Postpartum Depression: Break the Silence

Author: Purna K.V., Blogger

(Original Post appeared here: http://koumudi.blogspot.co.za/2013/10/post-partum-depression-yes-i-faced-it.htm)

Post-Partum Depression. Yes , I faced it and No , there is nothing wrong in talking about it.

Those of you who see my pictures on facebook and think that mine was a happy pregnancy and a perfect delivery and everything was a perfect little dream-come-true…… are wrong. It was actually far from it. I had suffered from a severe prenatal depression in my last trimester and an equally severe postpartum depression after delivery.

It took me a long long time to come back to normal and start living life normally. It took me a long long time to actually come to a conclusion that I should write about it. Yes, there is no need to be ashamed of it. It can happen to any other woman on this planet and it comes without a due notice and we are far from being prepared to face it. Knowledge is wealth and I thought I should provide awareness about PPD ( Post Partum Depression ).

All was well until the starting on my last trimester ( 7th month ). I was working as well in Johannesburg , South Africa, and didn’t have any problems. I moved back to India during the same time to rest at home and deliver in Hyderabad. Ravi came just to drop me back home , had a brief holiday and went back to wind up things at Joburg.I thought this phase would be the most relaxing time of all and was really excited with it. But the travel from Johannesburg to Hyderabad left me with swollen feet and a tiredness which didn’t go away for as long as a month after that. Even my swollen feet took a lot of time to get back to normal. And it is when I was staying at my home in Hyderabad , that depression set in. It started with lack of sleep and a frustrated mind as to why I am not able to sleep. I was bored at home and didn’t have anything to do. I couldn’t travel outside , because I didn’t know driving and the weather change between Joburg and Hyd traffic left me nauseatic. It was better to sit at home rather than travel outside with all the pollution and traffic. And above all , you know what elders say , you are pregnant so don’t do anything without out help. My stamina kept decreasing and so did my appetite. But I thought it was all normal and definitely hormonal. Yes , it was hormonal , but it was not normal and I realised this only in my 8th month. It was the first case of PPD in my family and nobody knew about it.I started imagining all kinds of things and was not happy about it. I always felt that , whatever came into my mind didn’t at all leave me and it only started creating deep impacts and craters in my mind. The ability to control my thoughts was absolutely gone. I felt that my mind was not in my control anymore. I felt that I was some other person and this person is nowhere near to what I am. I felt that something was happening to me and I am not able to stop it. Lack of sleep , lack of appetite , restlessness , no peace of mind and always sad about something which I was not able to apprehend properly. I also had insecure feelings about staying away from my husband and when it was un-bearable , I contacted Dr Vijaya and told her briefly about my situation. It was not only psychological and emotional , it was physical too. I had nervous weakness in my hands and legs , and I was not able to stand and do things properly sometimes. I never felt like waking up from the bed and do something to kill the boredom.

In our society , giving birth to a child and all the pregnancy and delivery phases of life are supposed to be “happy” things. And if it is anything different from it , nobody would want to talk about it. It is all hushed up and the fear of the society seeing you as a “bechara” makes us hide things. But I did no such thing and walked straight into Dr Vijaya’s office and spoke to her. My scared mother accompanied me. I am thankful she did.

May be Dr Vijaya knew already and was suspecting the worst. But she was kind to me and comforted me with her words. She appreciated my outward thinking and the boldness I had to come and talk to her. Because , she said , most women wouldn’t do it. She told me that PPD is a spectrum kind of a thing and almost 80% of pregnant women experience it but at different levels. Some are tolerable and some are not. But mostly , women don’t express it to the gyneac or the midwife. So most of the society doesnt know what’s happening on the inside.

