After giving birth, Brenda Wangari felt all alone, she felt unwanted and with the physical changes that she had gone through, nothing made sense to her.
“I had gone through a difficult delivery, as a first time mum, no one had prepared me for what would happen, but I constantly would convince myself that everything eventually would fall in place,” she recalls.
However, nothing seemed to be okay. “I had a stubborn baby who often cried— it felt like I was constantly failing her as a mother and this made me recent the child. You know a problematic child can throw you in the deep end in that you feel like you are all alone or nothing you do seems to be working out,” she says.
After five months, Brenda sought professional help. “That is when I learnt that even the learned and the economically empowered people can also have mental challenges,” she says.
Serious mental condition
“I was able to understand that it is easy for someone to do something that they didn’t intend to do due to the pressure and stigma that they could be facing from the society and to some extent, understood why some mothers harm their own children,” she recalls.
With the support of her partner and friends, she was able to overcome this although she felt like the society had a vital role to play in ensuring that new mothers’ mental health was protected.
Dr Wangari Ngugi a clinical and counseling csychologist defines Postpartum depression (PPD) as a form of clinical depression that can occur after childbirth.
“It is a serious mental health condition that can affect both mothers and fathers, although it is more common in mothers. PPD typically develops within the first year after childbirth, but it can occur at any time during the postpartum period,” she says.
She shares how PPD is characterised by feelings of sadness, hopelessness, and worthlessness that persist for more than two weeks. Other symptoms may include anxiety, irritability, difficulty sleeping or concentrating, changes in appetite, and loss of interest in activities that were once enjoyable. In severe cases, PPD can lead to thoughts of self-harm or harm to the baby.
Although there is no official statistics of PPD specifically among mothers in Kenya, a 2019 systematic review and meta-analysis published in BMC Psychiatry, (a peer review journal) showed the estimated prevalence of PPD among women in Kenya ranged from nine per cent to 39 per cent, depending on the screening tool used and the study population.
It further revealed that PPD is a complex and often underdiagnosed condition, and the actual prevalence may be higher than what is reported in studies.
Dr Ngugi says the exact causes of PPD are not fully understood, but it is thought to be related to hormonal changes that occur during pregnancy and childbirth, as well as psychological and social factors such as stress, lack of social support, and a history of depression or other mental health conditions.
She highlights that psychoeducation for the urban mentality will go a long way to curb PPD. “In the case of rural-urban migration, being away from one’s extended family in most urban set-ups may increase stress, since the number one issue for mothers in caring for newborns is sleep deprivation,” she says.
She adds that often, most new mothers relied on relatives such as mothers, mother-in-law and aunts to help in taking care of the baby as they enjoy the much needed nap. But in the case that doesn’t happen they feel alone.
“Generally, there is higher social isolation and inadequate psychosocial support due to the high cost of living, which may result in poor mental health for mothers. Transitional stressors of finding income, and culture shock, coupled with the emotional roller coaster of caring for the extra sensitive and numerous needs of newborns are to blame,” she adds.
Also, she believes that societal transformation to prevent the much-too-common so called “motherhood punishment”, whereby women work a double shift at home and work need to be addressed.
Workplaces could also consider enhancement of paternity leave in order to shift the caregiving burden.
“Women were never meant to care for newborns all on their own, therefore communal efforts should be encouraged. Hiring a night nurse/baby nurse, postpartum doula, mum’s club or religious group helps with ongoing social support,” she says.
On her part, Gladys Nyachieo, a sociologist lecturer at Multimedia University of Kenya says creating and nurturing a support system for new mothers can help combat the feelings of isolation and overwhelm that can lead to PPD.
She adds that PPD can strike anyone who has given birth, regardless of age, race, or socioeconomic status. However, certain factors can increase the risk of developing PPD, such as a personal or family history of depression or anxiety, a difficult pregnancy or childbirth, a lack of support from family or friends, and financial or relationship problems. “It is important to seek help if you or someone you know is experiencing symptoms of PPD, as it is a treatable condition,” she says.
“One way to do this could be through connecting with other new mothers in the area, joining support groups, or seeking out resources such as postpartum doulas or lactation consultants. Sometimes even having a listening ear would go a long way,” she adds.
Physical activity and access to green spaces help improve mental health and reduce the risk of PPD.
“Many new mother who have to return to work soon after giving birth, experience stress which contributes to the risk of PPD. Therefore, creating flexible work policies, such as remote work or flexible schedules, can help new mothers balance work and family responsibilities and reduce the risk of PPD,” she says.
She adds that educating new mothers and their families about the signs and symptoms of PPD, as well as the importance of seeking help, can help reduce stigma and encourage early intervention. “Public awareness campaigns and educational programmes can help increase awareness and reduce the risk of PPD in urban areas,” she says.