Postpartum depression: a community matter we must not ignore

THE months after the birth of a baby are often described as a season of joy and celebration. For many families, however, this period can also be a time of challenge, stress, and vulnerability. While it is natural for new parents to feel overwhelmed, it is important to recognise when these emotions go beyond normal adjustment and develop into postpartum depression (PPD).

How Common is PPD?

Research shows that PPD is more common than many people realise. A 2023 global study estimated that about 17% of mothers experience PPD, with higher rates in middle- and lower-income countries. The reasons are complex, but often linked to limited access to healthcare, food insecurity, and poor social support. Most cases begin within the first few months after birth, but once a mother has experienced PPD, the likelihood of it recurring in future pregnancies increases.

Risk Factors

PPD is not caused by a single factor but is the result of a combination of biological, emotional, and social influences. Some of the known risk factors include:

- Lack of support from partner, family, or friends.

- Challenges of being a first-time or teenage mother.

- Domestic violence, financial stress, or grief.

- Poor coping skills, low self-esteem, or unplanned pregnancy.

- Sleep deprivation and hormonal changes after birth.

- Smoking, alcohol, malnutrition, or HIV infection.

- Gestational diabetes and other pregnancy-related complications.

- A personal history of depression, anxiety, or psychiatric disorders

It is important to remember that fathers can also be affected. Recent studies suggest that up to 8% of fathers may experience PPD, often triggered by financial pressure, lack of sleep, or feelings of exclusion from the mother-baby bond.

Recognising the symptoms

It is natural for many mothers to experience the “baby blues,” which include mood swings, irritability, and anxiety that usually settle within two weeks. Postpartum depression is different - the symptoms are more severe, last longer, and interfere with daily life.

Some of the common signs include:

- Persistent sadness and loss of interest in activities.

- Irritability, panic attacks, or overwhelming worry.

- Feelings of guilt or being an inadequate parent.

- Withdrawal from family and friends.

- Difficulty bonding with the baby or feeling detached.

- Changes in appetite and sleep beyond normal newborn care.

- Physical symptoms such as fatigue or headaches.

- In severe cases, thoughts of self-harm or suicide (a medical emergency requiring immediate help). 

Rarely, some mothers may develop postpartum psychosis, a psychiatric emergency that may involve hallucinations, delusions, and dangerous behaviour. This requires urgent medical attention.

Why early help matters

The good news is that postpartum depression is treatable. Diagnosis is made through careful evaluation by healthcare professionals. With timely support, most mothers and fathers make a full recovery.

Treatment may include:

- Counseling and psychotherapy.

- Medication, when appropriate and safe for breastfeeding.

- Building a strong support system from family, friends, and community. 

Seeking treatment should never be seen as a weakness. On the contrary, reaching out for help is an act of courage and strength.

The impact on families

Healthy mental health in both parents is crucial for a child’s well-being. The first 1 000 days of a child’s life - from conception until age two - are a golden window of development. During this time, nurturing, bonding, and secure attachment lay the foundation for future emotional and cognitive health. Untreated PPD can disrupt these vital processes and lead to long-term challenges for the child.

Building a supportive community

Postpartum depression is not something to be ashamed of. It is a medical condition, not a personal failure. Communities play a vital role in breaking the stigma. By openly talking about PPD, encouraging early help-seeking, and supporting parents, we can create an environment where families feel safe, valued, and cared for.

If you or someone you know is struggling after the birth of a child, don’t wait. Seek help early. Together, as a community, we can ensure that parents are supported—because when parents thrive, children thrive too.

Dr Mark Moodley is a specialist paediatrician based in the private sector in Umhlanga in Durban. He treats acute and chronic conditions in children and has a keen interest in children with Autism Spectrum Disorder, including mental health in children and their parents.

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