Awareness of pre- and post-partum depression is crucial to ensure the safety and health of both new moms and their babies.

M lives in Hyderabad. After her delivery, she underwent the traditional 40-day confinement. Being restricted to a room with just the baby affected her. She began to feel suicidal; thoughts of harming both her baby and herself filled her head.

S is from Delhi. After she had her baby, she experienced severe crying bouts. Doctors at a premier mental health insitute diagnosed her as having Obssessive Compulsive Disorder (OCD). But treatment did not help. She lost interest in her baby her family and herself.

Neither M or S or their families understood what was happening to them, post-delivery; that they were actually experiencing some form of post-partum depression (PPD).

“M somehow got hold of my number. She called me to say she had a very bad feeling towards her baby,” recalls Dr. Archana Nirula, a Delhi-based gynaecologist and the India coordinator for Postpartum Support International (PSI), a voluntary group that supports new moms and creates awareness on post-partum disorders.

M’s husband was in the U.S. at the time. Dr. Nirula contacted him and with his help, convinced M’s in-laws to let her, literally, step out of the confinement room. The in-laws were told they had to help her care for the newborn.

“S is my cousin’s wife,” says Dr. Nirula. “I told my cousin to immediately hire help to care for the baby; that he must take S out often, spend time with her. I impressed upon him that he too must share the responsibility of looking after the baby,” she explains.

Counselling, along with medication and family support, helped. Both women are now healthy, active mothers. Their babies are growing well.

Baby Ahuti in Mumbai was not so lucky. The three-month-old infant’s death was plastered across newspapers and television channels in October 2012. The police arrested her mother Dharmishtha Joshi on charges of battering the infant. The mother allegedly beat her “because she would not stop crying”, reported the police. Later it emerged that Ahuti’s twin sister had died just 12 days after birth.

Was Dharmishtha Joshi suffering from post-partum psychosis (a result of untreated and prolonged PPD)? What role did the babies’ father, Kalpesh Joshi, play in this tragedy? “There are many such horror stories across India,” says Dr. Nirula.

If a new mother is feeling detached from her baby or unable to nurse or care for the infant, she finds it impossible to admit that she needs help. If she is herself not aware of these changes, then her family must seek help, stresses Dr. Nirula. “In India, families, whether educated or uneducated, consider this condition a stigma; a shame. Even the treating medical fraternity link it to a psychiatric problem rather than a PPD (which is what happened to S),” she points out.

Nora Kropp, a mother of two, a professional midwife and Bangalore-based founding member of the Bangalore Birth Network (BBN) concurs. “We have idealised the state of motherhood to such an extent that a mother is not supposed to feel anything negative,” she observes.

Yet, there is enough research, done in India and across the world, to show that post-partum disorders can harm if left untreated or undiagnosed. A 2002 report in the Journal of Nervous and Mental Disease said women with severe postpartum psychiatric disorders admitted to an Indian psychiatric hospital reported infanticidal ideas and behaviour. A 2004 research paper in World Psychiatry also suggests that, in India, the new mother is at a greater risk of developing severe post-partum disorders if, she is poor, has experienced antenatal depression, is in a bad marital relationship, subject to domestic violence, and has given birth to a female baby.

In the West, there are support groups such as www.postpartumprogress.com and active networks such as PSI. There is nothing of the sort in India though birthing communities such as Birth India and BBN do deal with post-partum care. Dr. Nirula says that panic calls come to her cell phone or Delhi clinic. She stresses that gynaecologists/obstetricians and birth networks across India must set up networks and counselling for post partum disorders.

If women like M and S receive the help and support they need, babies like Ahuti will not die.

PPD vs. the Baby Blues

PPD is not the Baby Blues. The blues manifests as weepiness, vulnerability, forgetfulness, and stress after the babies are born. The blues should be over around two weeks after delivery. If it continues, even if the symptoms are mild, it is called PPD.

PPD is one of six post-partum mood disorders and is the most common. The primary cause is thought to be the huge hormonal drop in the mothers' body after the baby is delivered. This hormone shift then affects the neurotransmitters (brain chemicals).

If the new mom is experiencing loss of appetite, difficulty sleeping at night when the baby sleeps, hopelessness, poor concentration, anxiety, anger, deep sadness, low self esteem, overwhelming energy or lack of energy, she or her family must get help right away.

Source: Dr. Shoshana Bennett, post-partum expert based in the U.S.

Helplines

Dr. Archana Nirula PSI Coordinator, India +91-9810192690 or +91-11-41634773/41634774. Email: sunrayclinic@gmail.com

The National Institute of Mental Health and Neuro Sciences (NIMHANS), Bangalore has a perinatal psychiatry clinic: 080-2699 5554

Bangalore Birth Network—http://www.bangalorebirth.org/bangalorebirth@gmail.com http://health.groups.yahoo.com/group/bangalorebirthnetwork/

Go to http://www.birthindia.org/ and click on the 'Services Directory' to contact midwives, birthing and lactation specialists in Bangalore, Delhi, Mumbai, Kochi, Goa, Gujarat, Kerala, Hyderabad, Pune and Chennai. They help new moms get in touch with counsellors for PPD