My mother was totally unprepared to face all this. And she never felt or knew that all this was due to hormonal changes or due to changes in pregnancy. She thought I was saying and thinking about issues wantedly .She was scared with the way I was thinking and manifesting things in my mind and her being scared , made me even more timid and frustrated as to why I was like that. After going to Dr Vijaya , we concluded that it might be the mood swings and depression kinds and was normal and a part of pregnancy sometimes. This comforted my parents and husband… but not me. Because it did nothing to my mind so that the pain and everything could go away. I wanted to be happy and welcome my little child. And the fact that some other things were taking precedence over it made me guilty and that guilt started killing me from inside. I couldn’t ignore it and as it was physical too , I was even more scared as to how I would be able to take care of my baby if I was not even able to walk properly and do things normally.It was pure hell. Ravi pre-poned his trip and returned early. But no matter who was beside me and what they had to say to me , the suffering didn’t go away. I had erratic fears over silly things coming into my mind and it scared the hell out of me.I had frequent fear and panic attacks. My brain would be blank and cold for a few minutes.  I knew that my family was putting a brave face outside but were equally concerned and scared from the inside.

Finally , when I delivered , I wasn’t scared of anything in my life , except the “thing” that I was going through. I gave birth normally  and very boldly. Because I wasn’t scared anymore. I had something else to be worried about. Physically , mine was the perfect delivery that anyone would want. Not a single medicine given to my body and not a single prick from the midwives. But psychologically , I was somewhere else. Nothing gave me happiness , expect for pure and intense sense of care towards my child. I took care of her to the core. May be the guilt that built up inside was coming out in this way. My physical  and psychological symptoms remained , even after delivery and then Dr Vijaya suggested me to a clinical psychologist. She spoke to another lady who gave birth in the same center and also a psychologist. Unfortunately , she was out of town , so she referred me to another elderly man in Sweekar-Upkaar , Jublee Bus Stand , Hyd.

I was breast feeding and my body was in the process of healing. But I had to go to consult him. He listened to me and referred me to take some tests. Not lab tests. Some written tests ( I thought they were like some tests to determine my concentration and mind body co-ordination ) which took a lot of time. I had to leave my baby in the car and go to take the tests , occasionally coming back to feed her. There is a phrase in telugu……….. “ Idemi kharmamooo” anipinchindi. I don’t know about the cure , but the visit to the doc itself can make you feel so low and less of confidence , as to something is seriously wrong with you and you need somebody’s help to fix it. It makes ourselves feel like yuk.  Finally , he told me that , I didn’t have any previous mental disorders and this was something that had popped up only in and around pregnancy and hence will be termed as “Post Partum Depression”. He gave me 2 sessions of relaxing my muscles as I was constantly complaining about the nervous weakness in my hands and legs. I almost begged him to give me a medicine to calm me down and make me peaceful. But he denied it as I was breast feeding. He said , treat it as a punishment from God and bear it for 6 months. My duty as a mother was more important than what I was going through and he asked me to come back after 6 months , if I felt it didn’t go away.

He told us a lot of things. He said that , in pregnancy , a woman’s body undergoes a lot of changes.Some are physical and some are psychological. Some are good and some are bad. Now , we the people , miss the bad part. We always think that having a baby only brings joy to us. Ofcourse it is a happy thing………. But it doesn’t always bring joy to us. It also makes us nervous and all the emotions around taking up that responsibility and doing our part correctly. So , “pregnancy and delivery is a happy thing” is highly overrated. It can be the opposite also and there is nothing wrong with it. Sometimes , the wiring in the brain changes permanently because of pregnancy , he said. And I am unfortunate that I have had the bad effects of pregnancy. Having a baby is a very big change in life and different people react in different ways to it, consciously sometimes and sub-consciously sometimes. Nothing is wrong or right in it. And if the pressure on the brain becomes un-bearable , then it translates into physical symptoms like the ones I had. In the spectrum of PPD , may be I fell into a “more and intense” scale. It happens to everybody and not everybody are vocal enough to go to a doc and express that something is wrong. Because we are bound by families and society. And this insecurity and the “unhappy” part are buried under the name of society and the family’s name in the society.

