Perinatal depression: What support is available for pregnant women and new moms in SA?

We often hear or read about postnatal depression and its effects on both mother and baby.

Perinatal depression doesn't seem to get as much press.

May is Maternal Mental Health Month, and Sara-Jayne Makwala King finds out more about perinatal problems and the help that is available in South Africa.

The aim of this dedicated month is to raise awareness around the fact that so many women - from all communities, stages and walks of life - experience mental health challenges during pregnancy and afterwards.

The stats show that perinatal depression affects 21–50% of women in South Africa.

Sara-Jayne King chats to Prof. Simone Honikman, Associate Professor of Public Mental Health at UCT and Director of the Perinatal Mental Health Project (PMHP) non-profit.

The term perinatal refers to the period of pregnancy and the first year after giving birth, Prof. Honikman explains.

She says the presentation of depression that presents during this period doesn't differ much from depression that presents in someone's life at any time, but may present different features that are particular.

"For instance, women who experience depression during pregnancy may have particular fears and concerns about the wellness of the pregnancy, they might have a lot of health concerns... They might find it difficult to adjust to becoming a parent, and to attach and be responsive to the baby once the baby's born."

"It's just that much more challenging to have relationships when one's depressed, and the relationship that is demanded through having an infant can be extremely challenging when a woman is depressed."

Dr Simone Honikman, Director - Perinatal Mental Health Project

The symptoms a pregnant woman or mother of an infant may experience are the classic ones, she says.

These include feeling low, feeling tearful and feeling helpless, as well as experiencing feelings of low self-esteem.

Finding it difficult to function at work or in daily daily tasks and within relationships are that much more difficult for people who are depressed.

"They may have a whole range of physical symptoms which are a reflection of their internal pain. They may find if diff to sleep or eat, or they may eat or sleep too much."

Dr Simone Honikman, Director - Perinatal Mental Health Project

If someone experiences these symptoms consistently over time, it indicates that they really need targeted support to help them get better, Prof. Honikman says.

Women also feel the added pressure of living up to society's expectations as new mothers.

In South Africa, perinatal anxiety seems to be as common as depression, she says.

And not having an emotionally supportive and loving person in one's life is one of the main risk factors of experiencing this kind of distress.

"It's absolutely critical that women have people around them to co-parent and to go through this process together. Quite often women may well have people around them... but the agenda that 'you must get over it', 'this is not normal'."

"This can be extremely isolating and damaging and hurtful, and women really need to be affirmed emotionally as well as having all that kind of practical support that's required to raise a child. Expectations that it's one person's job is a huge emotional burden on the mother, and we need to look at the quality of the support that people are getting - is it judgmental, is it 'pull up your socks', is it both practical and emotional?"

Dr Simone Honikman, Director - Perinatal Mental Health Project

Sara-Jayne also gets input from Rumbi Goredema Görgens, operations manager of Embrace.

This social movement focuses on the issues of early motherhood and aims to bring mothers' experiences 'into the halls of power' where decisions are made.

Görgens agrees with Sara-Jayne that new mothers shouldn't be needing specialist care as such, but acknowledgement of 'what is a very hard period of life'.

Embrace is connected to a range of grassroots organisations that work with moms in various different ways.

Görgens notes that South Africac ranks very poorly in a Save the Children survey of the support available for mothers.

"We are very focused on the health outcomes for the child which makes sense..., but this often leaves out all of the things that need to happen to facilitate a mum being able to raise her child in that (optimum) way."

Rumbi Goredema Görgens,Operations Manager - Embrace

"Looking at parental leave is one element of it; providing mental healthcare as part of physical healthcare is anther. Where wome are coming to services anyway, for social grant support or healthcare... we can't not provide mental healthcare for women who have ongoing symptoms and need counselling support."

Dr Simone Honikman, Director - Perinatal Mental Health Project

How to contact these two organisations to find out about available support:

Perinatal Mental Health Project: pmhp.za.org

Embrace: embrace.org.za