One in five new mothers experience depression before or after birth, says psychiatrist

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The SA Society of Psychiatrists says one in five new moms is likely to experience depression, which puts their health and the growth of their newborns at risk.  

This as the society revealed there was growing scientific evidence of the safety of antidepressants in pregnancy and that stopping medication could cause more harm to mother and baby.

“The risks posed to a foetus from antidepressants are consistently overestimated, while the risks of untreated depression are consistently underestimated because of the pervasive stigma against mental illness,” warned specialist psychiatrist Dr Bavi Vythilingum. 

Vythilingum said depression during pregnancy was often undiagnosed and went untreated because the focus remained on the physical health of mother and baby. 

She said diagnosed or not, it could lead to premature labour, low birthweights and developmental delays.

Meanwhile, postnatal mental illness, which mainly occurred as depression and anxiety, alongside malnutrition, were cited as the biggest risk factors for poor development in newborns and young children.  

Vythilingum said it later affected their mental and physical health, intellectual abilities and future potential of the children.

The society said life changes around pregnancy made women more vulnerable to mental illness, and women who had been diagnosed with depression were at higher risk of developing postnatal depression.

“Depression and anxiety cause significant suffering and disability, leading to a higher risk of substance abuse and suicide, hampering the mother’s ability to bond with and care for her child, and disrupting family and partner relationships,” said Vythilingum.

According to the society, virtually all women could develop mental disorders during pregnancy and in the first year after delivery, but pre-existing mental illness, alcohol or substance abuse, a lack of social support, poverty, unwanted pregnancies, exposure to extreme stress and sexual or gender-based violence put them at greater risk. 

The society urged pregnant women and new mothers experiencing symptoms of depression, including sleeping difficulties, feelings of inadequacy, helplessness or panic, lack of motivation or feeling like crying for no reason, to consult their doctor, obstetrician or psychiatrist to develop an individual treatment plan.

“While these are all common symptoms of depression, women and their partners should also look out for feelings of detachment from the baby, feeling like she doesn’t love the child as she should and thoughts of harming herself or the baby,” she said.

The society said psychotherapy was always the first line of treatment, along with mobilising family support, especially by the father or significant partner, and community resources, such as antenatal and baby clinics.

It said medication such as antidepressants could be prescribed, depending on the severity of the condition, and after weighing up the risks and benefits of medication for mother and baby.

“Clinicians should weigh the growing evidence of detrimental and prolonged effects in children due to untreated antenatal depression and depressive symptoms during pregnancy against the known and emerging studies on the safety of in-utero exposure to antidepressants,” she said.

Vythilingum advised women who fall pregnant while taking antidepressants not to stop taking the medication, but rather to consult their doctor or psychiatrist, who would determine whether the specific medication should be continued, changed or stopped