My struggle with depression after childbirth

Dorcas Wambui Ombati when the Sunday Nation spoke to her at her house in Nairobi on June 10, 2016. PHOTO | ANTHONY OMUYA

What you need to know:

  • After giving birth to her first child, Dorcas Ombati was shocked when the bliss she expected was overshadowed by feelings of confusion and desperation. Matters unravelled one day when she acted aggressively towards her baby. The first-time mother was suffering from post-natal depression, a condition which the Health ministry says affects one in 10 Kenyan mothers.
  • The Health ministry approximates that one in every 10 Kenyan women develop depression after giving birth which, in some cases, can be so severe that the mothers commit suicide.
  • Maternity blues, according to Dr Mwikali, start from as early as two days and last about two weeks. She says they are characterised by irritability, anxiety, confusion, mood liability, sleep disturbance and crying spells.

The climax came one day in 2009 when Dorcas Wambui Ombati was so upset with her baby’s crying that she shoved him away with her hand.

“Aargh!” she shouted at the teary-eyed, inconsolable boy lying on a sofa.

Maybe out of utter shock or perhaps taken aback by his mother’s new way of soothing him, the boy shut up.

But the aggressive behaviour startled the first-time mother more.

Yes, the hectic babysitting schedule had driven her crazy in the weeks after she delivered him on April 3, 2009. Yes, there were days she could not contain his incessant crying. Yes, staying at home alone as her engineer husband, Mr Kelvin Ombati, went to work was getting the better of her. But never before had she thought of raising a finger against the baby.

“What have I done to the baby? Have I hurt him?” she recalls thinking.

For a moment, she was afraid that one day she might do something worse.

“I’d read about people who had gone so mad after delivery that they murdered their babies. I saw where I had reached and just told God to help me,” she told Lifestyle on Wednesday.

That realisation triggered a chain of events that would later see her counselled as a victim of post-partum depression, a mental condition that was cited after a woman allegedly beheaded her one-month-old twins in Nairobi’s Uhuru Estate last month.

After the death of the fraternal twins, Buru Buru DCIO Jeremiah Ikao said the mother, Gladys Nyambura Githinji, was suspected to have killed them due to that kind of depression.

The Health ministry approximates that one in every 10 Kenyan women develop depression after giving birth which, in some cases, can be so severe that the mothers commit suicide.

Mrs Ombati says she never felt suicidal but it took her years after the birth of her firstborn to figure out why people say motherhood is the best thing in the world.

“People could ask, ‘How do you feel now that you have a baby?’ I would tell them I wasn’t feeling anything,” she says. “It made me not like children … They just made me nervous.”

She describes the experience with her firstborn as so traumatising that she had vowed never to give birth again.

At one time, she thought she had lost it but was afraid to tell anyone about the dark thoughts gathering in her mind.

UNWANTED NANNY

“Sometimes I would imagine that he was crying and he wasn’t. Or sometimes I would stay alone when the baby was asleep but I would be swinging my hands like someone holding a baby. I had done so for so long and now I was like a mad person,” she recalls.

Mrs Ombati believes the circumstances around her first delivery aggravated the situation.

She delivered after an emergency caesarean operation at the Kenyatta National Hospital and, in her own words, everything was out of place from that moment.

After the operation, she was taken to a large ward that had “all sorts of patients”, both male and female, where privacy seemed not to be a priority to the hospital’s administration.

The way she would plead for help from nurses to help sooth her painful surgical wound and the cries of the ill — ranging from fire to accident victims — was traumatising.

“I felt like I was in hell; the way we had been told that in hell there is screaming and gnashing of teeth,” she says.

Upon being discharged, she went home to their one-bedroom house at Kahawa Wendani. The tormenting continued full-force.

Her mother sent a farmhand at their rural home to be Mrs Ombati’s temporary nanny. That would turn out to be a very bad decision.

“The woman was strange. She would tell me how she had run away from her in-laws because they practised witchcraft,” she recalls.

The many stories that the house-help told Mrs Ombati about bizarre things like witchcraft turned her into one big bundle of nerves, and she would lock herself in her bedroom together with baby to limit contact with the nanny.

“I didn’t want her to hold my baby or to get near me … I was a prisoner in my bedroom: morning, night, daytime I was in the bedroom,” she narrates.

She says that she was in a catch-22 situation because she did not want to reveal to her mother that she was unable to cope with the nanny.

But, after two weeks, she managed to send the woman back to their rural home using an excuse that made her leave without knowing she had been rejected.

Mrs Ombati then resolved never to have a house-help, a decision that would later plunge her into more turmoil.

