If you’re expecting, the odds are good that you’ve heard about post-partum depression. Although treatable, depression during pregnancy can affect the mother and the unborn child.
According to research, depression affects roughly 7% of expectant mothers.
Up to 50% of expecting mothers in South Africa experience undiagnosed, untreated depression during their pregnancies and after giving birth, posing risks to their health and the long-term development of their unborn children.
Dr Bavi Vythilingum, a member of the South African Society of Psychiatrists, observed that while post-natal depression is well-known, depression during pregnancy is almost as common and can increase the risk of complications during pregnancy and labour.
Speaking in recognition of National Pregnancy Awareness Week (February 6-9), she said the high rates of maternal depression in South Africa were a result of the country’s high rates of poverty and intimate partner violence, as well as a lack of awareness of mental health issues, the stigma associated with them, and the underfunding of mental health services.
She underlines that there are treatments that can be used to successfully lower the risks associated with depression during pregnancy – such as psychotherapy, group therapy, and even prenatal support groups are all very beneficial. In addition, most antidepressants are safe to take during pregnancy based on the expecting mother’s healthcare provider.
Between 21% and 47% of South African women experience depression during pregnancy, and 31% to 50% suffer post-natal depression, compared to the global rate of approximately 12% of women experiencing depression during or after pregnancy.
“Pregnancy-related depression is often dismissed as ‘just the baby blues’ and women are told to ‘just pull yourself together’, but it’s a serious mental health condition which negatively affects not only women’s quality of life and experience of motherhood, but the prospects of the next generation too,” she said.
Stressful events that women experience every day, such as intimate partner violence, during pregnancy may lead to long-term depression that lasts a year or more after delivery.
Vythilingum says too that antenatal depression raises the risk of hypertension (high blood pressure), which increases the likelihood of difficulties during pregnancy and labour, low birth weight and early births, for mother and the baby.
Untreated depression during pregnancy increases the likelihood that the mother will experience post-partum depression and have trouble bonding with her child, both of which have an impact on the critical mother-child attachment relationship, and the child’s social, emotional and cognitive development, and can eventually result in mental health issues.
“The lack of awareness and stigma around mental health conditions, along with the tendency to focus more on a woman’s physical health than her mental health during pregnancy, means that depressive symptoms are often not picked up,” said Vythilingum.”
“Because many women in lower income groups, use under-resourced public health services, and only use those services during pregnancy, this is often the first time that depressive symptoms are picked up.”
A holistic, integrated approach to prenatal care should include the mother's social and mental requirements in addition to her physical health. This would go a long way toward resolving South Africa's high rates of depression, anxiety, and other mental health disorders that go misdiagnosed and untreated.
There are mothers' support groups held in both public and private clinics, as well as social media mom groups that meet in person regularly. Dr. Bavi Vythilingum underscores that many clinics, both public and private, offer antenatal support groups.
“Antidepressants are very effective for moderate to severe depression, or where a patient has not responded to psychotherapy. In cases where the woman doesn’t have access to psychotherapy, antidepressants are a recommended and effective solution.
As with all medications during pregnancy, she said it was vital for the mother to consult with her healthcare provider before stopping existing medication or starting any new medication.
The South African Depression and Anxiety Group (SADAG, www.sadag.org) lists toll-free helplines for general depression and anxiety and has free support groups around the country for various issues, including support for expectant and new mothers. Call 0800 21 22 23 for help and information.
In addition, you can join the network mumsupport.co.za for a caring community of women supporting women.