By Hafizah Rafie & Nabila Hanim, BMSG Counsellors

On 18 November 2017, BMSG was invited to attend a Maternal Health Awareness talk organised by Clarity Singapore, a charity that serves and assists persons with mental health issues. The talk comprised of two parts: an insightful sharing by Ms Ong Li Lian from KKH Women’s Mental Wellness Centre on how PND develops in mothers and its contributing factors. The second part was a panel sharing by five mothers who had gone through some form of postnatal depression (PND) and had overcome their conditions.

Hearing From the Expert

As breastfeeding counsellors, we come across mothers everyday in our work. From our hotline to our Facebook group, and even in our own personal capacities, we chance upon mothers all the time and knowing the symptoms and risk factors for PND was crucial for us to help mothers better.

According to Ms Ong, there are various contributing factors to mothers developing PND. It is important that a woman receives support right from the start of pregnancy as PND can be triggered by the stress that arises during pregnancy. With changing hormones and physical challenges faced by a pregnant mother, coupled with anxiety of what’s to come, it is important to ensure that pregnant mothers receive care and support from immediate family members and the community. This is even more so if mothers are experiencing a high-risk pregnancy.

The difference between a mother’s expectations of having a baby and the reality of the challenges that she has to face especially in the early days of her baby’s life is a major contributing factor to mothers developing PND. We have been cultured by advertisements and popular culture that having a baby and giving birth are rosy events which may not require much effort. On the contrary, life as a new mother, as well as having to face societal expectations and inner struggles, can even weaken the toughest woman. Apart from enduring physical recovery after giving birth, the new mother also has to learn to care for and breastfeed the baby. The uncertainty of raising a newborn and coupled with facing the physical stress of being sleep-deprived, especially if mothers have no help, can rattle them and cause them to fall into a spiral of negativity. According to Ms Ong, some mothers feel a lack of control over their lives and this is exacerbated when she feels lonely due to lack of social time. Some parents also face a strain in the marriage especially when husbands are unsure as to how to help their wives feel better about themselves.

Trapped in a Cycle of Faulty Thinking and Anxiety

According to Ms Ong, PND happens when a mother feels that things will not get any better over time. She will feel overwhelmed, anxious and unsure with the new challenges and only notice the negative situations. She will doubt and tell herself “I am not good enough”. Mothers with PND may feel that they are incapable as a mother and such faulty thinking spins her into a slippery slope of the Negative Thinking Spiral, where she falls deeper and deeper in creating a negative perception of herself. Some mothers with PND also get trapped into The Worry Loop, where she keeps on focusing on what could go wrong with her baby and gets entrenched in constant anxiety and feel tensed all the time.

For mothers who have already begun to feel this way even during pregnancy, it is crucial to seek help as this is definitely not healthy for the baby in utero due to the presence of the stress hormone, cortisol, which can negatively affect the baby during and after the pregnancy.

Other Contributing Factors to PND

PND can affect anyone regardless of socioeconomic status. Some mothers are plagued not just by the challenges of raising a baby, but also by their circumstances. One of the mothers in the panel shared about how crippled she felt when her husband had been retrenched. This led her to being constantly worried about the family’s financial situation. One day, after failing to receive a deal for her own business venture, she almost swerved her car into an accident. Thankfully, she got a grip of herself and drove instead to KKH to seek help from the Mental Wellness Service.

Some of the other mothers also talked about additional contributing factors, such as the stress caused by unsolicited advice, feeling trapped with family members who are insensitive to the emotional needs of a new mother, or struggling with loneliness or past history of depression as a new mother. These mothers also shared that taking that first step to seek professional help was a major step in improving their conditions. They also emphasised that there is nothing embarrassing about wanting to seek help as this is a gift for themselves and their families.

Helping Mothers with PND

As family members and friends, Ms Ong emphasised on the need to always be on the lookout for symptoms in new mothers. Some mothers may show that they are capable of managing their new role as a mother but are actually not able to express what exactly is burdening them. Some mothers may also not be able to embrace that feeling of helplessness and lack of control over their lives. Other mothers, despite having help, may still feel that they lack purpose in their lives as they get sucked into the mundane routine of caring for a baby.

As spouses, family and friends, it is important to offer help, a listening ear and not to dismiss a mother’s feelings. Some mothers may also face a late onset of PND months after they have given birth. It is important to continue looking out for the welfare of mothers constantly.

For some mums, attention and care may not be sufficient. This is when mothers should be encouraged to seek professional help. If you suspect that you or a friend/family member is struggling with some form of PND, you can seek help from the following services:

• KKH Women’s Mental Wellness Services – Email: pnd@kkh.com.sg
  
• NUH, Women’s Emotional Health Service – Email: wehs@nuhs.edu.sg, Tel: 6772 2037
• Clarity Singapore – Tel: 6757 7990

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