The tenth month
After another city mom gives up, it’s clear that with a hormonal storm and severe misgivings, sometimes, motherhood can kill.
I was gripped by the fear of whether I was doing a good job. The pressure was getting unbearable,” says Kavya Deshmukh. You’d think she is discussing a challenging assignment on which her appraisal depends, but she is only talking motherhood.
The 37-year-old Goregaon homemaker delivered a baby via C-Section earlier this month at a Bandra hospital. Within weeks of delivering, she began to “feel disconnected from it”.
The ‘low’ she describes was diagnosed by gynaecologist Dr Rishma Dhillon-Pai as mild Post-Partum Depression (PPD), a condition that leaves new mothers depressed and disconnected from their babies. While PPD is fairly common in Mumbai - gynaecologist Dr Kiran Coelho puts the incidence to 70 per cent - it’s rare that young expectant women discuss the fall-out of the hormonal changes and stress that follows the birth of a child.
Sometimes, it gets too much to handle. Barely two weeks ago, a 31-year-old Mulund resident jumped off the eighth floor of her building. Jaena Vishal Pandya, police officers had said then, had been suffering from depression since the birth of her baby three months prior.
Hormonal cocktail
During pregnancy, explains Coelho, a woman’s body produces placental hormones that boost her mental well-being as well as her child’s. When the placenta - an organ attached to the lining of the womb which keeps the unborn baby’s blood supply separate from the mother’s, while providing a link between the two - is removed at the time of birth, production of the placental hormones stops. “This drop in hormonal levels can lead to depression,” she adds.
Besides this, says Pai, there’s a dramatic drop in estrogen levels, too. “Some mothers also suffer reduction in their thyroid hormones, immunity, or levels of oxytocin - which facilitates maternal bonding. But not all mothers suffer from PPD.”
Women who have suffered a difficult pregnancy, suffer severe pre-menstrual stress or have had a history of mental illness before the pregnancy, are at a higher risk, believe doctors. Any form of domestic stress - lack of emotional or financial support - could also push women into depression post childbirth.
Anxiety regarding how their bodies will change only makes things worse. With pregnancy and childbirth come stretch marks and excess weight around the abdomen. “We recommend pre-natal classes where exercises to help get back into shape are discussed. It helps boost their self image,” says Coelho.
Lack of connect
Speaking about a patient who walked into her Powai clinic two years ago, psychotherapist Hvovi Bhagwagar says the mother complained of not being attached to her newborn. “While she did fine in the first few weeks, gradually, she stopped indulging in any activity involving her baby. She wouldn’t feed him, clothe him or even make eye contact with him. If someone gave her the baby to hold, she would pass him on to the first person she found,” says Bhagwagar, who sees at least one PPD patient every month. “This patient was contemplating suicide; thinking of jumping off with her baby.”
Bhagwagar says in extreme cases like this one, PPD is classified as psychosis and needs to be treated with both, sustained therapy - sometimes with the husband and the immediate family - and, medication prescribed by a psychiatrist.
A support bank
Often, breastfeeding becomes a bane. “Someone or the other’s telling you that you are not doing it right,” says Pai, adding, “I tell my patients to turn a deaf ear to what everyone’s saying. If they have doubts, they should consult me.”
It’s also important for the father of the child to pitch in. “Childbirth comes with a lot of physical stress. New moms barely sleep for five hours at a stretch, which leads to a build up of mental distress. This is the time for husbands to offer their partners understanding and care,” she adds.
Caregiving support isn’t enough. It’s emotional support, where the woman feels loved and connected with the world that’s crucial.
MUMBAI AND PPD
♦ In April 2013, Shobha Sonar, 30, a housewife from New Panvel, was arrested for drowning her month-old twins in a water drum. Investigations revealed that Sonar suffered from severe post-natal depression.
♦ The same month, Mamta Chauhan from Karanjade village near Panvel set herself, her three-year-old son Shivam, and eight-month-old daughter Rani on fire at their residence for the same reason.