It took me an year and half after delivery to completely come back to normal. And I didn’t take any medicines. It was long , hard and a challenging journey and at the end of it , I guess I have turned out to be a lot more tougher than before. I was sceptical about writing this post from a long time. But finally could muster the courage to put it in words and provide awareness to others. PPD in a severe way happens only to a very very few people. But we must be prepared to face it J.

“My Mil never likes to cook. They have maid at home who does most of the cooking cleaning stuff.”

Sharing an email. 

Do you think there are some expectations here, from the mother in law? If yes, then are those expectations fair?

What if the mother in law had a career or any other interests, or health issues, and there were no other relatives, …female relatives, who could come and cook for the couple?

Who doesn’t seem to be feeling any guilt in this email? Why is that so? 

Hi IHM

I frequently visit your blog.I am an avid reader of your blog. Almost all the topics touches a chord some where.

I m writing about a problem to get suggestions and inputs from bloggers here.

I work with a MNC married for one and half year. Now I am carrying three months. Initially all was good and we both were so happy. My Mil came to take care of me.

First few weeks I was not feeling like eating. Then slowly as pregnancy progress I took interest in simple daal subji chawal but served hot. This is difficult for my Mil.  She never like to cook. They have maid at home who does most of the cooking cleaning stuff.

I work in shifts so can cook only one time.

Now also due to weakness I found it is exhausting to stand and cook. But the truth is I don’t like her food. Sometimes it is good but most of the time she serve cold afternoon food.

And she won’t cook until you feel hungry.

Now I am feeling hungry too frequently.I need small stuff but in regular three four hr interval.

All these needs are not getting fulfilled.most of the time I eat office canteen food or outside snacks resulting severe gas and acidity.

Now I am cooking little things for my self but get tired soon. In all these my husband feels bad that I don’t like his mama’s food. His side is she could not cook now, still she is trying. So I should not complain. In reality I am not complaining for food. I started cooking but I complain of tiredness.

This could be a minor issue but at this time I feel like I m not getting enough nutritious food.

Otherwise I can eat all types of food. Don’t complain much.

Can anyone give valuable suggestion please.

Related Posts:

‘How I am going to manage two toddlers, work, home, chores etc etc without any physical and moral support from my in laws?’

If I made Baghban.

“After all, why do we as kids, feel so entitled to our mother’s time, indeed her entire life and personality?”

Why do men NOT have to choose between being a CEO and a father, but women have to make this choice.

How are mothers treated in Indian culture?

Mommy Guilt: A Western Influence.

“…and every month if my periods get delayed I am given a weird look and it clearly shows that she is afraid i might get pregnant again.”

Sharing an email.

Hi IHM,

I am a working mother of two kids..This email is regarding contraception and Family planning operation..
Here is a short description of my life post marriage:

My husband is a lovely and understanding person and a JKG :-)
During initial months of marriage we tried for kid but were unsuccessful in the first year. Then I got pregnant unfortunately that ended in a miscarriage…
Then started all the problems….I was blamed for the miscarriage (I was abused to the extent that word spread that I only took some tablets to end the pregnancy!!)
I felt suicidal but my husband was very supportive and was by my side whenever someone talked about miscarriage

Next year I again got pregnant and that too ended in miscarriage @ 11 weeks….I was completely devastated and it took 1 year for me to come to normalcy…

Then I took it as a challenge, reduced my weight (around 18 kgs) and tried to get pregnant and was successful immediately…. but i faced so many complications during the entire pregnancy… I was put on complete bed rest (was allowed to get out of bed only for using rest room) for the entire nine months and finally i delivered a lovely boy baby by C-Sec….

God blessed me with another baby (girl) within next 18 months :-)

But here started the problem… owing to my complications, my gynec refused to perform family planning operation when i delivered my 2nd baby….
Now I am being abused by my MIL that my ill health is the reason why the gynec didnt perform the operation and every month if my periods get delayed I am given a weird look and it clearly shows that she is afraid i might get pregnant again

But the same lady used to torture me earlier (before birth of my son) if i got my periods every month :-) what an irony

Ok I come to the point…I want to know if there are any contraception laws in India…. Does it work in favour of women?

