What can possibly make a mother want to kill her baby? Postpartum depression, said the Mumbai high court last week, in a historic judgment that acquitted a 26-year-old new mother for attempting to kill her newborn twice, before abandoning him near a scrap heap.
“She was incapable of realising the nature and consequences of her act… She did not know that it was wrong,” said the Bench, while accepting her counsel’s insanity plea.
Postpartum disorders can take the form of blues, or depression and psychosis, with symptoms usually beginning in the first few weeks after giving birth. A few may develop it later, sometimes even six months after birth.
The mood changes happen because of a sudden drop in the female sex hormones oestrogen and progesterone, and the thyroid hormones T3 (triiodothyronine) and T4 (thyroxine) immediately after birth, and are out of the mother’s control. Add to that the stresses of looking after a baby while juggling chores, and you have a large number of mothers feeling lost and out of their depth.
Depression after childbirth, or postpartum depression, is far more common in India than popularly believed. Worldwide, about one in 10 women becomes depressed immediately after giving birth, but even in India, the number of new mothers affected ranges between 15.3 per cent and 23 per cent, estimates the National Mental Health Survey, 2015. Of these, about 16 per cent – one in six new moms – continue to have symptoms six months after delivery.
The symptoms, which may last from a few days to a week, include mood swings, sadness, crying, irritability, feeling overwhelmed, anxiety, and changes in appetite and sleep patterns where women begin eating and sleeping too much or too little. If the symptoms last for more than a couple of weeks or are overwhelming enough to make the woman withdraw socially, affect their ability to care for themselves or the baby, or take their anger out on the baby, they need social and medical support.
The signs of postpartum psychosis – a very rare condition that usually develops within the first week after delivery – are even more severe and include paranoia, confusion and disorientation, hallucinations and delusions, paranoia and attempts to harm the self or the baby. Since this can quickly devolve into dangerous thoughts and behaviour, treatment is a must.
What keeps most women from seeking help is often embarrassment and shame they feel about ‘not being good mothers’. The pressure to be the perfect mother is immense, so many new moms hesitate to recognise or acknowledge that they are not. This is why it’s imperative for the family to look closely for signs of depression.
Depression in parents can also have a ripple effect, causing emotional strain for everyone close to a new baby. Parental depression, however mild, during the first years of parenting, also raise the toddler’s chances of developing troubling behaviours such as hitting, lying, anxiety or depression during the crucial early years of development, reported a study in the journal, Couple and Family Psychology. Children of mothers with untreated postpartum depression are also more likely to have sleeping and eating difficulties, excessive crying, ADHD (attention deficit/hyperactivity disorder), and delays in language development. The study shows that new dads may also get depressed after childbirth, with a man’s risk of depression after the birth of a child being greater than at any other time in his life. In fact, studies have shown that parental depression affects a child’s mood and behaviour far more than parents fighting.
This is because depression changes how people express emotions and interact with others. Depressed parents make less eye contact with their child and don’t smile as much. The more disengaged parents are in their child’s formative years, the more trouble the child will have in forming close attachments and developing social skills.
Apart from the obvious risk of recently giving birth, other factors that raise risk of postpartum depression include a personal or family history of depression or mood stability disorders, postpartum depression after a previous pregnancy, stressful events such as pregnancy complications, illness or job loss, a baby with health problems or other special needs, marital or family conflict, financial instability, lack of social support, or an unplanned or unwanted pregnancy.
What mothers need to know is that if you’re not as happy as you are expected to be after having a baby, it’s neither your fault nor the baby’s.
It’s a biological change, much like high blood sugar, and can be treated with counselling and medication.
They also need to know they’re not alone, and they’re not abnormal. Millions of women are feeling what they’re feeling; they’re just usually afraid to say so.