DEPRESSION AFTER CHILD BIRTH

Objective
To determine the predictors and incidence of post-natal depression and its impact on mothers and infant developmant.

Background
Childbirth is undoubtedly one of the happiest moments in the lives of most parents. However, there is also the tragic reality that, in some women, this happy event can lead to a crippling emotional disorder called post-natal depression. In severe cases, postnatal depression can even lead to suicide and neglect of the baby.

It can be treated most effectively by relatively cheap techniques such as counselling. If untreated, there is evidence that postnatal depression in the mother leads to significant development problems in their children which can be detected even five years after the mother has herself recovered.

   The aim of this research study was to determine the prevalence, predictors, outcome and impact of postnatal depression on maternal and child health. This study was based in the antenatal clinic of the Asilo Hospital, a district hospital in north Goa. It involved the recruitment of 270 mothers in the 3rd trimester of pregnancy.

The mothers were interviewed at recruitment to obtain information on their psychological health, family life and obstetric history. They were reviewed soon after birth and again at six weeks and 6 months after delivery. The diagnosis of postnatal depression was made on the basis of an interview carried out at the 6 week review. Qualitative interviews with a sample of depressed and non-depressed mothers were done to explore the experiences and cultural contexts of depression after childbirth. Growth in babies was examined at each review; at six months, approximately 90 babies undergo a detailed developmental assessment to investigate the impact of postnatal depression on infant growth and development.

     The study findings show that 23 per cent of mothers suffer from post-natal depression. Mothers who have suffered violence, poverty and poor marital relationships are at high risk. More than 3/4 of post-natal depressions are extensions of low mood in the antenatal period. More than 50 per cent of depressed mothers remain depressed at six months. The gender of the newborn child modifies the effect of risk factors; if the child is a girl, the risk is much increased. Babies of depressed mothers show significantly poorer growth outcomes and worse mental development scores at six months.

    This is the first prospective study of postnatal depression to examine the relationship between postnatal depression and infant development in South Asia. The study has generated precise data on how common postnatal depression is, which mothers are more likely to develop postnatal depression, how the depression is experienced by mothers and husbands, and its impact on mothers general health and the growth and development of their babies.

    Sangath aims to integrate the work on the development of a counselling intervention for depression, its ongoing parenting program and this study to develop a home-based counselling programme for mothers at risk of becoming depressed.