Motherhood is often thought to be a magical experience. For 1 in 7 new mothers who suffer Postpartum Depression, this may not always be the case. Maternal mental illness can be very lonely and isolating.
Unfortunately, Kenya’s shortage of mental health specialists means that many mothers do not get the treatment that they need. There are just about 62 psychiatrists serving a population of 49.7 million people. These glaring gaps in the mental health sector paint a grim picture.
Gaps that exist in Kenya’s maternal mental health field
Some of the gaps that exist in Kenya’s maternal mental health include:
Low awareness of maternal mental health in the society
Stigma surrounding (maternal) mental disorders
Discrimination against mothers who have a mental illness, making it hard for them to reach out for help.
The ‘Elimisha Mama’ Program
‘Elimisha Mama’, Swahili for ‘Educate a Mother’ is PPDKenya’s flagship project that seeks to address these gaps. The program seeks to incorporate maternal mental health into routine antenatal and postpartum clinics. The aim of the program is to create awareness on maternal mental health as well as provide psychosocial support for moms with a mental illness.
The program takes a two-pronged approach:
offering psychoeducative talks during Antenatal and Postpartum Clinics
pregnant women and new mothers who screen positive for a maternal mental illness get psychological help. Peer supporters from PPDKenya will also offer psychosocial support onsite. Severe cases will be escalated to the hospital’s psychiatric department.
PPDKenya partnership with Akshar Healthcare Facility, Kikuyu
The Elimisha Mama program rolled out on April 3rd 2019. This was made possible following the partnership between PPDKenya and Akshar Healthcare Facility. Akshar Healthcare, formerly known as Kikuyu Nursing Home, was established in 2012. The health facility takes great pride in providing professional and compassionate care for its patients.
Akshar offers the following services:
out-patient and inpatient services
The availability of maternity and psychiatric services at Akshar provides a solid foundation for Elimisha Mama.
Antenatal Clinics at the health facility run every Wednesday. Volunteers who would like to join us for Elimisha Mama can email firstname.lastname@example.org
This past weekend, we were invited to join Supamamas at the New Pampers Premium Care Launch. The event was held at PrideInn Rhapta Road. As expected, the event’s audience drew from various professionals in the maternal field, pregnant women and new moms.
Insightful session on pregnancy and beyond
Alongside launching the New Pampers Premium Care, the colorful event covered a number of topics related to pregnancy and motherhood. These insightful sessions were made possible by the panel that included:
Hamida Ahmed, a psychologist based in Westlands, Nairobi.
Some of the topics that were covered included:
self care during pregnancy and beyond
Maternal Blues and Postpartum Depression
Psychologist Hamida adequately spoke about maternal blues and Postpartum Depression (PPD). There is a difference between maternal blues and PPD. Maternal Blues affect upto 80% of new moms, are short-lived and do not often need treatment. PPD on the other hand, affects 1 in 7 moms, lasts up to a year after childbirth (longer if undiagnosed) and requires treatment.
She also emphasized that there was no health without mental health. Hamida also highlighted the symptoms of Postpartum Depression, and how moms can get help. Treatment for PPD includes psychotherapy, medication and support group therapy.
PPDKenya was well-represented by our founder, Samoina. She shared on the work that the organization does in offering psychosocial support for moms with PPD. PPDKenya also advocates for maternal mental health. Some of the lovely moms who have benefited from PPDKenya’s support groups in the past year were also present at the launch.
We would like to thank the team at Supamamas for putting together a great event for moms and moms-to-be.
Below are some photos from the event, and you can view the full album here.
Every birth experience is unique. Many new moms look forward to the end of pregnancy and the beginning of a new journey as they enter motherhood. Some moms will, however, experience trauma during childbirth, sometimes leading to Postpartum PTSD (Post Traumatic Stress Disorder).
After delivery, many
moms may feel fearful, disappointed and even angry that their birth experience
did not go according to plan. There are many reasons why a birth experience may
be difficult or traumatic. To understand this better, it is important to define
what birth trauma is, and how it affects new moms.
What causes trauma during childbirth?
