Post natal blues? Reach out

When Thabisa Ntoza* heard she was pregnant two years ago she was ecstatic at the news.

She and her boyfriend had been talking about having a baby for years. According to Ntoza, the pregnancy was bliss and she enjoyed watching her body expand and change shape as her baby grew inside her. The pregnancy was made even more special by a surprise baby shower thrown by her friends.

The hell began the day she gave birth.

Ntoza started doubting her mothering capabilities while still in the labour ward. This was followed by anxiety and what she described as “feeling generally low”.

“It was then that it hit me that I would now be someone’s mother forever,” she said. “I was asking myself a lot of questions, mostly how I would keep this little person alive.”

From there the situation got worse. She did not know that breast-feeding would be so painful or how hard it would be to go without sleep, sometimes for days on end.

“It was easy at the hospital with the nurses around but when I got home the baby wasn’t sleeping. He had colic. I thought I was losing my mind. I started giving him gripe water and different kinds of colic medication to get him to sleep.

“When he started becoming immune to this, I gave him different types of painkillers to get him to sleep through the night. I just kept adjusting the dosage.

“I felt so guilty doing that. I worried about how all that medication was affecting his body but I just needed him to stop crying and I needed to sleep.

“I missed showering and combing my hair. I wasn’t eating. I felt so low and like such a failure. I was miserable.

“I felt that way for months. I told my family and friends but they just told me to get on with it and that I was not the first woman to have a baby,” she explained.

Feeling a bit low after the birth is quite common – but having the blues for longer than 10 days after the event could be a sign that something more serious is wrong.

Postnatal depression – where new mothers feel low, tired and anxious with possible changes to their eating or sleeping patterns – is a condition that affects around 13% of mothers worldwide, the South African Depression and Anxiety Group (Sadag) estimates.

Sadag operations director Cassey Chambers said research from the Peri-natal Mental Health Project revealed that in South Africa, a whopping 30 to 50% of moms suffer from postnatal depression, while around 80% of new moms experience fleeting moments of sadness, tearfulness, irritability and mood swings shortly after birth known as baby blues.

Psychiatrist Dr Bavi Vythilingum explains that symptoms of postnatal depression include a depressed mood or marked loss of interest or pleasure most of the day, nearly every day for a period of more than two weeks. The new mother may also feel anxious and overwhelmed, especially around the baby. Feeling numb and thoughts of being the worst mother are sometimes also present, with some women having thoughts of harming themselves or the baby.

While the issue of postnatal depression has featured in several media reports over the years, the issue has recently been brought to the fore by a number of Hollywood celebrities admitting to having a bout of the blues when they welcomed their little bundles of joy into the world.

Real-life accounts from celebrities such as Sarah Michelle Gellar and Chrissy Teigen have sparked conversations on various media platforms with many other women also coming forward.

The conversation, however, remains somewhat taboo in certain communities.

In black communities mothers are often scoffed at when they admit to negative feelings or struggles, yet research shows that low-income earners – and in South Africa these are predominantly black women – are more susceptible to postnatal depression.

According to Chambers, the Post Natal Depression Support Association (PNDSA) recently conducted a study in Khayelitsha, Cape Town, which showed that more than 30% of new moms there suffer from postnatal depression.

In the US a similar study conducted by the University of Iowa, published in the journal Social Psychiatry and Psychiatric Epidemiology, reported that postnatal depression was more likely to affect African American or low-income mothers.

In an article in Psychology Today, writer Gloria Malone says research shows that black women are twice as likely as women from other ethnic groups to suffer from postnatal depression.

“Researchers aren’t entirely clear on the reasons for these statistics, but one obstacle to treatment is stigma around mental health issues, specifically the stereotype of the black superwoman.

“As black women, we are socialised and raised with the goal of being strong women. Part of achieving this can mean associating very human emotions and reactions like sadness and crying with weakness and failure,” the article reads.

Clinical psychologist Vuyo Themba said while she had no statistics on the prevalence of the condition in black communities, her interaction with various women suggested it was indeed quite high.

“I hold various workshops with women to speak about this issue and based on those and based on my clients I would say postnatal depression is very prevalent in the black communities. It affects more women than we think,” she said.

“Even from the baby blues stage, which affects almost all new mothers, black women are not given the space to talk about their feelings within their circles or in their communities. Even when they do reach out, in most cases black women are only given the practical advice needed to be able to raise a baby.”

Themba said black women are usually only taught things like how to make a bottle, how to change a diaper or how to get the baby to sleep.

Little emotional support is given, which is why in many cases what starts out as just baby blues quickly escalates into depression – mainly because the women feel so alone.

For Ntoza, the situation improved after she reached out to other mothers who were also struggling. “I met the first one when I took the baby to get immunised. She said she had not slept in a month. Her baby also suffered from colic. After listening to her story and sharing mine, I felt a lot better. From there I started sharing my feelings with my family and friends and forcing them to listen. I explained that yes, many women have had children but this is how I felt about it. After a while they started to understand and they started offering to help more.

“With some regular sleep, food and a daily shower I started feeling like my old self again. At one stage I was feeling so low I was regretting ever having a baby and I was considering taking antidepressants.”

Vythilingum said treatment for postnatal depression can be psychotherapy and medication, depending on the severity.

Themba, however, warned that psychotherapy could prove difficult for some.

“When a mother is feeling exhausted from lack of sleep it may be difficult for her to fully engage in therapy.

“She may struggle to express herself in order to receive help. That’s where medication comes in.

“Medication can lessen the depressive symptoms, which then allows the therapy to work,” Themba explained, adding that women should share with each other the realities and hardships of caring for a baby.

“No one told me how hard this was going to be. I thought a baby was like a doll. I thought after washing my son, clothing him and feeding him he would just sleep all day and all night,” Ntoza said.

“I thought the hardest part would be serving refreshments to the visitors who would be coming to admire my new baby.

“I had read about colic and the trouble some women experience with breast-feeding and not sleeping but I had no idea it was going to be that bad. My expectations and my experiences were two completely different things.” — zisandan@dispatch.co.za

* name changed