Postnatal Depression

“Postnatal Depression – it is a term that has gained momentum over the decades in the arena of research, but one I, as a Pacific woman, “still” struggle to fully understand and while we have terms to describe symptoms, we have yet to create Pacific translations that define what it means or capture the essence of what our sons and daughters of the Pacific go through.  So, here is my attempt at asking questions that will hopefully start us on a journey of better understanding.   

Here’s what we know

  • Postnatal depression is not restricted to mothers. It also affects 1 in 10 fathers worldwide, with maternal depression the most significant link to paternal depression.
  • Internationally, an estimated 10% of pregnant women and 13% of women who have just given birth experience a mental disorder, primarily depression. In developing countries this is even higher, i.e. 15.6% during pregnancy and 19.8% after child birth.  
  • The overall rate of postnatal depression in Pacific peoples is at the upper end compared to the general population BUT STILL a large proportion of Pacific women have untreated depression in the community
  • Intra-ethnic variations in rates vary by Pacific ethnicity with one study suggesting that in NZ, the prevalence rates differ from 7.6% for Samoans to 30.9% for Tongans.

While, postpartum depression can affect anyone, perceived stress has been identified as a risk factor.  This is often triggered by low socioeconomic status, previous mental health issues, relationship problems or abuse, ethnic discrimination and stereotyping, stressful life events and unplanned pregnancy – issues, that statistically, put our Pacific mothers and fathers at heightened risk.

AND while we know it is a problem, what does it mean for those going through it?

In a book on postpartum depression, author Judy Dippel writes  

“Postpartum depression makes you suddenly feel like a stranger to yourself… it makes you feel like you’re in the grip of something dreaded and dark, and it’s scary. . . but you’re likely ashamed to admit it because you can’t explain it!”

American novelist, essayist, and poet Barbara Kingsolver also notes

There is no point treating a depressed person as though she were just feeling sad, saying, ‘There now, hang on, you’ll get over it.’ Sadness is more or less like a head cold – with patience, it passes. Depression is like cancer.”

These quotes have taught me two things.  

Firstly, the depth of despair, fear and guilt attached to depression is real and secondly, we NEED to capture the stories of Pacific mothers and fathers who face the same scary journey yet, for the greater part have remained voiceless.  

To see things through a Pacific lens

While there is a paucity on direct narratives from our mothers, in a recent interview with e-tangata, Tongan consultant psychiatrist Dr Siale Foliaki was quoted as saying  

“If she (the mother) was stressed or depressed, then that child has a different trajectory — just as we know that, after birth, if the mother suffers from post-natal depression, psychosis, or some serious drug and alcohol-related issues, that child will start to demonstrate abnormal behaviours by around the age of three. If you follow those children over a long period of time, there’s good research that show that they will have what’s called an “insecure attachment,” causing all manner of other problems. This tells me that there’s something about that formative period in the making and growing of a child that is profound.”

While, the body of research, is starting to build evidence on how Postnatal depression impacts children, partners and the individual facing postpartum depression, from a Pacific perspective, the potential long term and flow on effect of the postpartum period is still unknown.  Retrospectively, with Pacific social structures the way they are, I am often left wondering how our ancestors dealt with depression and whether our communal way of living was a protective factor for recognising signs and working collectively to support our families.  

So, moving forward, what signs should we look out for?

If you yourself, or you see another feeling any of these things

  • Tired
  • Worried all the time
  • Sleep deprived
  • Easily angered
  • Not thinking properly
  • Having thoughts of harming baby
  • Feeling Sad
  • Feeling empty

It is important that you/they talk to someone early about how they are feeling in order to access the right support. AND if you see any of these signs in yourself and/or other people useful tips you might find helpful include.

  • Being kind to yourself
  • Max time to relax, rest and sleep
  • Ask for help
  • Talk, sing and look into your baby’s eyes
  • Eat healthy
  • Go for a walk
  • Make some alone time with your partner

Bottom Line

Unless we generate a body of knowledge on this health issue, we won’t fully comprehend how to support those who suffer from postnatal depression. Learning more about the science behind it, how to best describe it so that its understood and talked about and advocating for policies that ensure screening during and post pregnancy for mother and father will help us move forward as a collective.