Understanding postpartum depression

Florence Radull
Correspondent | Monday December 13, 2010 00:00

She wears a threadbare cotton nightdress that has seen better days and her hair is matted with perspiration against her scalp.

In the far corner of the room, the soft whimpers of an unhappy baby break the otherwise silent morning.

It is almost midday but Gaasite seems unconcerned about the half-wasted day or the fidgety baby. In fact judging from the glazed look in her eyes she hardly seems aware of her surroundings or her obvious duties.

Her total disregard for her four-month-old baby has baffled her mother and sister and shocked her other relatives.

Her negligence is incomprehensible given the eight years it took Gaasite to conceive baby Lesego. She seems to have no interest at all in the baby and on most days even has difficulty breastfeeding her, not for lack of milk but principally due to total lack of concern.

Initially her family thought her detachment was due to her failed relationship with the baby's father during the course of the pregnancy but they eventually realised that her depression stems from some kind of medical condition and have sought medical and psychological help for her. Gaasite is one of the lucky ones.

In the past year alone there have been numerous newspaper reports about new-born babies being found dumped in pit latrines or in other unacceptable places or mothers committing suicide after giving birth.

In February this year 33-year-old Keabonye Mojuta of Thamaga, a patient at Princess Marina Hospital committed suicide by hanging herself from a tree at Gaborone Secondary School sports grounds. It was alleged by her sisters that she was suffering from post partum depression. Mojuta had recently given birth.

One of Mojuta's sisters, Keafiwa told The Monitor at the time that her sister sent her an SMS on December 27, saying she would be 'departing' and that she should take care of her children.

'My other sister and I got worried and decided to visit our sister to better understand the meaning of her message and to stop whatever plan she intended.'

After their arrival at Princess Marina's maternity ward, they found Mojuta crouching, almost cowering, in a corner.

The nurse then counseled Keabonye and promised her sisters that she would be referred to social workers.

However, the sisters said this never happened: 'What surprised us was that our sister had clearly shown signs of mental instability or confusion and the nurse was well aware of that,' Keafiwa says. 'The nurse should have at least ensured that our sister was under constant watch.'

In another incident on July 10, a day-old baby was found dead in Gaborone's Maruapula location.

'We are yet to receive the post-mortem report and cannot say much about the matter at the moment,' assistant superintendent Pitse Etsile of Gaborone Central Police Station told The Monitor at the time.

Etsile said that while instances where people throw away babies were not rife in his area, they nonetheless cause concern.

'Last year we had a case in which a mother threw away her newly-born baby. We managed to find the mother and gave the baby back to her.'

Numerous other cases have been reported country-wide that can be attributed to post-partum depression.

Matthews Okumbe, a clinical psychologist based in Ramotswa says that post partum depression is an occurrence of depression, experienced by 'new' mothers, which usually manifests itself about a month after giving birth.

It is caused by hormonal changes that accompany childbirth, he says.

'Childbirth brings immense psychological and social changes, which include decrease in sleep and relaxation, financial challenges because of added responsibility and changes in marital relationships,' he says. Other changes include giving up careers due to childbirth and care.

'The symptoms of post partum depression include excessive sadness, despair and hopelessness, crying spells or tearfulness, insomnia (difficulties with initiating and maintaining sleep), anxiety, compulsions, panic attacks, feelings of inability and suicidal tendencies,' he says.

In Gaasitse's case, the fact that she had parted with the father of her baby might have had something to do with the condition as Okumbe explains that the condition is more common in women who are in unhappy relationships or marriages or those who have experienced long labours or difficult deliveries.

Researchers in developing countries put the figure at 10 to 30 percent of new mothers being diagnosed with post partum depression, while in Africa (according to postpartumprogress.com) one out of eight new mothers will be diagnosed with the condition.

The good news, however, Okumbe says is that there are medical and psychological treatments available.

'Antidepressant medications that are applied to other forms of depression are quite helpful in stabilising women with this condition, while psychotherapy and self-help groups and social support from relatives and friends have proved extremely helpful for many women with this disorder,' Okumbe says.

Even though treatment is available, during the period when a mother is suffering from this disease it not safe for a newborn baby to be in her care.

 'One characteristic of this disorder is suicidal tendencies. As such, the mother may think of or actually kill herself; however, she may first of all kill the baby before turning to herself,' Okumbe says. He advises that these women should be given round the clock attention and support until they are stable, since the slightest freedom may be dangerous.

Women with a prior history of postpartum depression have a 50 percent chance of recurrence.