BOSIRE: In a dark hole after childbirth? It is more than just baby blues

Celeste was a pregnant woman who thought all was well, until she woke up to her cervix opening silently way before her baby was due to make an entrance into the world.

The little one came anyway, despite every trick in the book to make her wait just a little longer. Two more months in the newborn unit, just to get to a weight of 1,800 grams and have a shot at life, and Celeste’s resilience was wearing thin.

While all new mums begin motherhood with a lot of anxiety, for Celeste, it was a roller-coaster. She was young, without a strong social support system and had a baby the size of her palm to take care of. It is no wonder she sunk into depression. Motherhood became a daily struggle.

Post-partum depression is one of the most damning conditions that cause severe morbidity and yet easily goes untreated. The glaring signs are completely ignored by the patient and those around them because they are veiled behind the motherhood excuse.

The new mother will start experiencing feelings of inadequacy; that she isn’t up to the task. She loses the ability to nurture her little one, yet deep down it is all she wants, but cannot figure out how to.

Imagine a 22-year-old mother without a helping hand at home, with a three-week-old infant with incessant colic. The inability to sooth her own baby creates monumental frustration that may lead to acting out.

Babies in such a scenario are at high risk of harm. They are shaken, beaten or completely ignored.

The mum involuntarily learns to switch off the sound of the crying baby and he may be left unattended for hours, unfed and in soiled diapers. Such babies lack affection and mother-baby bonding.

POST-PARTUM PSYCHOSIS

The extreme spectrum of post-partum depression manifests as post-partum psychosis. The poor mother exhibits complete bipolar symptoms. Her mood swings from low depressed states to extreme manic behaviour.

Anyango* was one such mother. She was a young 18-year-old orphan who was sexually assaulted by her employer.

The encounter left her pregnant and in due course, the employer turned her out of his home, where she worked as a nanny for his children.

She went through a harrowing pregnancy, alone, living on the streets, and unsure of her next meal. She gave birth unattended and eventually reached the end of the tether.

With nowhere to go, she completely lost it. She was discovered three days after delivery by a good Samaritan, starved and confused, clutching her baby, while shouting mindlessly.

It took the intervention of the local area chief and askaris to get her to hospital. She was violent whenever anyone tried to touch her baby and it took four men to restrain her. She was bound by ropes and brought to the hospital at night.

It took heavy sedation to calm her down and send her to sleep while her baby was whisked away to the neonatologists in the paediatric unit to receive emergency care. She was cold, dehydrated and soiled, but miraculously stable.

Anyango was out of it for 48 hours before the sedation would be allowed to wear off.

SUPPORT

It is not an easy journey to recovery. The mother needs care by qualified psychiatrists to help restore her mental health as a matter of urgency so as not to deprive her young one of a mother’s nurture.

Drugs or a combination of drugs and electroconvulsive therapy (passage of an electric current though the patient’s brain) may be prescribed. As she settles down, she can then undergo psychotherapy as part of treatment.

One should never underestimate the power of a solid social support system. As her mind is treated, there is need to ensure that the woman’s self-confidence as a mum is restored and she is not overwhelmed with the care of her baby.

It is critical for all of us to understand this and mind how we perceive mums and the huge responsibility they bear, of raising a little one. It is not acceptable to ask them to get over their unexplained feelings.

Suicidal ideation should raise a red flag. An overwhelmed mother needs all of us to extend a solid hand of support without judgment.

Anyango and her baby are alive and well today because we got to her on time and she got the help she needed. Many are not so lucky.

Sometimes, the only time we know there is a problem is when the struggling mother makes the news headlines for killing her baby. A little diligence goes a long way in keeping everyone alive!