Trauma is defined as the result of an extremely distressful event that interferes with an individual’s ability to cope with daily living. According to a 2013 News Release by WHO, trauma may result from experiencing violence, accidents, war and loss among others. WHO estimates that up to 3.6% of the global population has experienced PTSD in the years preceding this release (link).
Trauma during childbirth as the perception of threatened or real injury or
death to the mother and/or the baby. A different school of thought opines that
childbirth trauma should only be defined by the women going through it.
A 2017 study conducted to explore the experiences of women who have had traumatic birth experiences indicated the following findings: Many of the responses included extremely severe physical pain, the lack of support, the lack or loss of control over the birth experience as well as fear for the baby’s health.
What then makes
certain birth experiences difficult?
Some moms will experience births that look really difficult to the outsider, yet, the moms are able to process the experience and feel optimistic about it. Others on the other hand, present what looks like a perfect birth experience, and remain deeply distressed in the postpartum period. For a number of moms, the birth experience brings them close to death, and affects them for years to come.
To further understand these
dynamics, it is important to define what constitutes a good or bad birth
experience. Research provides four objective parameters for this:
duration of labour
The use of
medication to relieve pain
These four parameters shed some light on trauma during childbirth. For instance, some moms experience early labour so that they feel that everything happened too fast. In such scenarios, there is the lingering thought that the birth process did not go to plan. One of our moms once reached out and shared how, despite having hoped and planned for a vaginal birth experience, her baby was not progressing as expected and she ended up getting a CSection. In her experience, everything was moving too fast and this proved to be traumatic.
“I feel like my body failed my baby,” she shared with us.
Some moms will feel so
taken up by the whole process that they feel disconnected from what is
happening (without the use of anaesthesia). One mom explained how the birth
process felt like ‘an out of body experience’, like she was an outsider looking
in and completely swept away by the procedures.
A matter of life and
For moms whose birth experience is a medical emergency, there is always the risk of trauma. Whether it is failed anesthesia, baby developing complications and/or staying in NICU, or the mom experiencing heavy bleeding, an experience that places either mom or baby in danger can prove to be traumatic. This is also seen in moms who fear that their babies may die after birth.
PS: This study also indicated that for many moms, a
traumatic birth experience can be traced back to actions by health care
providers. When a nurse is unkind, or breaks sad news without empathy, new moms
tend to feel ignored and that their needs do not matter.
“In some cases, care providers used lies and threats to coerce women into complying with procedures. In particular, these lies and threats related to the wellbeing of the baby. Women also described actions that were abusive and violent. For some women, these actions triggered memories of sexual assault”
BMC Pregnancy and Childbirth (2017)
As such, it is
important to note the extent to which care providers can influence a woman’s
experience of trauma during birth. Other risk factors for a traumatic birth
experience include a history of mental illness, previous sexual abuse and
trauma in previous births.
Postpartum PTSD is
different from Postpartum Depression
Many moms will often confuse Postpartum PTSD with PPD, but the two maternal mental disorders are very different. Mothers with PPD will typically experience difficulty bonding with the baby, weepiness, loss of appetite, inability to enjoy activities they previously did, and in some cases, suicide ideation. Read more about the symptoms of PPD in this post.
In Postpartum PTSD
however, moms experience the following symptoms:
thoughts relating to the process of childbirth
or flashbacks that are too real
avoidance of things that relate to the specific birth experience such as
details of the hospital and the thought of labour and birth
to talk about the birth experience because it is painful and may lead to panic
Postpartum PTSD is treatable, and if you think you may be suffering, it is important to get help. Postpartum PTSD arising from childbirth trauma is NOT your fault. Please get in touch with us and we will link you to professionals who can help.
Lately we have had moms getting in touch with us to ask, “Can I get Postpartum Depression (PPD) after the first year?” This is almost always followed by their own admission that their kids are above 1 year, but they do not still feel like themselves, and they wanted to know if we would help.
Granted, it is not possible to make a diagnosis over the phone, neither is it possible to offer a general statement for all of the moms who reach out to ask for help. To answer this question, it is imperative to define postpartum depression as one of the perinatal anxiety and mood disorders.
