility of looking after the baby,” she explains.
Counselling, along with medication and family support, helped. Both
women are now healthy, active mothers. Their babies are growing well.
Baby Ahuti in Mumbai was not so lucky. The three-month-old infant’s
death was plastered across newspapers and television channels in October
2012. The police arrested her mother Dharmishtha Joshi on charges of
battering the infant. The mother allegedly beat her “because she would
not stop crying”, reported the police. Later it emerged that Ahuti’s
twin sister had died just 12 days after birth.
Was Dharmishtha Joshi suffering from post-partum psychosis (a result of
untreated and prolonged PPD)? What role did the babies’ father, Kalpesh
Joshi, play in this tragedy? “There are many such horror stories across
India,” says Dr. Nirula.
If a new mother is feeling detached from her baby or unable to nurse or
care for the infant, she finds it impossible to admit that she needs
help. If she is herself not aware of these changes, then her family must
seek help, stresses Dr. Nirula. “In India, families, whether educated
or uneducated, consider this condition a stigma; a shame. Even the
treating medical fraternity link it to a psychiatric problem rather than
a PPD (which is what happened to S),” she points out.
Nora Kropp, a mother of two, a professional midwife and Bangalore-based
founding member of the Bangalore Birth Network (BBN) concurs. “We have
idealised the state of motherhood to such an extent that a mother is not
supposed to feel anything negative,” she observes.
Yet, there is enough research, done in India and across the world, to
show that post-partum disorders can harm, if left untreated or
undiagnosed. A 2002 report in the Journal of Nervous and Mental Disease
said women with severe postpartum psychiatric disorders admitted to an
Indian psychiatric hospital reported infanticidal ideas and behaviour. A
2004 research paper in World Psychiatry also suggests that, in India,
the new mother is at a greater risk of developing severe post-partum
disorders if, she is poor, has experienced antenatal depression, is in a
bad marital relationship, subject to domestic violence, and has given
birth to a female baby.
In the West, there are support groups such as www.postpartumprogress.com
and active networks such as PSI. There is nothing of the sort in India
though birthing communities such as Birth India and BBN do deal with
post-partum care. Dr. Nirula says that panic calls come to her cell
phone or Delhi clinic. She stresses that gynaecologists/obstetricians
and birth networks across India must set up networks and counselling for
post partum disorders.
If women like M and S receive the help and support they need, babies like Ahuti will not die.
PPD vs. the Baby Blues
PPD is not the Baby Blues. The blues manifest as weepiness,
vulnerability, forgetfulness, and stress after the babies are born. The
blues should be over around two weeks after delivery. If it continues,
even if the symptoms are mild, it is called PPD.
PPD is one of six post-partum mood disorders affecting women but is the most common. The
primary cause is thought to be the huge hormonal drop in the mother's
body after the baby is delivered. This hormone shift then affects the
neurotransmitters (brain chemicals).
If the new mom is experiencing loss of appetite, difficulty sleeping at
night when the baby sleeps, hopelessness, poor concentration, anxiety,
anger, deep sadness, low self esteem, overwhelming energy or lack of
energy, she or her family must get help right away.
Source: Dr. Shoshana Bennett, post-partum expert based in the U.S.
Helplines
Dr. Archana Nirula PSI Coordinator, India +91-9810192690 or +91-11-41634773/41634774. Email: sunrayclinic@gmail.com
The National Institute of Mental Health and Neuro Sciences (NIMHANS), Bangalore has a perinatal psychiatry clinic: 080-2699 5554
Bangalore Birth
Network—http://www.bangalorebirth.org/bangalorebirth@gmail.com
http://health.groups.yahoo.com/group/bangalorebirthnetwork/
Go to http://www.birthindia.org/ and click on the 'Services Directory'
to contact midwives, birthing and lactation specialists in Bangalore,
Delhi, Mumbai, Kochi, Goa, Gujarat, Kerala, Hyderabad, Pune and Chennai.
They help new moms get in touch with counsellors for PPD
(To read my original article, go to: http://www.thehindu.com/features/magazine/the-secret-illness/article4269176.ece)
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