Recent cases of women suspected of murdering their children have raised public awareness about depression and psychosis after childbirth. 13 per cent of women in Canada will experience postpartum depression within the first 12 weeks after giving birth. Eight per cent will have symptoms that continue past one year.
Symptoms can range from feeling lonely, isolated, anxious, having difficulty sleeping to the more severe difficulty making decisions, caring for oneself or the baby.
Postpartum psychosis is much more severe and can involve hallucinations like seeing or hearing things that are not really there. This affects one per cent of women soon after they give birth, frequently women who already have been diagnosed as bi-polar. Typically they are hospitalized because they may be a danger to themselves or their babies.
Stress a risk factor
Anyone can get postpartum depression, but there are certain factors that increase the risk and certain people who are more at risk. People who have a past history of mental health problems are more likely to get postpartum depression, as are those who were depressed during pregnancy. Anyone facing multiple stressors is more at risk, whether the stress is marital, financial or other.
The poor, the young and immigrants are at higher risk. Research out of the University of Toronto suggests that immigrant mothers might be three to five times more likely to develop postpartum depression than are Canadian-born mothers.
Immigrants have higher risk
“We think it might be related to acculturation, a cultural-related stress related to their ability to practice traditional postpartum rituals,” said Cindy-Lee Dennis, a professor of nursing and medicine in the Department of Psychiatry at the University of Toronto.
“Often in certain cultures, there are certain things that mothers like to do after a baby is born that provide a protective element to her and the baby as she recovers from delivery and when they come to a new country they may not have the supportive resources in place to practice these traditional rituals.”
Immigrant women also undergo a change in environment, possibly changing from a rural setting to an urban one and may suffer a decline in work or economic status, all of which can contribute to depression.
Important to seek help
Certain cultures stigmatize mental health problems and so immigrant women or their families may be discouraged from acknowledging there is a problem or seeking help. Lee says it is important to raise awareness about the problem and the resources available to deal with it.
She says they need to understand that “a lot of women experience this, that it’s okay to acknowledge that they are experiencing this condition, that there is treatment available…through public health departments, through family physicians (who) can refer on to mental health specialists.”
Treatments can include medication, talk therapy, and cognitive behavioural therapy. Lee thinks one of the most important services that are available are mother-to-mother groups. “Mothers can go and meet other mothers in a group setting in their community and just talking to other mothers provides social comparison and it makes you feel better to know that it can be challenging having a new child and other mothers experience this and that it’s okay and it gets better. Mothers also can problem-solve any concerns they may have.”
Lee continues to study postpartum depression and other health issues of mothers in Canada.