Understanding 'postpartum psychosis' in new mothers

GASEBALWE SERETSE
Staff Writer | Friday January 22, 2010 00:00

After finishing her tertiary education, she got a good job at a bank in Gaborone and soon after she met Tumelo, a dashing young man and the two fell madly in love. Two years down the line, Dineo falls pregnant and the young couple is happy at the prospect of having a child. Although they are not yet married, the child is planned and both Dineo and Tumelo are looking forward to having the baby since they can afford it.

One day, Tumelo leaves Dineo who is on maternity leave behind, to go to work. When he comes back home in the evening he finds a crowd of people, including the police, outside his house. As he rushes forward to investigate what is happening, a police officer pulls him aside and tells him something terrible has happened to Dineo and the baby.

'We suspect that your girlfriend delivered the baby in your absence and killed it,' the officer says curtly.

'No that can't be true, Dineo and I were looking forward to having that baby,' Tumelo says.

The police march away with Dineo and she is arraigned for the murder of her baby.

A few months later, Dineo is discharged and acquitted because psychiatrists found out that she suffered from a condition called postpartum psychosis (PPP). Although Tumelo is saddened by the loss of his only child, he decides to forgive his girlfriend since he knows that she was not in the right state of mind when she committed the crime.   

The story of Dineo is not an isolated one because in Botswana, it is commonplace to hear stories of young mothers who throw their newborn babies into pit latrines soon after giving birth.

Experts say that normally, before the birth of the child, a mother who has PPP would be ecstatic at the prospect of having a baby. More often than not, the mother-to-be would not show any signs of mental problems and therefore would not seek professional help.

The signs that the new mother is not coping well will begin to show soon after the birth of her baby.

Interestingly, the affected mothers do not always harm the newborn babies and a typical example is the case of a mother who recently committed suicide after giving birth to a baby at Princess Marina Hospital in Gaborone. Experts say that PPP affects one in 500 to 1000 new mothers worldwide. According to a Gaborone-based psychologist, two conditions that can affect new mothers are PPP and postnatal depression, which are often confused.  She further says that PPP is a far more serious condition than postnatal depression as it can end up with the mother either hurting the baby, herself or others.

Recently, a local newspaper carried a news piece about a woman who attempted to kill her children. Fortunately, the young ones were saved by their father who cut off the cords that were used in the attempted killings. 

Towards the end of last year, the news of a young American mother who killed her newborn baby and ate bits of his brains made international headlines.  After the murder, the woman allegedly stabbed herself in the neck screaming, 'I've killed him! The devil made me do it!' Later, the woman was diagnosed with PPP, which mostly affects women who have just given birth.

More than eight years ago, another case that made international headlines is that of an American woman who drowned her five children claiming that she was trying to save them from satan whom she claimed was inside her.

As mentioned before, horrid stories of new mothers who throw their babies into pit latrines while others literally kill them often make headline news in Botswana, this despite the Setswana saying, 'Mmangwana o tshwara thipa ka ha bogaleng,' loosely translated 'A mother does whatever it takes to protect her child.' The direct translation would even be more expressive as it means that the mother holds the knife at the sharp end (when her child's life is being threatened).

In this country, normally a woman who shows signs of hostility towards her newborn baby is shunned upon. Traditionally, a woman is expected to nurture her baby until it is mature enough to take care of itself. A mother is defined as the 'bearer of the nation' or thari ya sechaba and therefore she is expected to be a primary protector of her baby.

In the case of someone who has PPP, it is the exact opposite. According to a South African family magazine, research shows that fewer than 20 percent of mothers affected by the disease reach out for help until the condition is full-blown.

Experts say more than half of all women experience mood-related symptoms after giving birth because of hormonal changes in the body. If the symptoms do not disappear after two weeks, this might develop into postnatal depression whose symptoms include feeling restless, moody, sad and crying a lot. Unlike postnatal depression, PPP is far more serious and can have tragic consequences.

Symptoms of PPP include the following, hallucinations, illogical thoughts, refusal to eat, chronic insomnia, extreme anxiety and agitation, periods of delirium or mania and suicidal and homicidal thoughts.

Experts advice those who have signs of either PPP or postnatal depression to seek professional help from their doctor or gynecologist who would be in a position to refer them to a specialist.

Here are some of the signs that might show a new mother might be developing postpartum psychosis:

-Hearing voices instructing her to do certain things, more especially those that concern harming either the baby or herself.

-Loss of appetite or change in appetite.

-Developing negative feelings about the baby, which might include avoiding the baby altogether.

-Inability to organise thoughts.

-Insomnia

-Talking about harming herself or the baby.

*Not her real name.