Depression after childbirth takes toll on Indian mothers

Lack of awareness and traditional taboos mean the condition is slow to be recognised and treated

Pregnant women in Chennai, eastern India. An estimated 22 per cent of Indian mothers experience symptoms of maternal depression, says the WHO. AFP

Neha Ghosh cried tears of joy after a positive pregnancy test in 2020. The business development associate was about to become a mother for the first time at the age of 30.

But two years later, she says her experience of motherhood was very different from its portrayal in popular culture and society.

After giving birth, there were days when she felt befuddled, anxious and frustrated. At other times she was overprotective, extra careful and loving to her daughter, now 20 months old.

But the scariest days were when she had fleeting suicidal thoughts.

“Whenever I started to feel like that, I used to get so furious and helpless that I wanted to end my and my baby's life … I thought no one cared or would care for my baby if I died alone,” Ms Ghosh told The National.

She is among millions of women globally who, to varying degrees, are found to experience postpartum depression, or PPD.

This is a complex medical condition in which new mothers experience difficulty connecting with their child and swing between emotional highs and lows with frequent bouts of crying, anxiety, guilt and tiredness.

But women in India, where there is little awareness of the condition and discussion of mental health issues is considered taboo, appear to experience higher levels of PPD than elsewhere.

A report in 2020 by the US Centres for Disease Control found that about one in eight women experience symptoms of maternal depression, whereas about 22 per cent of Indian mothers are diagnosed with the condition, according to a report by the World Health Organisation in 2018.

PPD typically affects new mothers within two weeks of childbirth and in severe cases can lead to the woman harming herself or the child.

In January, a woman, 30, took her own life in the southern Indian state of Karnataka nine months after giving birth to a baby boy.

Soundarya Neeraj, a doctor and a granddaughter of former Karnataka chief minister BS Yediyurappa, had been diagnosed with PPD, according to some media reports.

“Out of every 10 depressed patients we receive, two are for PPD. There has been a consistent rise in such cases in the past decade,” Dr Pulkit Sharma, a psychologist at Vimhans, a neurosciences hospital in New Delhi, told The National.

While the condition is treatable, experts say there is very little awareness about PPD and the dangers it poses to the life and health of a new mother.

In many cases neither the women nor their families recognise the condition in time to get professional help and prevent complications.

Dr Sharma blames the lack of awareness and space for a woman to express herself as her life changes emotionally, physically, financially and socially after childbirth.

Traditionally, Indian women were seen as “just” mothers, but many now have flourishing careers and live in nuclear households instead of joint households.

For them, having a child brings overwhelming feelings of sidelining their careers and having to care for the family and the new baby alone.

Many people dismiss such feelings as “baby blues”, which primarily manifest as moodiness for up to two weeks after delivery. But in some women these feelings last much longer and can turn into PPD.

“Families do not understand the kind of changes a woman has gone through in such a short span of time, from her body to whole lifestyle,” Dr Sharma said.

India is a country with a strong family system, but some women feel left out as families, including partners, focus on the care of the baby, ignoring the needs of the mother.

“Families pay entire attention to the newborn. They forget the needs of the woman who has just given birth,” said Anjali Jain, 30, a mother recovering from PPD.

Ms Jain, from Noida, outside Delhi, had her first child, a son, three years ago. The pregnancy was not smooth but her real struggle began post-delivery.

“I felt disconnected from the child and detached from my husband. I started seeing my in-laws as an enemy who were smitten by my child but paid very little attention to me,” she said.

“They could not understand that I also needed love and care. But this has been a norm. Once the baby is out, the woman's identity is lost.”

A voracious reader, Ms Jain turned to medical blogs and books for answers. She also spoke of her feelings to her husband and in-laws, helping in her slow recovery.

But for Ms Ghosh, the severe mood swings and suicidal thoughts continued until she sought medical help last April after her father died in India's second wave of Covid-19 infections.

She is now receiving counselling and says that although the road to complete recovery is long, she is working towards healing.

“Something happened … I know the problems and am working on them. Most importantly, I am glad I didn’t take the extreme step,” she said.

Dr Sharma says while severe cases — about 3 to 4 per cent of the total — require professional treatment, including counselling and medication, patients with mild cases can be treated with emotional support and patient hearing, like in the case of Ms Jain.

He emphasised the need to watch for early signs of PPD in mothers, such as self-neglect, feeling disconnected from the child, crying and doubting their decision to give birth.

If you have been affected by any of the details raised in this story, you can contact the Vidyasagar Institute of Mental Health, Neuro & Allied Sciences (Vimhans) helpline, [phone], or email [e-mail].