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“It felt like somebody took my body”: An Overview of Postpartum Depression » Women's Courage

“It felt like somebody took my body”: An Overview of Postpartum Depression

February 23rd, 2012 by tiana Leave a reply »

“ And it just worsened and 3 days after I was home … I didn’t want anything to do with him [the baby]/and he cried and cried” (5)

 

Outside of the course, my academic interest primarily focus on parental engagement and a child’s linguisitic competency. Mother-child physical and verbal interactions are crucial for a child’s development. Often, the quality and quantity of speech a child hears from a caretaker can serve as sufficient predictors of later language outcomes. This is the reason that I chose to focus this week on a mental health issue that can potentially disrupt such interactions between mothers and their children. While I initially intended the focus of my blog to be around acute traumatic experiences and mental health issues that subsequently arise, post partum depression is an mental health issue that affects women globally and is an important problem that needs to be touched upon at least once throughout my blog.

Post partum depression is a form of clinical depression which usually first manifests itself within the first four weeks after birth and generally lasts six months after giving birth to a child (1). During this period, great hormonal changes and psychosocial factors emerge to trigger the onset of the disorder. For the most part, rates of PPD in developed countries is consistent. There are three distinct stages of PPD (in order of increasing severity: PP blues, PP nonpsychotic depression, and PP psychotic depression) and data from the United States and Germany estimate this to be anywhere from 8 to 15 percent of pregnant women could be classified into one of the three stages (2). Although these figures are cause for concern, it is even more concerning given the fact that most instances of PPD are unreported, often because of stigma attached to mental illness and demonization of mothers who are suffering from the illness (i.e. PPD mothers who have harmed their children physically are often sensationalized in the media, creating social barriers for women who are depressed to seek help) (1).
This is especially problematic given that two risk factors of PPD (unhappiness about pregnancy and child mortality) would likely manifest itself disparately in developing countries. When family planning is unavailable or difficult to access, the likelihood of a woman having an unwanted child is increased, putting her at risk of devleoping PPD after giving birth. Additionally, the infant mortality rate in developing countries is often much higher than that of developing countries. An example of a country where women may be at a unique risk is Afghanistan. According to UNICEF, Afghanistan ranks second in the world in terms of under-5 child (infant mortality rate in 2009 was 134/1000 live births) and also relgious customs often make access to family planning difficult if not impossible (although there is some glimmer of hope that these religious customs are becoming less of a barrier to access, see referecne 4) (3, 4). Given the prevalence of both of these risk factors in the country, one would expect rates of PPD to be much higher in this country. However, one can only make inferences since data on the rate of PPD in Afghanistan is not readily available.
In looking for possible treatments and preventative measures, anti-depressants are often looked to as the answer. However, in resource poor countries, this is not always the best option financially (expense of anti-depressants) and logistically (distribution of the medication to women who need it). One Canadian study approached the issue with this in mind and sought to look at what mitigated some of the symptoms of PPD experienced by theses women. They found a negative correlation with the mother’s perception of the father’s involvement in the care of the child and severity of PPD symptoms. (5)
Overall, after researching this important issue in women’s mental health, I was disheartened by the seeming lack of data surrounding this issue in the developing world. One argument explaining the lack of data in these developing countries is that PPD is not distinctly recognized as a valid mental health issue. Another argument put forth is that the family unit is often stronger in non-Western cultures and thus PPD is prevented since this support system exists (2). Whatever the reason for this lack of information, future research should seek to provide more insight into the non-physical experience of new mothers.