She found herself a prisoner in her house yet again because they lived on the third floor of their rented house and, because of the wound, she did not like the experience of using the stairs.

And then, the child developed eczema when he was two months old.

“He was just crying and crying and crying: day, night, morning. I was home alone, can’t go downstairs because it’s three floors down and the stairs were steep, I couldn’t leave the kid, couldn’t do anything. I was now a prisoner, now not in the bedroom but in the whole house,” she recalls.

It was around that time that she found herself shoving the child on the sofa and later decided to come out of the cocoon she had enclosed herself in.

During that period, Mrs Ombati had kept all her troubles to herself for she feared a backlash.

“I couldn’t tell other people because they would think I was ready to harm the kid,” she says.

Her husband suspected that she was suffering emotionally but did not think much of it because she had not opened up to him.

When she finally resolved to find a solution, she decided to hire a house-help then went for counselling at the Christ is the Answer Ministries church at Nairobi’s Valley Road.

BABY BLUES RELOADED

Dorcas Wambui Ombati when the Sunday Nation spoke to her at herhouse in Nairobi on June 10, 2016. New mothers may be ashamed to admit that life with a new baby is not always bliss. But not Dorcas Mbatia, who underwent post-natal depression, a condition that is characterised by confusion and dark thoughts. She shares her story to empower and encourage those who might be going through the same condition. PHOTO | ANTHONY OMUYA

By this time, the very thought of going back to her house was traumatising.

“Whenever I approached the house, I would feel some stress building up. It’s like you’re walking to the office of the deputy principal (in high school). That feeling of, ‘I’m in trouble, I can’t take it. I just want to turn back’,” she says.

A pastor who counselled her explained why she needed to be strong and why she needed to turn to God for recovery.

Fast-forward to 2015.

Despite Mrs Ombati promising herself that she would not get a second child, a friend told her how she regretted waiting for long before she started bearing children.

Having reached her 30s, Mrs Ombati decided that it was time she got another child to avoid regrets like her friend.

That’s why, on April 3 this year, she was in a theatre bed for another Caesarean section. It was a boy.

This time round, she says, she gave birth “on my own terms”.

“Last time it was an emergency: you don’t have control over anything; you’re like a leaf falling on a river and just being carried away,” she says.

Mrs Ombati adds: “It’s a pregnancy that I was looking forward to, so it was different. I was not a victim, I was not young — everything was okay.”

But despite having delivered at the Nairobi Hospital that had way better conditions than Kenyatta, having a good gynaecologist and having hired a nanny early, the depression symptoms recurred.

She recalls how she broke down one day when she went with her husband to see the gynaecologist, which shocked everyone.

She wept loudly, holding her two-week-old child at the gynaecologist’s waiting room, because she felt people who had arrived after her were being served as she waited.

“Such a trivial thing triggered it,” she recalls, noting that the doctor called her in after the ruckus.

“Tears were rolling down my eyes. And I told her, ‘I think I’m getting depressed.’ My hubby was quite disturbed because he had never seen me cry in public. The doctor was stunned.”

The gynaecologist then told her husband to ensure that his mother or Mrs Ombati’s mother was called immediately to give the wife some company.

“She told him, ‘You better arrest it now.’ She said what I was going through was post-partum stress and baby blues,” Mrs Ombati says.

After that session at the gynaecologist’s office, her husband took it upon himself to ensure that his wife was never alone at any one time.

“It seemed like my house was just full of visitors every weekend … That feeling has now disappeared. We are now on our second month and I’ve not found myself feeling desperate,” she says.

She found more resolve to shake off the depressive feelings on the advice of her sister-in-law, who works with an organisation that caters for the mentally ill.

“She was telling me to be careful because she had seen cases of post-partum depression and some of them are on medication. I don’t want to go that route.”

That cocktail of interventions, she says, has made her overcome her fears.

“In fact, for the first time, I feel like motherhood is fun. I have a smiling baby, I feel like I’m coping, I feel like I understand what is happening to me,” she adds.

“Now I understand what it means to say being a mother is the best thing in the world.”

Mrs Ombati, an office administrator at a global non-governmental organisation, said she had decided to share her story to encourage others who may be in the same situation to open up about their condition.

“Don’t be alone. Ask for help beyond your husband because sometimes your husband has become used to your mood swings and he thinks it’s a continuation,” she says.

GOOD MOTHERS

Gynaecologist Virginia Mwikali in 2013 conducted a study on 180 mothers who were receiving post-natal care at the Kenyatta National Hospital and discovered that 19 of them had post-partum depression, which translated to 10.6 per cent of the sample.

