Mental health during and after pregnancy

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It was sad to read last week’s Mmegi story that a 25 year old mother committed suicide five days after giving birth.

Often, clinic/hospital check-ups during and after pregnancy focus mostly on the physical changes of the mother and child. The mental health of the mothers is rarely actively investigated. This neglect has dire consequences for the mother because pregnancy can trigger episodes of mental illness, and childbirth can lead to postnatal mental illnesses. Also, active episodes of mental illness impact the child’s physical and mental development.

The physiological changes during pregnancy can compromise the mental health women. For example, hormonal changes and disruptions in the normal sleep-wake cycle are associated with an occurrence of an episode of mental illness. Women with severe mental illnesses especially bipolar disorder find themselves at increased risk for such a re-occurrence. Furthermore, changes during pregnancy may interfere with the effectiveness of mental health medication, thus leaving the women vulnerable to a re-occurrence of an episode of mental illness if their medication doses are not adjusted. There are also cases were some women stop taking their medication (especially valproate which is commonly used in bipolar disorder and epilepsy) because such medication has been associated with an increased likelihood of children born with birth defects and disorders like autism spectrum disorder. By stopping the medication, these women have been found to be two or three times more likely to have a re-occurrence of a manic episode.

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