Baby blues are no small matter

KOCHI: The birth of a baby is a source of joy and excitement for a family. For the new mother, however, the child can trigger a range of emotions that aren't always positive. As maternal mortality rates decrease the world over, the focus is now on maternal morbidity.

According to a study conducted by the World Health Organisation (WHO) in 2017, the prevalence of postpartum depression in Indian mothers was 22 per cent. More and more mothers today suffer from depression that not only impacts the bonding between the mother and her newborn but also could have a lasting effect on the child's psychology.  

Women who have previously experienced depressive disorders or ones suffering from anxiety are more prone to postpartum depression.Although there is no way to diagnose the incidence at the time of pregnancy, Dr Praveena E Joseph, head of the Department of Obstetrics and Gynaecology at Lourdes Hospital, stresses on some markers that could raise red flags.
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A disruptive family life, an abusive partner, financial difficulty or personal stress could lead to the manifestation of this trait of depression. In India, the birth of a girl child has also been registered as a cause in a study conducted by WHO. Having said that, these are not the only indicators."

Experts point to the importance of differentiating postpartum blues with postpartum depression. The feelings of being sad, overwhelmed, anxious, and having an urge to cry and inability to connect with the baby peak a couple of days after the delivery and should subside by the end of the second week. If these emotions do not taper off and continue for several weeks, it would be diagnosed as depression and requires medical intervention.

Of 100 new mothers, maybe 40-50 or more have what we call as postpartum blues. Emotional support or counselling from family or partner dissipates the blues. Only a small per cent of the cases advance into a full-fledged depression. This number could be around one to five per cent," observes Dr U Vivek, senior psychiatrist at Renai Medicity.

Mothers undergoing postpartum depression fail to develop an emotional bond with the baby, then the child is often neglected and in some instances malnourished. Cases of severe postpartum depression can lead to psychosis which can be extremely life-threatening to both the mother and child.

"Women suffering from postpartum psychosis develop feelings that something has happened to the child and want to injure the baby. Such suicidal and homicidal thoughts are a major cause for concern," says Dr Vivek.

With the number of postpartum depression incidents increasing every year in the country, experts call for increased awareness in the family and partners.

"Most of the referrals we get is through the gynaecologist or pediatrician who observes some adverse signs in the mother. Yet, it's the family who needs to be alert to behavioral patterns and seek help," says Dr Vivek.

Treatment methodologies range from cognitive behaviour therapy or counselling to prescription of medicines.

"The one positive aspect is that postpartum depression is completely treatable. In low and moderate cases, counselling works well to remove hostile thoughts from the mother's mind. For serious episodes, we now have drugs that are perfectly safe during the lactation period and are lifestyle compatible. But medication needs to be continued until the doctor deems fit," says Dr Vivek.

What the trends say
Women who have previously experienced depressive disorders or ones suffering from anxiety are more prone to postpartum depression. Although there is no way to diagnose the incidence at the time of pregnancy, a disruptive family life, an abusive partner or financial difficulty are some  red flags