What is Postpartum depression?
A literature review on the WHO website defines postpartum depression as a common mood disorder that affects moms up to the first year after child birth. Contrary to popular belief, PPD does not just affect moms with newborns. Since it lasts up to a year after birth, it can affect moms whose kids are way past the infancy stage. Additionally, the ‘one year after delivery’ time frame is not cast in stone either.
There is mounting evidence that in many cases, PPD could be the result of mental illness that remained undiagnosed before the pregnancy. An article in the Journal of Dialogues in Clinical Neuroscience underpins these findings:
The onset of PPD is usually within the first few months after childbirth, although some women report onset of symptoms during pregnancy.
For some moms, antenatal depression (also known as pregnancy depression) that is left untreated may also progress to PPD. When you consider the numerous changes that a woman’s body goes through during the postpartum period, it is easy to see why pre-existing mental illness can get severe. These changes include drastic hormonal changes, lack of sleep, lochia, breastfeeding and all the typical stressors that come with new motherhood.
The Postpartum Period
According to Postpartum Progress, the use of prepartum and postpartum typically refers to the period during pregnancy and in the year after delivery. It is important, however, to mention that certain stressors may lead to the characteristic symptoms of PPD even after the one year mark. These stressors may include sleep deprivation, weaning from breastfeeding, financial constraints and abuse among others.
As Postpartum Progress
postpartum episode of depression or anxiety can be triggered by one or more of
the above. While they aren’t aware of this when they first call, most of
these moms can trace their initial symptoms back to the earliest moments of
Why is all this
important? It matters that moms have this information. It is easy to feel
resigned to fate – the fate of not been able to enjoy motherhood. Some moms
will even wonder whether they are ‘too silly’ or ‘too emotional’ to ask for
help and support. Time continues to pass by, with each day bringing more
overwhelm and anxiety.
How will I know
whether it is Postpartum Depression or the Baby Blues?
The truth is that
there is no shame in having Postpartum depression, whether you are a mama to a
newborn or a one-year old. It doesn’t matter what age your baby is – if you
feel like you need help it is best to talk to someone.
Many new moms will often wonder if what they are experiencing is the baby blues or postpartum depression. We have previously covered this topic, which you can read in this post. But to provide a rundown, the baby blues are a short-lived condition in which a new mom may feel emotional/ overwhelmed/ weepy after having a baby. This condition typically lasts for about two weeks, and therefore requires no treatment.
PPD however, is more intense and interferes with a mom’s ability to carry out daily activities and bond with her baby. PPD lasts up to a year (or longer if undiagnosed), and therefore requires medical attention. It is also one of the most common maternal mental illnesses, affecting about 1 in every 7 mothers. Many moms tend to think that PPD is ‘not that severe’ and ‘will pass on its own’. This is not true, as moms with PPD need help and support to make a recovery.
PS: We share information, resources and events regularly on our social media pages. Please follow us on Facebook and Twitter as we raise awareness on maternal mental illness.
We are starting a new series titled #PPDMyStory where we will be sharing life stories of moms with Postpartum Depression, their motherhood journey and how they are recovering/ recovered. This is in line with our efforts to sensitize the community on maternal mental health and to raise awareness for Postpartum Depression (PPD).
Today’s entry comes from one of the moms who we have had in our support group sessions. She requested anonymity, so we will simply share her story as she did.
You recently had a baby, how was pregnancy?
My pregnancy had few complications. However, I enjoyed the last two trimesters because I did not experience intense morning sickness like I had been experiencing in the first trimester. In the last few weeks, I experienced some intense feelings of physical discomfort and this was made worse when I got really bad news about two weeks before I gave birth.
is 2 years old now, how has the experience been with him?
experience with the baby has been more blissful than I thought it would have
been. Initially I thought that I was never capable of loving this new human
being but I have grown to learn what he likes and what he doesn’t. I have also
grown to dedicate moments where we spend time together just to bond and
appreciate each other’s existence on earth. Being a mother to my son is the
most amazing experience ever.