As I told earlier, I am working so it is difficult for me to take long leaves as I have already taken two back to back maternity leaves…
Also my health is very bad that i will not be able bear another operation…

Any advice?

– A Confused Mother

Related Posts:

How are mothers treated in Indian culture?

An email from a new mother: Of long term Contraception and Ayurvedic oil massages.

An email: Is it selfish to not want to be parents yet?

Mere consent to conjugal rights does not mean consent to give birth to a child for her husband.

“I waited for maternal love to overcome me – it didn’t… After my baby was born, I didn’t feel anything…”

An email: “She is considering having an abortion without telling her husband about it.”

An email: “I find it very hard to forgive my husband for all that happened at the time of my delivery.”

Who is afraid of awareness about menstruation, and open letters to all Gynaecologists?

An email: Is it selfish to not want to be parents yet?

Mamta: A perspective on roles of Indian Women. – Careless Chronicles

Woman,un-role yourself! – Usha

Motherhood Pain – SuKupedia

In the Name of Culture – Crescentia Kalpana David

Let’s Talk about Contraception – Sue

No sex education for us. We’re Indian – Amodini

New scare for urban women: Menopause in 20s

Sharing this link to share the reactions it elicited.

New scare for urban women: Menopause in 20s

A five-year long study conducted by Sattvam, a city-based care centre for women and children, found that 432 of the 980 women covered entered menopause in the age group of 30-35 years, while 216 were between 35-40 years age. The centre has also treated 68 women, who entered menopause in the age group of 25-30 years, while 264 women were above 40 years of age.

“What is worrying is that 42% of these women are working women….”

(Note: ‘Working women’ here probably means only the ‘earning’ women, or women who are paid for the work they do.)

Women’s negligence of their reproductive responsibilities seems to have offended many. Many have ‘solutions’ to offer.

Here’s one comment:

“Being modern is fine, but getting carried away by media and abusing their body with alcohol and smoking (and many other modern ways) is making overly advance women unfit for producing kids.. very rightly so.”

Women in Indian villages didn’t smoke bidi or drink? They did and still do. Also, many women in the past, stopped having any children in their thirties (without use of contraception), some never had any children, for which they were stigmatized. So really not sure how modern is ‘early menopause’.

Another reaction:

“Decide GREED versus Life. What to choose when and by how much % and where you draw the line”

So those who think women should not choose the GREED of self reliance and career over motherhood, do they then support joint ownership of whatever a couple makes during the marriage and joint parenting? [Should couples’ assets be treated as joint property?]

How else does the society ensure that marriage (and homemaking, motherhood etc) does not result in women becoming financially dependent on their husbands?

Some comments blame women for ‘going against nature’.

“This is result of not following natural laws and going against nature. In modern time, every body is subject to tension, work pressure, frustration, irregular food, fast food,in adequate sleep,dissatisfaction, haste of urban life…”

What is ‘natural’ or stress-free about traditional Indian semi-forced and early arranged marriages, where women are expected to produce male heirs within a year (so that the family-name-of-the-husband is carried forward)? Arranged marriages which are forced, semi-forced or coerced (with emotional blackmail etc) are not ‘natural’ either.

So much of concern for women’s reproductive health, by those who would be outraged if women attempted to give their own names to the children they bear. (Often women don’t have names of their own to give).

What about women who do not smoke, drink, try to be independent or ‘overly advance’ and who do have many children? What has patriarchy got to offer them?

Feodor Vassilyev: The Russian Who Sired 87 Children in 35 Births.

