Disclaimer: Reader discretion is advised as the story involves accounts of postpartum depression

Post-delivery stress among new mothers is often overlooked, though it can trigger suicides or infant killings in severe cases. A Kudumbasree initiative in Thiruvananthapuram district’s Nanniyode panchayat seeks to remind women that they are not alone.

Thiruvananthapuram, Kerala: It shook the collective conscience of the society when a 25-year-old woman from Kundara in Kollam district of Kerala strangled her baby to death on March 9 last year. The incident triggered social workers to brainstorm on ways to prevent such cases in future.

Aged just over three months, the baby girl was not a victim of female infanticide, but postpartum stress. "Baby blues are common among new mothers. Support from family and friends helps a lot," said psychologist Aswathy FS, who formerly worked with the Women and Child division of Karuna Sai Mental Health Centre.

"However, postpartum depression can cause serious issues if the mother does not get proper counselling and medicine. This can cause postpartum psychosis, where the mother reaches a state of hallucination leading to incidents like suicide and infant killings.” 

The Kundara incident set Kudumbasree (a government initiative to empower women) circles in the state capital Thiruvananthapuram abuzz. Divya Vijayan V and Surya S, who work as service provider and counsellor, respectively, at the Snehitha gender help desk of Kudumbasree, were tasked with the mission to find a solution.

Based on their inputs, the Kudumbasree Thiruvananthapuram District Mission launched ‘For You, Mom’ programme in April last year. Psychologist Aswathy offers counselling under the programme.

Nanniyode village panchayat in Thiruvananthapuram was the first to implement the programme, with the support of the National Rural Livelihood Mission and state health department.

Speaking to 101Reporters, Divya Vijayan said it was a different challenge to begin with, as most women were reluctant to share their woes, especially relating to pregnancy and their immediate family members. “However, we eventually gained their trust and created an inseparable bond with them. We pledge that no baby would be strangled to death by a depressed mother.”

Kudumbasree workers mostly deal with postpartum stress among the poor and those facing domestic issues. Very few mothers from economically weaker sections are able to get family support, medical care and counselling during the postpartum period. To make matters worse, people in rural areas think behavioural changes are normal soon after delivery.

However, the Kundara incident has brought to light the severity of postpartum stress. Some of the symptoms to watch out for are depressed mood, excessive crying, loss of appetite or eating too much, inability to sleep, intense irritability and anger, hopelessness, and recurrent thoughts of death or suicide.

Solace at doorstep

Sixteen months after the programme’s launch, AK Akhila (25) stood proudly in front of the Gender Resource Centre (GRC) at Nanniyode with her 10-month-old baby girl. She received continuous online counselling from the centre during her pregnancy and postpartum period.

Altogether, 15 women from Alambara, Puliyur and Kallipara wards of Nanniyode panchayat received counselling in the initial batch.

“I got unflinching support from my husband and family, both before and after my delivery. Like any other woman, I was very anxious. However, periodic online counselling sessions gave me immense courage, all thanks to the Kudumbasree workers who made me feel like their own sister,” Akhila told 101Reporters.

At first, a questionnaire prepared by mental health experts was given to all 15 women. From their answers, the social workers identified three cases of postpartum depression, with one showing symptoms of severe depression.

On condition of anonymity, one of the women from the identified group told 101Reporters that she suffered from uncontrollable anxiety. “I felt my baby was about to die, even though my family and doctors repeatedly tried to convince me that the baby was alright. I lost appetite and sleep, and was unable to control my anger also.”

Luckily, the ‘For You, Mom’ programme helped her overcome stress. “Even now, I receive phone calls from the GRC at least twice a month, enquiring about my well-being. And my baby is healthy and fine,” she said.

Another woman cited financial difficulties as the reason for her postpartum depression. “In the wake of COVID-19, my husband lost his job. I was pregnant then. I was under relentless stress, always worrying how I would raise the child. I cannot express the pain I suffered after the most difficult days of pregnancy. But I got through everything with the kind words of my sisters from the GRC,” she told 101Reporters.

The three women identified with postpartum depression received individual psychological counselling, while the one with severe depression got special medical treatment. That apart, all the 15 received six online counselling sessions to ensure they do not slip into depression.

“COVID-19 was at its peak then. Most of the identified women belonged to poor rural backgrounds, and were very unfamiliar with digital tools. With repeated interventions, all of them patiently listened to the classes using their mobile phones. They shared their sorrows and miseries. In the later stage, many of their family members also attended enthusiastically,” said Kudumbasree community counselling educator G Mallika. 

Reaching out to more women

The ‘For You, Mom’ entered its second stage on July 25 this year, with 23 women joining for online sessions at the Nanniyode GRC. Nine other GRCs in Thiruvananthapuram district also took up the programme.

A survey conducted by the Nanniyode GRC has found that various social issues such as alcoholism and drug abuse of husbands stress out women during pregnancy and postpartum stages. “Apart from providing support to bring down postpartum stress, the root cause for the same should be identified and addressed,” said psychologist Aswathy.

A Thiruvananthapuram native aged 25, who attempted suicide twice during her postpartum period, shared her harrowing experience. “During my pregnancy and postpartum period, I did not receive any support from my family. At the same time, I occasionally faced domestic violence from my husband, a chronic alcoholic and drug addict. After my delivery, I experienced hallucinations and was afraid that my baby girl would be killed by him,” said the woman, seeking anonymity.

After the second suicide attempt, the woman was taken to her parental home and given psychiatric treatment.

“The programme has already created a great impact in our village. We want to continue the project with more participation. In fact, the entire state should adopt it. No woman should bear the brunt of postpartum depression,” said Nanniyode village panchayat president Shylaja Rajeevan.

Edited by Sharad Akavoor  

The cover image is for representational purpose (Photo - Amit Ranjan/Unsplash)