Postpartum Depression .. Where Are Women’s Rights to Psychological Support and Treatment?

Almost a year ago, Mona (31 years old) went to the hospital early in the morning to undergo a cesarean section at the time set for her by her doctor.

She was expecting some pain, but what she experienced in the days following the birth exceeded all her expectations.

In the early days, she felt physical pain, and the women in her family told her it was normal and nothing to worry about.

But on the fifth day, severe insomnia began to prevent her from sleeping and eating.

Then her pain doubled with Postpartum endometritis, which is an infection that some women develop after giving birth, and she ended up in the hospital again.

On this experience, Mona told “Sharika Walaken”: “I had violent and turbulent feelings; intense fear mixed with anxiety and lack of self-confidence. I felt a strong aversion to my child, and at the same time an overwhelming sense of guilt towards her. I had nightmares during the few hours I got to sleep.”

She added, “I was consoling myself that it is only a temporary condition and it will pass, but the severity of the symptoms increased day after day, so I began to hallucinate while I was awake.”

World Health Organization: 1 in 5 women suffer from a deterioration in the psychological state during pregnancy and after childbirth.

Postpartum care to prevent depression

Meanwhile, her sister took her to a psychiatrist, who confirmed that she had postpartum depression.

Immediately after that, she started medication and psychological treatment, which lasted about a year.

Afterwards, she returned to her normal life again, and her physical pain disappeared. She felt an improvement in her relationship with her newborn daughter.

Mona confirmed that she is now considering “conceiving children again and I do not feel afraid. I overcame my difficult experience and challenged society, which denigrates women for their right to psychological treatment, and does not acknowledge their pain after childbirth.”

She explained, “I did not hide that I visited a psychiatrist, and what I hope most is that no woman will go through what I went through. And to get psychological support, which is considered one of her basic rights.”

The World Health Organization revealed that more than 3 out of 10 women and children do not receive postpartum care in the first days.

According to the international organization, it is “a critical period in which consequences may occur on physical and psychological health, ranging from injuries, pain, and repeated trauma.”

The organization also warned that one in five women will suffer from a deterioration in their psychological state during pregnancy and after childbirth.

It emphasized that about 20% of women who suffer from these psychological problems may have suicidal thoughts or harm themselves.

So, WHO called for the inclusion of “the mental health of women during pregnancy and after childbirth, within the maternal and child health services.”

Postpartum depression may progress to postpartum psychosis

In an exclusive interview with “Sharika Walaken”, the Egyptian specialist in psychological therapy and counseling, Salma Mahmoud Ahmed, said that “many mothers suffer from feelings of sadness and depression after childbirth, even though the birth of a new child is happy news.”

She explained, “Symptoms begin within two or three days after birth, and continue for two weeks or more. This is normal, and feelings of sadness often fade on their own.”

However, she pointed out that “some cases in which the mother suffers from long-term and more severe depression are known as postpartum depression.”

She added that “a percentage of new mothers may develop what is called postpartum psychosis.”

It is a more severe disorder, associated with psychotic symptoms such as hallucinations, delusions, and the desire to harm oneself or the child.

And she pointed out that “in this case, a medical intervention must be made to protect both the mother and the child. Symptoms may start to appear as early as during pregnancy, or as late as a year after delivery.”

She emphasized that “signs and symptoms of postpartum depression differ from one woman to another. It can range in severity from mild to very severe.”

There are, for example, symptoms of depression, which a woman may suffer from as a result of exhaustion and hormonal imbalance.

Such as: mood swings, anxiety, sadness, crying spells, and poor concentration. It may be associated with problems affecting appetite and sleep.

She added, “These symptoms may extend from a few days to two weeks after delivery, and then fade on their own.”

As for severe symptoms that require treatment, they last longer than that, according to Salma.

These symptoms are more severe, such as severe mood swings, excessive crying, difficulty accepting the child and unwillingness to take care of him/her. Withdrawal and inability to communicate with family and friends.

Added to this is a disorder of appetite, either by an increase or decrease, a sleep disorder, a feeling of extreme fatigue or loss of energy, and a loss of the ability to enjoy activities that were enjoyable in the past.

The mother may also experience bouts of extreme irritability, anger, guilt or despair.

Where is women’s right to obtain the necessary psychological support?

Raising awareness of women’s right to psychological support after childbirth was part of an awareness campaign on reproductive health launched by the “Super Woman” initiative in Egypt.

Its aim is to emphasize women’s need for mental and physical health care, to protect them from postpartum depression.

The founder of the initiative, the Egyptian feminist activist, Aya Mounir, told “Sharika Walaken,” that “the campaign also included raising awareness of the forms of psychological violence that women are exposed to during and after childbirth. Among them is ignoring their pain, as if they have no right to suffer.”

She added, “During the campaign, we heard many testimonies from women who suffered from neglect of their pain by their husbands and family members, which worsened their psychological condition.”

She explained, “On the other hand, there were cases in which women received psychological support from their circles, which helped them recover, overcome physical and psychological pain faster, and improve their relationship with their children.”

She also indicated that there is a belief in Arab societies that “women feign pain and exaggerate it, and therefore, their suffering is dealt with with disapproval, and the role of motherhood is portrayed as idealistic and angelic, and the pain they feel from this role is strange.”

Thus, according to Aya, women are told that “the pain is normal, and all women get pregnant and give birth without complaint, and the focus is only on the rights of the child. As if the mother is forced to do her role while enduring the pain.”

And she added that “in the context of the campaign, we have presented many awareness campaigns on reproductive and sexual health for women, including pregnancy, childbirth, circumcision, postpartum symptoms, dealing with boys and girls, and we have organized workshops for them to talk about their experiences, and we are now preparing for a campaign on sexual violence that women and girls are subjected to and its various forms.”

“Psychological examination is a necessity and a right for all women after childbirth”

For her part, the Egyptian specialist for treatment and psychological counseling, Salma Mahmoud Ahmed, confirmed that “postpartum depression, if not treated, may continue for several months.”

And she indicated that “it may develop into more severe symptoms, such as severe anxiety and panic attacks. The mother may have thoughts of harming her child or herself, and recurring thoughts of death or suicide. And this is a very high degree of disorder, which includes life-threatening thoughts or behavior, and requires immediate treatment.”

For all these reasons, Salma stressed that “psychological examination is a necessity and a right for all women after childbirth. There are several signs, if a mother feels then she should immediately seek help from a specialist, and from her family, without hesitation or shame.”

Among the signs that the psychologist talked about: “The symptoms of depression do not fade after two weeks of giving birth, and the condition worsens, so it will not become difficult for the mother to take care of her child, or to carry out her daily tasks, or it could cause her to have thoughts of harming herself or harming the child.”

And she continued, “Sometimes the mother does not realize that she has postpartum depression, and she feels guilty because she cannot fulfill the role of motherhood, without understanding the reason.”

And she emphasized that “here comes the importance of the circle of support from family and friends, and raising societal awareness to accept the psychological distress of women after childbirth. And help them get the necessary medical care without delay.”