Introduction

Maternal depression refers to a wide range of depressive conditions that affect women who are within a 12-month postpartum period and pregnant mothers at different stages of their pregnancy. Some of the most common conditions associated with maternal depression include postpartum psychosis, postpartum depression, and prenatal depression. This paper discusses the causes of maternal depression and the solutions towards dealing with depression with South Africa being the main county of focus.

Causes of Maternal Depression

Provision of maternal mental healthcare is always a major issue of concern for every mother during and after the pregnancy period, however, in many developing countries where the population is mainly made up of low and middle-income households, the provision of this form of health care has been neglected over time. Medical stakeholders have identified mental health especially among pregnant women as a global health issue, the effects of maternal depression are not only felt by the mother and child, it affects the whole society. Women who have gone through maternal depression have had their work life and social life affected by this mental health condition with few in developing countries having the necessary resources to cope with the condition. Failure to address maternal depression at an early stage can complicate the birth of the child; other long-term effects included retarded development of the child. With depression being one of the main reason the leads people to suicide, understanding the causes of maternal depression is important in order to provide support to women during their pregnancy and the postpartum stage (Hiltunen, 2014, 308).

Perinatal depression is a collective word used to describe the depression during and after pregnancy, this form of depression cannot be linked to a single cause. There are different causes of perinatal depression, with one of the main ones being family history. For expectant mothers or women who are in the postpartum stage, there are higher chances for them to experience maternal depression if there is a history of depression in their families. Women who have a history of depression or comes from the family who has a history of depression need to inform their medical practitioners. Proper health care needs to be provided to such women to ensure that they are able to cope with antenatal depression or postpartum depression. Women who have had any form of maternal depression in their past pregnancies have higher chances of being affected by this form of depression in any future pregnancy, understanding mental health of the woman’s family as well as that of the mother can be a key preventative measure. Lack of family support and marital conflict has also been linked as a factor that can cause maternal depression. Women require social support from their family and those close to them during and after the pregnancy period, if this does not happen, they are likely to experience the different forms of depression. During the pregnancy period, the female body undergoes different changes, physical hormonal changes, stress due to marital conflict or lack of family support can result to depressive conditions that can harm the mother and the baby (Lefkovics, Baji and Rigó, 2014, 367). Cases of maternal depression are also higher in women who have had relationship issues with their mothers while growing up, the child bind relationship for a mother can trigger different behaviors when a woman becomes pregnant.

Mood disorder is higher in women than in men, this form of disorder tends to occur more in pregnant women due to the hormonal changes taking place in their bodies.Premenstrual dysphoric disorder (PMDD) is a common cause of perinatal depression in many women, PMDD occurs just before the menses begin. Various symptoms indicate that a woman is undergoing PMDD, some of them include lack of appetite, insomnia and suicidal thoughts. The hormonal fluctuations that occur during pregnancy trigger the different neurochemical pathways that are associated with depression hence resulting in different depressive symptoms during and after pregnancy. Cases of severe Pre-Menstrual Syndrome (PMS) have also been identified as major cause of maternal depression; the change in hormones that takes place in a woman’s body can trigger different moods that are linked with depression. The hormonal change can cause anxiety and even trigger different emotions such as hate, for mothers who were not prepared for the pregnancy, it can cause them to hate the baby. Past cases of drug and substance abuse can also result to perinatal depression, mothers who have had a history of drug abuse are likely to be more affected by the hormonal changes as well as life changes that come with pregnancy, this can be depressing in women.

While most of the major causes of maternal depression are social, there are also economic issues that cause maternal depression. A large percentage of the South African population is made up of people who are within the lower and medium economic class, and many mothers have to deal with the huge economic challenge of bringing up a child. Poverty can be a significant cause of depression, financial insecurity results in depression during pregnancy and even after giving birth. Many young girls in developing countries such as South Africa have to cope with unwanted pregnancies, with lack of proper social support, many ends up suffering from depression, this has resulted to increased abortion and even suicide for many young girls once they realize they are pregnant (Yayla, 2003, 64). The social, economic status of a family can also affect the pregnancy and childbirth; many mothers are forced to bring up children on their own with the men being absent from their families as they strive to earn a living.

Treatment and Control

Understanding the causes of mental depression is essential in developing appropriate intervention measures, these measures should be made easily accessible to women during the antenatal period. The treatment methods used for maternal depression are almost similar to medical approaches used in other forms of depression, however, the methods based on various factors such as the social, economic position of a country. Use of antidepressants is one of the most common treatment methods for perinatal depression. Medical exposure during pregnancy should be monitored appropriately since some drugs might have negative effects on the unborn baby and even the mother. The use of antidepressants should be combined with professional counseling, women who are going through maternal depression needs to have a physician who provides the counseling services. A physician should be able to evaluate the patient’s mental health history to identify the most effective intervention measure. While medical intervention measures are suitable in the prevention and treatment of medical depression, women require to experience positive social support during and after pregnancy for them to cope with any signs of maternal depression (Arsova and Manuseva, 2017, 405). Family members and friends need to ensure that there are there for the mother during the pregnancy period. Support groups provide women with a chance to talk about the issues that they are going through during their pregnancy and ways to cope with these issues. In countries such as South Africa where some households might not be able to access medical services, social groups provide a suitable alternative (Shidhaye, 2014, 463). For the preventative and treatment measures to effectively work, medical physicians need to be trained and well equipped.

Gaps in Control and Treatment

Although medical practitioners have stated that maternal mental health is a global issue, there are still gaps in addressing and coping with maternal depression. Many women, especially from poor households, cannot afford medical healthcare during pregnancy. The provision of antenatal care remains a challenge; this has resulted in late detection of maternal depression. A multilevel approach is required when providing treatment to women who are suffering from perinatal depression, in countries where there are social, economic challenges, this form of approach is difficult to apply. Women continue suffering in silence due to lack of social support especially in households facing marital issues or when mothers have to deal with unwanted pregnancies. Lack of awareness has also hindered the success of the intervention measures used to deal with maternal depression, and many women do not understand what they are going through until it is too late. Due to poor awareness on maternal depression, there are societies especially in Africa that link maternal depression with evil spirits, and some do not believe that suicidal thought during pregnancy are caused by a medical condition, they believe in superstition. There are still gaps in the integration of formal and informal approaches used in dealing with maternal depression. Rural areas in developing countries lack the necessary facilities required for social intervention measures while pregnant mothers have to rely upon general physicians who might not understand maternal depression to provide medical intervention. It is also difficult for some women to understand their family history since there are no proper medical records in many of the health care facilities.

Conclusion

Maternal depression is not a mental health issue that faces only developing countries such as South Africa, t is an issue that requires global intervention. Women need to understand the importance of mental health during and after pregnancy to safeguard their mental health wellbeing and that of the child. Understanding formal and informal intervention measures is essential for women and health care providers to ensure that maternal mental health is promoted on a global scale.

References

Arsova, S. and Manuseva, N. (2017). Treatment of maternal antenatal depression. European Psychiatry, 41, p.405.

Hiltunen, P. (2014). Maternal postnatal depression: causes and consequences. International Journal of Circumpolar Health, 62(3), pp.308-309.

Lefkovics, E., Baji, I. and Rigó, J. (2014). Impact of Maternal Depression On Pregnancies And On Early Attachment. Infant Mental Health Journal, 35(4), pp.354-365.

Shidhaye, P. (2014). Maternal depression: A hidden burden in developing countries. Annals of Medical and Health Sciences Research, 4(4), p.463.

Yayla, M. (2003). Maternal mortality in developing countries. Journal of Perinatal Medicine, 31(5), p.64.

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