A closer look into postpartum depression
Postpartum depression, although common, is one of the most unrecognised and often undiagnosed complications of childbirth globally, yearly affecting about 10–15% of postnatal women. It involves a major form of depression that begins within 4 weeks after delivery.
The diagnosis of postpartum depression is not only based on the length of time between delivery and onset but on the severity of the depression.
Also referred to as PPD, postpartum depression is often described as a complex mix of physical, emotional, and behavioral changes that women experience after childbirth. It is linked to chemical, social, and psychological changes that happen when having a baby. The chemical changes involve a rapid drop in hormones after delivery. The actual link between this drop and depression is still not clear, but what is known is that the levels of estrogen and progesterone in the female reproductive hormones increase tenfold during pregnancy. Then, they drop sharply after delivery.
In addition to these chemical changes, the social and psychological changes of having a baby create an increased risk of depression. It is not uncommon for most women to experience baby blues after delivery but research shows that about one of every 10 of these women will develop a more severe and longer-lasting depression after. About 1 in 1,000 women develop a more serious condition called postpartum psychosis.
In a recent study by WHO, postpartum depression has a heritability rate of about 44-45% and could become a reason for permanent mental disorder if not treated. Also, research conducted by the Centre for Disease Control and Prevention (CDC) reveals that postpartum depression affects 17.22% of the world’s population with 18.4% specific to the African continent and over 1.5 million prevalence in Nigeria yearly.
Postpartum mental illness is real and even worse is the relatively poor understanding our society has. Since the discovery of postpartum depression, there has not been a major redress by the healthcare system and stakeholders to help mothers identify, prevent and treat postpartum depression.
As part of its aim of increasing awareness around women-related medical issues, Paelon Memorial Hospital launched a platform called the village. The Village is a safe space that enables women to meet and engage in unfiltered conversations about various aspects of life and their health. The first of the meeting, which was held on Saturday, June 18, 2022 themed “The Reality of Postpartum Depression” was hosted by seasoned Journalist and media personality, Laila Johnson Salami.
The two-hour webinar highlighted real talks, medical perspectives and personal stories from the speakers: Dr. Gbonjubola Abiri, a consultant psychiatrist and lecturer, Dr. Olusola Abodunrin, obstetrics and gynaecology consultant, Erimma Nwanmah, registered nurse and midwife and Onovughakpo Fajusigbe, a change-maker and mother.
Discussions were held on the many symptoms and individual experiences that the speakers faced. For Nurse Erimma Nwanmah, despite being a seasoned nurse who continues to help mothers navigate motherhood when it came down to the idea of labour, her fears surfaced. She stressed the importance of awareness of issues like postpartum depression and the realities of motherhood.
According to Dr Abodunrin, having social support is essential for mothers because of the differences in intensity, and frequency of the depression. Like all types of depression, she stresses that mood swings, energy and appetite level may be affected. Mothers tend to feel guilty, or lonely for fear of not wanting to be around their children and family members.
The topic of awareness through antenatal was expanded on. For the speakers, they believe it created a sense of community that manages reality vs expectation. Dr Olusola Abodurin explains that having “ME” time for mothers is crucial to tackling postpartum because while caring for the baby is a priority, the mother’s health and well-being is vital.
As a result, Nurse Emma stressed the importance of mothers seeing their doctors as early as two weeks after birth for psychoanalysis and proper care and attention. Situations where both mother and father experience such ordeal is rare but occurs and in such a situation, the family effort can be the component that turns things around.
In advice to women, Dr Olusola Abodunrin stated that “women must be willing to put in the work to get their mind and body back, there are no general rules, find one that works for you and stick with it”.
Postpartum depression can be treated with medications or psychotherapy otherwise known as talk therapy or a combination of both. The appropriate method of treatment is recognised by a specialist and this depends on the intensity. Panel on offers that haven for conversations without prejudice or shame, the multi-specialist boutique hospital offers family healthcare, obstetrics and gynaecology, paediatrics and corporate health services. The health facility boasts of well-seasoned experts that can provide therapy to mothers, fathers and families going through postpartum depression.
Chike-Nwanmah holds RN, RM, BNSc, HMP