I was gripped by the fear of whether I was doing a good job. The pressure was getting unbearable,” says Kavya Deshmukh. You’d think she is discussing a challenging assignment on which her appraisal depends, but she is only talking motherhood.
The 37-year-old Goregaon homemaker delivered a baby via C-Section earlier this month at a Bandra hospital. Within weeks of delivering, she began to “feel disconnected from it”.
“I was worried that his weight was not up to the mark, although the doctor said a certain amount of weightloss is normal after birth. My mother and mother-in-law would tell me to try this and that,” she says.
The ‘low’ she describes was diagnosed by gynaecologist Dr Rishma Dhillon-Pai as mild Post-Partum Depression (PPD), a condition that leaves new mothers depressed and disconnected from their babies. While PPD is fairly common in Mumbai - gynaecologist Dr Kiran Coelho puts the incidence to 70 per cent - it’s rare that young expectant women discuss the fall-out of the hormonal changes and stress that follows the birth of a child.
Sometimes, it gets too much to handle. Barely two weeks ago, a 31-year-old Mulund resident jumped off the eighth floor of her building. Jaena Vishal Pandya, police officers had said then, had been suffering from depression since the birth of her baby three months prior.
Hormonal cocktail
During pregnancy, explains Coelho, a woman’s body produces placental hormones that boost her mental well-being as well as her child’s. When the placenta - an organ attached to the lining of the womb which keeps the unborn baby’s blood supply separate from the mother’s, while providing a link between the two - is removed at the time of birth, production of the placental hormones stops. “This drop in hormonal levels can lead to depression,” she adds.
Besides this, says Pai, there’s a dramatic drop in estrogen levels, too. “Some mothers also suffer reduction in their thyroid hormones, immunity, or levels of oxytocin - which facilitates maternal bonding. But not all mothers suffer from PPD.”
Women who have suffered a difficult pregnancy, suffer severe pre-menstrual stress or have had a history of mental illness before the pregnancy, are at a higher risk, believe doctors. Any form of domestic stress - lack of emotional or financial support - could also push women into depression post childbirth.
Anxiety regarding how their bodies will change only makes things worse. With pregnancy and childbirth come stretch marks and excess weight around the abdomen. “We recommend pre-natal classes where exercises to help get back into shape are discussed. It helps boost their self image,” says Coelho.
Lack of connect
Speaking about a patient who walked into her Powai clinic two years ago, psychotherapist Hvovi Bhagwagar says the mother complained of not being attached to her newborn. “While she did fine in the first few weeks, gradually, she stopped indulging in any activity involving her baby. She wouldn’t feed him, clothe him or even make eye contact with him. If someone gave her the baby to hold, she would pass him on to the first person she found,” says Bhagwagar, who sees at least one PPD patient every month. “This patient was contemplating suicide; thinking of jumping off with her baby.”
Bhagwagar says in extreme cases like this one, PPD is classified as psychosis and needs to be treated with both, sustained therapy - sometimes with the husband and the immediate family - and, medication prescribed by a psychiatrist.
A support bank
Often, breastfeeding becomes a bane. “Someone or the other’s telling you that you are not doing it right,” says Pai, adding, “I tell my patients to turn a deaf ear to what everyone’s saying. If they have doubts, they should consult me.”
It’s also important for the father of the child to pitch in. “Childbirth comes with a lot of physical stress. New moms barely sleep for five hours at a stretch, which leads to a build up of mental distress. This is the time for husbands to offer their partners understanding and care,” she adds.
Caregiving support isn’t enough. It’s emotional support, where the woman feels loved and connected with the world that’s crucial.
MUMBAI AND PPD
♦ In April 2013, Shobha Sonar, 30, a housewife from New Panvel, was arrested for drowning her month-old twins in a water drum. Investigations revealed that Sonar suffered from severe post-natal depression.
♦ The same month, Mamta Chauhan from Karanjade village near Panvel set herself, her three-year-old son Shivam, and eight-month-old daughter Rani on fire at their residence for the same reason.