The study, recently published by the University of Nairobi’s School of Medicine, found that 14 out of the 19 who had the depression had started by experiencing maternity blues, which befalls up to 80 per cent of mothers.

Maternity blues, according to Dr Mwikali, start from as early as two days and last about two weeks. She says they are characterised by irritability, anxiety, confusion, mood liability, sleep disturbance and crying spells.

If the baby blues last beyond two weeks and last up to 12 months after delivery, then the likely culprit is post-partum depression.

“It consists of any or a combination of the following symptoms: sleeping and eating disturbance, mental confusion, loss of self-esteem, anxiety, lack of interest in one’s environment, insecurity and suicidal thoughts,” Dr Mwikali writes in the report.

Dr Mwikali, who is a gynaecologist at Kajiado County Referral Hospital, told Lifestyle that the climax of post-partum depression mostly occurs six weeks after delivery.

According to Dr Catherine Syengo, the deputy head of the Mental Health Unit at the Ministry of Health, post-partum depression could be a danger to both mother and child because it can develop into post-partum psychosis that is akin to insanity.

“In cases of post-partum psychosis, the mother can lose touch with reality. In such situations, they often see as if the baby — despite being born without any abnormality — is deformed and ends up killing them,” she says.

“We have also seen some women who have killed their children and committed suicide because they felt they were not good mothers therefore assuming that by killing the baby, they will end their suffering.”

The killing of toddlers is classified in law as infanticide and, according to police data, 30 infants were killed countrywide last year.

The data, published in the Economic Survey 2016, says that 19 of the 30 infanticides were caused by females. In 2014, some 31 cases of infanticide were reported, a decline from 60 in 2013.

Dr Syengo says there is no single cause of post-partum depression.

“Physical and emotional issues may play a role. After childbirth, a dramatic drop in hormones (oestrogen and progesterone) in your body may contribute to post-partum depression,” she says.

In her report, which was a dissertation for her Master’s degree, Dr Mwikali found that a woman from a low-income background is more likely to go into depression after birth. Fourteen out of the 19 who were depressed did not have a job.

Statistics by the World Health Organisation show that worldwide, about 10 per cent of pregnant women and 13 per cent of women who have just given birth experience a mental disorder, primarily depression.

In developing countries, the figures are higher, standing at 15.6 per cent during pregnancy and 19.8 per cent after child birth.

In her research, Dr Mwikali established that factors such as partner support, the mode of delivery and the mother’s religion did not have a significant impact on the likelihood of having post-partum depression.

“The mode of delivery, desired sex of infant and marital status did not appear to be significantly associated,” she added.

Dr Mwikali told Lifestyle that post-natal clinics should have the capacity to test for post-partum depression.

SUPPORT SYSTEMS

Mrs Ombati with her children. PHOTO | ELVIS ODIEKI

“Let there be screening, just the same way we are screening for hepatitis, diabetes,” she says.

Referring to the incident where a woman is suspected to have beheaded twins in Nairobi, she says having two children at the same time is almost guaranteed to stress the mother.

“Normal in human beings is one. So, when you have twins, triplets, it has to be stressful,” she says.

Forensic psychologist Oscar Githua says that while there are no specific risk factors associated with post-partum disorders, there is a need for society to treat the women who suffer from the condition with kindness.

“We should look at it as any other illness and avoid stigmatising the patients.

Instead of perceiving them as criminals, we should help them getting medical and psychological helps,” says Dr Githua, an assistant professor at the United States International University — Africa.

Anyone can develop PPD, says Dr Githua, adding that while 85 per cent of mothers present with postpartum blues, 15 per cent go on to develop adverse depression.

“When you begin noticing behaviour changes in this woman, it is advisable that you seek the advice of a doctor.”

Although he says that it is difficult to diagnose PPD, he advises that pregnant women to constantly go for prenatal clinics because doctors can pick up the symptoms before delivery.

Dr Githua also advises that beyond the medical and psychological care, it is important for first-time and new mothers to have strong family support systems.

“When there are people to encourage and help her, she will get through that rough moment rather easier than if she was alone,” he says.

Mrs Ombati hopes that the advancement in technology will help mothers better deal with postpartum stress. A WhatsApp group, she says, is all one needs to ask their peers for advice and to vent their worries.

In the course of the interview, her son Kyle, now in Standard Two, comes in from school. He throws his mother a loving glance and the mother tells him to go change his clothes first.

He hops away to his room and when he returns, he goes next to his mother and kisses the forehead of his two-month-old brother. An inseparable trio, it appears.