Hidden Struggles of Perinatal Depression in Malawi: Breaking the Silence
A 2014 study revealed that one out of five pregnant women exhibited features of perinatal depression.
Neno, Malawi-On a cold morning, June 12th, 2016, Mercy Biyeni embarked on her journey into motherhood at the Magaleta Health Centre in the rural district of Neno, southern Malawi, writes Chrissie Hazimthera Mainjeni.
Little did she know that her path to motherhood would be fraught with unexpected challenges.
At just 18 years old, Mercy had recently dropped out of her second year of high school due to an unplanned pregnancy.
Her boyfriend, denying responsibility, left her with a difficult decision to make.
Despite the adversities she faced, including a lack of financial support and bullying from friends for dropping out of school, Mercy chose to keep her pregnancy.
The ensuing nine months were far from easy. She struggled to attend antenatal visits and maintain a healthy diet.
Upon giving birth, her emotional detachment from her baby became alarmingly clear. She refused to feed her baby and avoided close contact.
"After the baby arrived, I thought I would be happy, but no, I was not. I just developed hatred towards it, defeating my expectations of joyful motherhood," Mercy explained.
Her family resorted to pleading and sometimes forcing her to feed the baby for its survival. However, they were unaware of the true nature of her condition and believed it to be witchcraft-related.
"We took her to different witchcraft doctors to ascertain the problem, but things did not improve. My family never gave up until her sanity returned on its own over time," her sister Sarah Biyeni said.
Medical journals revealed that Mercy was suffering from perinatal depression, defined as depression occurring during pregnancy or in the year following childbirth. It is a global public health concern for women.
According to the World Health Organization (WHO), approximately 10% of pregnant women and 13% of women who have recently given birth worldwide experience a mental disorder.
In Malawi, perinatal depression is often misunderstood and attributed to witchcraft, victim weakness, or pregnancy-related problems.
A public opinion survey revealed that victims are frequently blamed for their irrational decisions due to their condition.
A 2019 study by Mwawi Ng'oma identified factors such as financial difficulties, relationship problems, and partner violence as triggers for perinatal depression.
Mercy’s mother, Bertha, expressed sadness over the public's perception of perinatal depression, which often leads to discrimination and stigma against those who are suffering.
Spokesperson for the Ministry of Health, Adrian Chikumbe, acknowledged that no formal research has been conducted to determine the extent of depression in Malawi, and many affected women do not seek medical attention.
Chikumbe cited a shortage of mental health professionals at the primary level of healthcare and called on other organizations to assist.
Signs and symptoms of perinatal depression include loss of appetite, weight loss, substance abuse, avoidance of antenatal care, and a higher risk of low birth weight and complications during delivery.
Untreated depression can lead to dysfunction in the mother-child relationship and have long-term socioemotional consequences.
Today, Mercy and her sister Sarah are advocating for the government to raise public awareness about perinatal depression so victims can recognize the signs and seek help in a timely manner.
Despite her struggles, Mercy's bond with her son is gradually normalising, though he feels distant at times.
Dr. Eric Umar, a psychologist at the Kamuzu University of Health Sciences, emphasised the need for government-led sensitization campaigns to reduce the occurrence of perinatal depression.
He called for regular screening of expectant mothers and immediate treatment if symptoms were detected.
Dr. Umar also highlighted the issue of health service providers failing to notice perinatal depression, leading to undiagnosed cases and inappropriate treatment.
He called for police to handle such cases with more care, as many are detained without receiving the necessary medical or psychotherapy assistance.
Men were also urged to support their pregnant partners and be aware of the impact of their behavior on them.
A 2014 study revealed that one out of five pregnant women exhibited features of perinatal depression.
"Perinatal depression and any other mental condition are preventable, but only if people learn to lessen the impact of factors that trigger them," Dr. Umar pointed out.
In conclusion, it is imperative to normalise conversations about perinatal depression and ensure that pregnant women receive the care they need for a healthy start to motherhood.