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Motherhood abroad and postpartum depression

A myriad of factors, including a shallow support system and language barrier, can compound a new mother’s life with postpartum mood disorders. Yet stigma and lack of awareness keeps mothers from seeking professional help.

Photographs: iStock

Text: Judy Wanjiku Jøregensen

About two months after giving birth to her first child, Fatma, a Pakistani living in Denmark, began to experience constant feelings of anxiety, sadness, anger and frustration. She could barely manage her self-care and felt misunderstood by her husband, who one day said out loud that ‘she was not the only one to have a child, and had no reason to behave in ‘that’ manner.” Citing that she only had one child to take care of, and thus he couldn’t understand her mood swings.

Fatma (not her real name) begun to understand that her depression was not a ‘manic evolution’ as she knew depression from her experience with PTSD. Instead, the new sense of imbalance was turning her into an undervalued and anxious mother, thus keeping her from savouring the joys of first-time motherhood.

Elsewhere in Copenhagen, Nancy Njoka, a young Kenyan mother found herself entrapped in the all-consuming and terrifying postnatal motions of anger and crying. Like Fatma, she too felt stuck in the fog of depression, which was compounded by language barriers, cultural shock, winter, and loneliness.

What is postpartum depression? Postpartum depression (PPD) affects 8-9000 new mother each year, according to the Danish national registries. Further research from the University of Copenhagen cites that PPD affects approx., 5%-15% of women after childbirth.

While this mood disorder is no respecter of persons; age, race, religion or class, immigrant or migrant mothers like Nancy and Fatma, who are already facing challenges of living abroad, are more vulnerable to experiencing PPD.

Admittedly, there is limited research available in Denmark to show the percentage of migrant, immigrant, expat mothers with PPD or postpartum related depressive symptoms, vis-à-vis Danish-born mothers. Nevertheless, PPD is one of the most common postnatal complications of childbearing, and is more debilitation than sadness or ‘baby blues’. After giving birth, most mothers (and fathers) experience sadness and mood swings, often as a result of changing sleep patterns and hormonal fluctuations. These symptoms last for days – but occasionally made develop into PPD.

Signs of PPD include persistent feelings of hopelessness, loss of autonomy, excessive crying, insomnia, lack of bonding with the child, loss of appetite, and suicide ideation.

Symptoms can appear any time between delivery and six months after birth, often peaking around 4 – 6 weeks postnatal and may last up to a year. If left untreated, the disorder can have long-term implications in the mother-child bond. It may harm the child’s cognitive and emotional development as well as prolonged maternal depression.

"Signs of PPD include persistent feelings of hopelessness, loss of autonomy, excessive crying, insomnia, lack of bonding with the child, loss of appetite, and suicide ideation."

Overcoming stigma and seeking help International mothers may find themselves navigating the sea of motherhood and life abroad with limited social support. For mother’s coming from collectivist cultures, where it takes a village to raise a child, they may face added loneliness.

Fortunately, if you give birth in Denmark, you are entitled to a home nurse, who makes regular home visits throughout the first year to ensure baby and mother are doing well. The nurse can advise and place the new mother in local mother-baby group, which serves to ease the loneliness and create a sense of community support.

As the nurse makes home visits, he/she may access the new mother’s emotional adjustment to motherhood. If the nurse detects PPD, she/he can refer the mother for further screening, evaluation and psychiatric or psychological intervention, all of which are free in Denmark’s public hospitals.

Creating awareness and education about this once-taboo subject allows mothers to seek help and put everything into perspective. The Danish health care system is well equipped to handle the treatment for depression, which, when administered, is effective and safe during pregnancy and breastfeeding.

Mental vulnerability is nothing to be ashamed of, but the stigma and feelings of inadequacy worsen the problem and leave mother suffering in silence.

Nancy and Fatma ultimately got the help they needed, through a mix of family support, psychological care and personal creative outlets and exercise.

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