A few months after birth you started feeling that something was off, that it was more than just baby blues. Please share with us about that period.
Getting sad news just two weeks to delivery made me question if I was ready to be a solo parent. It made me question my capabilities and I gradually started to feel like I had let down a small human being who had no idea of what I was going through. I gradually sunk into a state of physical numbness and emotional turmoil, and stopped enjoying activities I used to love like writing or going out with friends.
Waking up was dreadful, and during some moments I would play out thoughts of cutting my existence for good. I felt worthless. My self esteem took a plunge and I could not bring myself to work (as a freelance writer) because the voices in my head were constantly playing out situations that were far-fetched and independent of my reality.
When did you learn that it wasn’t just feeling off, that you had Postpartum Depression?
I came to the realization that these were not baby blues or just feeling off after 9 months of stagnation in my daily life. Things were crushing in my reality. I got to a point I could not effectively handle the bills, all my savings were almost depleted, I was in a constant state of despair, guilt and regret and to top it all I never wanted to live any longer.
What symptoms did you experience? What did you feel during this time?
Some of the
symptoms I experienced include:
Feeling helpless and out of control
Lack of interest in activities I once enjoyed
Intense guilt and feelings of regret
Constant exhaustion but total lack of sleep
Constant sadness and moments where I would cry without a distinct reason
Feeling like I am a bad mother for not being happy and grateful for this new bundle of joy
Intrusive thoughts of harming myself and having someone better take care of the baby
How did you get help? What kind of support did you receive?
I was referred to Samoina of PPDKenya by a mutual friend and after a few weeks of direct communication with her, she recommended that I attend some group therapy sessions that were organised for both young moms and dads with signs of PPD. Initially she had recommended that I seek individual counselling sessions but I was a bit hesitant to open up so I eventually felt like the group therapy sessions would help me open up. After attending the group sessions I was subscribed for a series of additional individual sessions with the therapist for about three months and I was accorded thorough emotional and psychological support.
What about your healthcare provider? Was anyone able to pick up your symptoms?
My healthcare provider at the time did not pick any symptoms mainly because when a mother goes to clinic after childbirth the focus is normally on the wellness of the baby. There is also the general assumption that is made, that the mother is okay, while they may not be.
Looking back, what risk factors do you think predisposed you to PPD?
My biggest risk factor that triggered depression was an unsupportive partner. This drained me a lot. In addition, I was constantly exhausted due to lack of good sleep.
What positive coping mechanisms have worked for you in your recovery journey so far?
Positive self-talk is a winner for sure. I used to love myself before conception but when PPD hit me hard I hated how I looked and even how I felt inside. After therapy, I am able to refute negative thoughts about my being and during moments when I feel overwhelmed, I always remind myself that I am in control (among other positive affirmations). I have grown to embrace meditation as part of my daily routine where I get in touch with my soul and I also get to let go of what no longer serves me.
In addition, I also engage in daily physical exercises which play a big role in breaking tension in moments when I feel otherwise. I journal long-term and short term goals to keep me motivated to work and achieve something tangible. I stick to a distinct schedule which also includes time for me to take naps and a quality time to sleep. Also, I have gradually revived my spiritual life which was typically dead.
What encouragement would you give to a mom who has PPD, or an expectant woman on how to take care of her mental health during pregnancy?
Depression (PPD) is a mental health condition that should not necessarily be a
death sentence. As a woman, many factors can predispose one to PPD hence one
should be keen to look out for distinct symptoms and at the onset of PPD seek
psychotherapy/counselling. In addition, there are various inexpensive ways of seeking
professional help as offered through PPDKenya.
What one thing do you wish you knew about PPD before your experience?
I wish that
I knew what PPD is, its symptoms and how to protect myself from the trigger
factors that initially sent me into a extended period of depression.
Thank you for sharing your experience with us, and with other moms. We hope your journey will encourage a mom who is scared of asking for help. Would you like to share your story on our website? Please get in touch on email: email@example.com with the subject ‘PPD My Story’