References:
(1): http://jama.ama-assn.org/content/287/6/762.full
(2): http://www.aahperd.org/aahe/publications/iejhe/loader.cfm?csModule=security/getfile&pageid=39147
(3) http://www.unicef.org/infobycountry/afghanistan_statistics.html
(4) http://www.nytimes.com/2009/11/15/world/asia/15mazar.html?_r=1&hp
(5) http://www.biomedcentral.com/1472-6955/8/8

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7 comments

  1. fiona says:

    In general, mental health seems to be ignored when we look at global health problems. I am sure that women in these developing regions must also suffer from PPD, especially when we start considering whether the pregnancy was wanted, the conditions she gave birth under, stress associated with providing for other children, war/conflict, and abuse at home. I wonder if women in these areas have noticed that it is a problem, and if they have utilized other resources, like sisters, mothers, and aunts in the absence of more formalized care.

  2. christine says:

    Wow! This is a very interesting post. I totally agreed with your last sentence about being disappointed with the limited amount of information that was out there about mental health disorders in the developing world. When I started my blogs, I was thinking of looking at the mental health issues involved around domestic violence, however, being a psychology major, and being from Tanzania, I knew that realistically there would not be a lot of published information available. Psychology is still a field that has not received recognition in many parts of the world. I can only speak from personal experience, for example, in Swahili, we do not have a word for stress. And just from a linguistic point of view, if it does not exist in the language, then it is difficult for people to grasp the existence of the terminology in real life.
    I wanted to also comment on Post-postpartum depression. Till today, I still shake when I think of Andrea Yates, the Texan woman who drowned her five children in the bath tub. This is something very serious. I had not known until I read your article that not wanting a child/child mortality leads to postpartum depression. I think of many women in developing countries, and the example you gave of Afghanistan who are in danger of this. I also think of how getting access to medication is a barrier, especially in countries which do not think that psychological disorders exist.
    This is a very interesting post to me. It is something that I have often thought about because I would like to go back home and help people through dealing with mental health, but it will not be an easy task. That is for sure.

  3. natalie says:

    I have heard of PPD, but have to admit that I really do not know much about it as an illness. I feel like there is such a cultural expectation around birth as a happy event that even though I knew the disorder existed, I pretty much know absolutely nothing about it. I find it particularly fascinating because I feel like the first five years (or at least thats what I have heard) really set the precedent for how a person grows up to feel about relationships. In this sense, it seems like PPD would be a self perpetuating cycle, where children are lacking early maternal care would be more likely to develop social issues later in life. It seems like part of the reason that PPD, and most psychological illnesses for that matter, are understudied and underreported is because they are so difficult to diagnose in the absence of physical symptoms. Particularly in impoverished areas where people are living hand to mouth, physiological needs are considered a secondary issue, if they are considered at all.

  4. tracyh says:

    I was surprised to see post-partum depression as a topic in one of our blog posts this week. It is definitely a topic that does not receive enough coverage, but does affect a number of women in the world. (One of my closest friends’ mother had post-partum depression after her older sister’s birth. She spent the next 6 months in China before returning home.) Do you know what has been done for PPD not only for developing countries, but here at home? Do we have organizations or counseling that can help? Anti-depressants aren’t necessarily the best answer…

  5. June says:

    That is really interesting that there hasn’t been that much research on other types of initiatives to reduce PPD since it is widely known that PPD is a common amongst women. Have there been any initiatives that have been started to treat PPD in developing countries? Has any sort of initiatives that have been attempted that have failed?

  6. adrienne says:

    It seems to me that in many communities in developing countries, especially rural communities, the combination of a woman’s network of female friends and her husband/partner (if she has one) may be her only support in facing PPD. This makes me wonder what it would take to mobilize women to begin to recognize the warning signs of PPD within their fellow community members and to take appropriate action when they believe a woman may be at risk. Are there already NGOs that are doing this? Could this be included in a larger sexual health education program?

  7. kristin says:

    It’s not surprising that data regarding postpartum depression is so scare in developing countries. In some parts of the world, I wonder if the disorder is even known to exist? It would also be interesting to look at rates of postpartum depression among women who are raped, especially in conflict situations. I would guess they’re much higher. That reminds me of the opening paragraph of chapter 7 in From Outrage to Courage, when a Rwandan woman expresses her inability to love her only child because he was conceived with the “killers”.

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