Postpartum depression is a mood disorder in mothers that can result after giving birth. It hampers the mother’s ability to take care of the child. It is a considerable public health problem that affects women and their families (Warner et al., 1996). During the first few weeks, around 80% of moms are found to express feelings of sadness, tearfulness, unwanted crying, sleeping problems, appetite disruptions, anxiety, and a feeling of general unhappiness (London Health Sciences Centre, 2011). Consequently, this can make it difficult for them to complete daily chores and take care of themselves as well as their children. Hence, it affects mother-child relationship and negatively impact growth and development of children. In addition, children of mothers with postpartum depression have greater cognitive, behavioral, and interpersonal problems compared with the children of non-depressed mothers.
Postpartum depression is a common complication among childbearing mothers. It occurs in 10-15% of women after delivery (O’Hara & Swain, 1996). It usually begins within the first six weeks postpartum and in most cases require treatment by a health professional.
There are three types of postpartum psychiatric disorder:
- Postpartum blues: According to Kids Health, “ baby blues” are feeling of sadness and surges of emotions that may occur in the first few days after childbirth. Baby blues normally only last a few days or weeks.”
- Postpartum depression: Postpartum depression is the most common complication of childbearing and as such represents a considerable public health problem affecting women and their families.
- Postpartum Psychosis: Postpartum psychosis, which has a global prevalence ranging from 0.89 to 2.6 per 1000 births, is a severe disorder that begins within four weeks postpartum and requires hospitalization.
STATEMENT OF PROBLEM
Postpartum blues, affect mothers with an incidence of 300‒750 per 1000 mothers globally. Similarly, the global prevalence of postpartum depression has been estimated as 100‒150 per 1000 births. First-time mothers have a more than twofold risk of needing mental health care during the first months after delivery as compared to a year later, and the increased risk of depression lasts the first five postnatal months (Munk-Olsen et al., 2006).
Children of mothers with this condition are likely to be underweight and stunted. Furthermore, depressed mothers neither breastfeed their babies properly nor seek health care. In developing countries, more than three-quarters of people with the serious mental disease do not receive any treatment (Demyttenaere et al., 2004).
In Nepal, among women aged 18–65 years the prevalence of anxiety is 17.8%, depression 5.4%, and co-morbid anxiety and depression 7.5%. Since Nepal has a multiethnic, multicultural, pluralistic society with enormous socioeconomic disparities, it is a formidable task to provide affordable and effective mental health care. There exists a very poor awareness of the maternal health risks of the postpartum period.
According to the studies conducted in Nepal, a higher risk of postpartum depression is seen among:
- Young aged of mother (16-25).
- Mothers belonging to disadvantaged community.
- Mothers with low education levels
- Unplanned pregnancy
- Excessive alcohol intake
- Excessive tobacco intake.
- Poor communication with husbands.
- Women with less financial stability.
- Women with lack of social support.
Furthermore, the studies also found that around one in every five pregnant women had an increased level of anxiety and nearly one in four had an increased level of depression. Psychological conditions among women during their pregnancy and in the postpartum period pose a challenge in countries like Nepal where the health systems are not yet prepared to provide mental health services to the population as they lack specialist mental health professionals and a reliable supply of medication(Aryal KM et al., 2018 and Basnet S et al., 2012).
The postpartum period is the most crucial time for the wellbeing of mothers and their children. Early recognition of postpartum and social support can help to prevent it to be worst. Postpartum services to mother should also include screening for anxiety and depression. Program that encourage supportive environment to postpartum mothers should be conducted.
- Aryal KM, Alvik A, Thapa N, Meheta S, Roka T,et al. Anxiety and Depression among Pregnant Women and Mothers of Children Under one Year in Sindupalchowk District, Nepal. NHRC 2018;16(39):195-204.
- Basnet S, Budhathoki M,Bhusal H,Dahal N,Ohja H, Pandey S,et al. Violence against Women by their Husband and Postpartum Depression .NHRC 2012;10(22):176-80
- Alfayumi-Zeadna, S., et al. (2015). “The association between sociodemographic characteristics and postpartum depression symptoms among Arab-Bedouin women in Southern Israel.” Depress Anxiety 32(2): 120-128
- Bernstein, I. H., et al. (2008). “Symtom features of postpartum depression: are they distinct?” Depress Anxiety 25(1): 20-26.
- Silverman, M. E., et al. (2017). “The risk factors for postpartum depression: A population-based study.” Depress Anxiety 34(2): 178-187.
- Jensen, S. K., et al. (2014). “Developmental inter-relations between early maternal depression, contextual risks, and interpersonal stress, and their effect on later child cognitive functioning.” Depress Anxiety 31(7): 599-607.
- Aarya Krishnan Rajalakshmi, Amardeep Kumar,et al. “Postpartum depression in India: a systematic review and meta-analysis” Bulletin of the World Health Organization 2017;95:706-717