“Feodor is apparently notable enough for a Wikipedia article because his wife sets the record for the most children birthed by a single woman. Just to reiterate, it is Mr. Vassilyev and not Mrs. Vassilyev who is deemed notable enough to have a Wikipedia article here!” Do we realize how patriarchy controls and claims ask rights on women’s bodies and reproductive healths? [Read the entire post here: Feodor Vassilyev: The Russian Who Sired 87 Children in 35 Births]

Related Posts:

1. How can the society ensure that marriage (and homemaking) does not result in women becoming financially dependent on their husbands?
2. How are mothers treated in Patriarchal cultures?
3. Society benefits immensely from childbearing, child rearing, and care giving work that currently goes unpaid.
4. “I waited for maternal love to overcome me – it didn’t… After my baby was born, I didn’t feel anything…”
5.Mere consent to conjugal rights does not mean consent to give birth to a child for her husband.
6. An email: Is it selfish to not want to be parents yet?
7. Woman you are not doing anybody a favour…
8. An email: “I find it very hard to forgive my husband for all that happened at the time of my delivery.”
9. Cabinet clears bill: Equal rights in Marital property, Easier divorce.
10. When a newly married Indian woman gives up her career, what else does she give up?
11. An email: “She is considering having an abortion without telling her husband about it.”
12. An update: “My friend is having the baby because her mother absolutely refused to support her decision to abort.”

She chose to get pregnant so that she can miss all the work, enjoy attention and eat to her heart’s content.

So here’s someone with a different perspective to this post, How are mothers treated in Indian culture?

How would you respond to their views?

Below is their response, in their own words.

“Let me put a different perspective here… (doesn’t mean u r wrong in any way)

There are women who don’t like what they are expected to do.. for example i know an average scoring gal who was engaged to a topper guy who belongs to a family of toppers… Now this gal had already lost a year. She was forced by her parents to take up engineering in the first place. Now her in-laws were expected her to be a topper. She had got married when there was one year remaining for her engineering to complete. She chose to get pregnant while she was still studying so that after engineering her in-laws will not taunt or question her why she is not a topper in her college.

Another woman I know is not passionate about anything.. No passion to study or do anything.. She is not interested in cooking too. She was from a house where no one told her or ordered her to work. When she got married, she did not know even to prepare tea. She got married into a house where she had to stay with her husband’s parents, unmarried brother and unmarried sister. Apart from this, there was a lot of work as her family runs on just one grocery story. She chose to get pregnant (in fact she missed her first period after wedding) so that she can miss all the work, enjoy attention and eat to her heart’s content.

What would you say about these woman?

I am saying again, I know both the women and their in-laws family closely.. They are really good people.. But every gal after getting married cant be sitting like a guest right? Obviously they will have to help a bit.. It will be rude if her mother-in-law slogs to prepare food for all and the daughter-in-law just stays in her room all the time or watches tv.

First case:
The in-laws are nice and the husband too.. They had only one thing to crib about which is the topper thing. That too because their son had been stubborn he wanted to marry this gal. They are too rich and none of the women in the house get to do the household chores.. There are many servants in the house..

Second case:
The gal’s brother got her married to this house.”

Possibly Related Post:

It seems getting pregnant is not the only thing Indian women do with ulterior motives:
Dying statements of vengeful women settling scores by attempting suicide.

Mere consent to conjugal rights does not mean consent to give birth to a child for her husband.

Here’s a judgment I agree with, because it implies that a wife is a partner, not a baby-making machine.

‘In a significant decision, the Punjab and Haryana High Court last week ruled that the right to abort a pregnancy in a marriage rests with the wife and not husband.

A woman is not a machine in which raw material is put and a finished product comes out. She should be mentally prepared to conceive, continue the same and give birth to a child. The unwanted pregnancy would naturally affect the mental health of the pregnant woman…” said the court.

Stressing that marital intimacy between a couple does not automatically translate to the woman’s consent to child bearing, Justice Jitendra Chauhan said, “Mere consent to conjugal rights does not mean consent to give birth to a child for her husband.”’ [Link] Thanks for the link Brown Vagabond.

