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Health News of Monday, 10 December 2018

Source: Farida Yusif

Postpartum depression; a ‘forgotten’ mental illness harming mothers

Quite a number of Ghanaian women and their counterparts in other African countries can attest to the pressure our society puts on them to have babies to justify their womanhood.

Many of you might have at least seen one Nollywood or Ghanaian movie where a woman who doesn’t have any children is maltreated, mocked and given all kinds of unpalatable names. I know most of you know what I am talking about and can relate.

As a woman, you are supposed to get pregnant and bring forth children, carry a baby bump for nine months or more, and be able to combine all the house chores. Many women in Ghana go through this, don’t be stunned.

That kind of pressure can weigh down any human being, and according to Amina Yakubu, a midwife at the Accra Regional hospital, Ridge, the pressure from pregnancy and combination of chores is one external contributing factor to a kind of depression most women face.

This type of depression is called Peripartum (PostPartum) Depression. Postpartum depression is a complex mix of emotional and behavioural changes that a woman experiences during conception and somewhere around four weeks after childbirth.

Depression is a mental disorder that affects one’s mood, loss of interest or pleasure, energy, feelings of guilt or low self-worth, disturbed sleep or appetite, poor concentration, and can bring about suicidal thoughts.

Major depression, Persistent depressive disorder, Bipolar disorder, Seasonal Affective Disorder, Psychotic Depression, Peripartum (PostPartum) Depression, Premenstrual Dysphoric Disorder(PMDD), Situational Depression, Atypical Depression, are types pf depression one can suffer.

A report by the Daily Graphic in 2015, revealed that Ghana records 1,500 suicide cases annually, and this is caused by depression.

Peripartum (PostPartum) Depression for women, can make a mother not want to see her baby, touch her babies, and sometimes the feeling of wanting to kill her child.

Amina Yakubu, a midwife at the Accra Regional Hospital, Ridge, said most cases of PostPartum Depression cases the hospital receives are mothers who have been raped or gotten pregnant mistakenly.

“Victims of rape, unintended pregnancy, women who had a lot of ill-health during the pregnancy and didn’t have any support during the pregnancy, and women who have a lot of children, are usually most of the cases that come my way,” she said.

Anima Yakubu recounted to me a story of a postpartum depression patient whose husband had come to her for help. The woman refused to eat, but was forced to eat and when she finally got food (Meat) in her mouth, she refused to swallow for three days.

The woman had refused to hold or care for her baby because the baby didn’t look like her baby.

“Some of them don’t feel like eating at all, there was an instance where we had a lady who had this condition; she refused to chew nor swallow the meat, the meat was in her mouth for three days. She was brought to the facility [Labour ward], I spoke to her kindly and was able to convince her to bring out the meat, when she opened her mouth, the whole area was just engulfed in the stench from the rotten piece of meat that had been in her mouth for three days,” she said.

There was another young mother who was in labour, but refused to push out the baby because she was convinced she was never pregnant, and that she only had abdominal pain.

This young lady was impregnated by her aunt’s husband, who sneaks into her room to sleep with her whenever she went visiting.

When the doctors finally got her to push out the baby, she totally refused to care for the baby.

The midwife narrated to me how she had to take care and nurse a newly born whose mother didn’t want anything to do with the baby.

“I did the vaginal examination and I realized she has dilated and was in labour, I had to tell the girl’s mother. I put some drips on her, and it will help with the abdominal pain, and told her whenever she feels like using the toilet, she should just push, whatever comes out the doctors would handle it from there. She pushed out a bouncy baby girl,” she said

Aisha said after the childbirth, it was a lot of work getting the mother to accept the baby as hers.

Stella Allotey, who is also a midwife at Ridge, who has had a couple of experience with postpartum depression patients, said she once had a case where a patient had to be restricted and separated from the rest of the patients.

There was another case where a mother in Stella’s unit poked the eyes of her baby, so the baby had to be immediately separated from the mother and treated in a different unit.

“In some cases, you have to detach the other clients from others because if you should mix them, they might cause harm. Some of the patients even attack us [Nurses and Midwives], but not all of them are aggressive; some are just moody, crying and don’t want to eat,” she said.

”She put her hands in the baby’s eyes, the baby’s eyes had discharge coming out, I remember the story very well, the baby was taken to the eye clinic for the eyes to be nursed,” she said.

A mother who had come for a postnatal visit to the hospital, who had suffered the mild form of postpartum depression said taking care of a baby by oneself without help is quite frustrating, and it is even more frustrating if that is your first child.

“When I was in that period, I was very unhappy, I easily get mad at every little thing, when I hear the baby cry I become frightened, and this was because I really didn’t get any help during my pregnancy,” she said.

The motive behind this piece and the experiences of these mothers I am sharing, is not a showcase the painful experiences of these mothers.

This is to inform you of what postpartum is, and what it does to a mother, that it is a mental health condition like other mental health conditions that need all the attention it can get.

This is to advocate for public education on mental health, that these patients need attention, and so government must address mental health issues holistically.

Six years after the Mental Health Act, 2012 (Act 846) was passed, parliament is yet to fast-track the Legislative Instrument (LI) to ensure effective implementation of the Act.

This is evidence that Ghana has a long way to go when it comes to giving mental health issues prominence, and this is quite evident in the number of mentally challenged people roaming some of the busiest streets of Accra, Kumasi and many other cities.

Ghana as a country needs to care more about mental health, because according to the 2007 situational analysis by World Health Organisation, 650,000 Ghanaians suffer from various forms of severe mental disorder, with 2,166,000 suffering from mild mental disorder.

In the month of February and March 2017, suicide cases made headlines in Ghana, but they didn’t mean much to us as a country. It was not for fun, that the theme for the World Health Day in 2017, was “Depression: Let’s talk.”