Hajia Amina was excited to be pregnant, within a year of marriage. She read many articles
around health and safety during pregnancy and she marked every milestone with pride. She
duly registered for antenatal services after making enquiries for the best facility where her
pregnancy could be supervised, and she could be rest assured that she and her baby would be
in safe hands. Everything went smoothly and she was delivered of a bouncing baby boy. But she
was just feeling tired and exhausted. There was no excitement or joy. She felt drained, tired and
would burst into tears for no reason. She started feeling guilty for bringing the innocent baby
into the world. She was not sure she could be a good mother. She didn’t want to take the baby
or breastfeed him. She didn’t feel like eating or talking to anyone. She just felt miserable and
wanted to be alone. Her husband and mother felt she was only tired and will snap out of it. But
when these behaviours continued even after the naming ceremony, they became worried.
Her mother was getting irritated with her and tongue-lashed her without mincing words. ‘Are
you the first to give birth to a child or what’s all this nonsense now?’ ‘You want us to be begging
you to take care of your own baby?’ ‘Better stop being lazy,’ she concluded. Amina simply burst
into tears again as she didn’t understand what was wrong too. Eventually her husband took her
back to the hospital. The doctor informed them that she had postpartum depression and they
will invite a psychiatrist to review. They became alarmed. Does that mean his wife is running
mad? What is really happening?
Perinatal Mental Health
During pregnancy, and the aftermath of pregnancy, the rate of mental health problems in
women is much higher than at other times. In developing countries like Nigeria, 1 out of every 5
women (20%) going through pregnancy and childbirth will experience a mental health problem commonly anxiety and depression.
The term ‘Perinatal Mental Health’ covers the emotional and psychological health and
wellbeing of a parent (mother) during the period from conception to 12 months after a baby is
born (infancy). If attention is not paid to the emotional wellbeing of women during the
perinatal period, the negative impact will be felt by everyone – new mother, the baby, father,
other children and the entire society. In some tragic instances, it leads to suicide or the killing of
the baby (infanticide).
Pregnancy
Anxiety and depression commonly occur here, usually having a U-shaped frequency of
occurrence across the three trimesters of pregnancy. Thus, levels are high during the first
trimester, lowest during the mid-trimester and high again in the final trimester just before
delivery. These fluctuations follow the expectant mother’s pattern of worry: first trimester –
will the pregnancy stay, or will I suffer a miscarriage? Hope it is not a false alarm and that I am
truly pregnant? And so on. But by mid trimester, these worries are allayed, and she is calm. By
the final trimester, anxiety and depression again increases, with concerns over safety of
delivery, will the child be normal or abnormal? E.t.c.
Immediate aftermath of delivery
Mental health challenges here may include depression (post-partum depression) or psychosis.
In post-partum depression, it is characterized by excessive moodiness, crying for no specific
reason, feeling tired and not being excited while everyone is celebrating the birth of a new
child. This may be transient – lasting only for a few hours or days, in which case, it is simply
called post-partum blues.
However, in some instances, such feelings may persist for weeks or months and the mother
may even begin to question why she brought an innocent child into this miserable and sinful
world. She may have suicidal ideas and entertain thoughts of harming the baby and herself. The
early warning signs include weepy spells, not being willing to nurse the baby or pay attention to
the baby, refusing to eat and neglecting to take care of her personal hygiene. In such instances,
coupled with the possibility of harming herself and her baby, immediate attention from a
psychiatrist should be sought without delay.
Post-partum psychosis may also occur in the aftermath of childbirth. In this instance, the
woman begins to talk abnormally and may be restless and agitated. Her behavior may also be
inappropriate. It should be clear to close family members that something is wrong, and she
needs urgent medical attention.
Conclusion
Mental health conditions may be triggered by pregnancy and the aftermath of childbirth. Just
like women developing high blood pressure or diabetes during pregnancy. They can be easily
treated, and they will fully recover and return to normal functioning. It does not mean they are
running mad. Or that their children will have mental illness. We need to be understanding, to
show support and ensure they receive prompt treatment in such instances.
Dr Jibril Abdulmalik
Tribune Article for the column “Your Mental Health & You”
Thursday, 7th March 2024
Asido Foundation
www.asidofoundation.com
Asivuri Consulting
www.asivuri.com