I wish this judgment and what it conveys was understood by families of women like Sita. (All names changed)

A friend (and a social worker) told me about this woman in her twenties who lives in a village in Haryana.

Sita’s parents had first arranged her marriage into a family where she worked all day and wasn’t given enough food.That marriage did not last. When the parents arranged a second marriage for her, their biggest worry was that she may not conceive because her first husband had raped her violently.

In her new home she works all day, but she is given enough food to eat and her husband is kind to her. (Although my fried noticed that Sita has not even seen the local market, because the family does not believe in their daughters in law stepping out of the house).

Now she is pregnant and her mother in law took her to a city hospital where they said since she is the ‘size of a ten year old girl‘, she must have a caesarean section in the eighth month, although the baby is growing well and there are no other complications. Sita’s mother in law, Kaushalya is excited about raising a second  grand child.

Kaushalya has raised the child of her first daughter in law too. This little boy has little attachment to his mother, who my friend was told, is a bad mother. My friend shopped for gifts for this mother in law saying this would make them treat Sita kindly. She was excited about meeting them but came back disappointed, because Sita is so stressed, she fears she might miscarry.

Sita is worried that she won’t be allowed to take care of her baby, her mother in law believes her ‘age and experience’ make her better qualified for caring for this child. (Sita is expected to cook, clean, wash the family’s clothes etc). Sita’s husband, though kind to her, is an obedient son. Sita is also upset because he will not be with her during or after the baby’s birth. Kaushalya told my friend he is the most devoted of all her sons.

This is not one rare story. Take a look at the pregnant woman in this advertisement. In another case the daughter in law was sent to her parents’ home as a punishment for general incompetence, and the mother in law raised the grandchild. This daughter in law was called back when the family started arranging a marriage for the second son.

I have blogged about another set of grand parents who raised the grand child, because the mother was only good enough to give birth, here ‘Better than mothers?

“A clandestine, and irresponsible, affair may prove dangerous. A city girl learnt it the hard way,”

“A clandestine, and irresponsible, affair may prove dangerous. A city girl learnt it the hard way,”[link]

What makes such reporting harmful?

A much larger number of women die due to Domestic Abuse and Dowry, do we ever read, “A traditional Arranged Marriage may prove dangerous, this small town girl learnt it the hard way.“?

The article fails to convey that the fault lies with the Clinic and indirectly with the Society for leaving a young woman no option, but to approach such a place.

A ‘what will people say‘ ruled society is affected by what is written about them.

It’s starts a dangerous cycle.

1. Judgmental reporting is like malicious gossip and it reinforces prejudices and encourages community judgement of women’s personal lives and sexuality.

2. Fear of loss of privacy, and public condemnation (for something that is nobody’s business but a woman’s own) pushes women (and their families) to risk their lives.

3. Prejudice is what discourages women from going to and looking for reliable abortion clinics.

Terms like ‘Clandestine affairs’ and ‘Illicit affair’ are judgmental and inaccurate. (There is no mention of either of the partners being married). 

Premarital sex and pregnancies are not ‘dangerous’. Social stigma and illegal abortion clinics are.

Just like Arranged Marriages are not dangerous, seeing ‘Getting Married-Staying Married’ as the only goal in a woman’s life is.

4. Women’s fear of such judgement encourages quacks and such clinics.

What made the woman turn to her friends  instead of her parents? (Nothing wrong with turning to friends but just like the Indian police, such clinics too are aware of the Parental Fear and general prejudice young adults in Indian face.)

Such clinics understand how vulnerable a young, unmarried and pregnant Indian woman is.

How severe is the stigma?

If this young woman’s father had realised she had died during an abortion, is there a chance that he would have preferred not to reveal how she died?

And that would have kept the clinic and the doctors safe. So it’s not just rapists who are excused and supported by such controls on women’s lives and choices.

Related Posts:

1.No second chances for an Indian daughter.

2. Teenage pregnancies – not our culture.

3. If she was born somewhere else…