By Lungi Langa
A large proportion of pregnant women who receive antenatal care in South African clinics and hospitals are depressed, which could pose a risk to their unborn babies.
Most programmes tackle cases of depression among pregnant women only after the birth of the baby. However, the Perinatal Mental Health Project in the city, which offers counselling to mothers throughout their pregnancy, is playing a role by tackling depression in the initial stages of the pregnancy.
Simone Honikman, director of the project, said although it was common belief that depression occurred after pregnancy, depression was often noticeable in the beginning stages of pregnancy. Severe cases of depression could be treated more successfully if detected early. The Perinatal Mental Health Project is part of UCT's Department of Psychiatry and Mental Health.
South Africa's postnatal depression prevalence is three times that of developed countries. According to research, the rate of antenatal depression in Hlabisa in rural KwaZulu-Natal is 41 percent and the rate of postnatal depression in Khayelitsha is 35 percent.
Honikman said it was sad that mental health services were not yet incorporated into primary healthcare.
"At the moment mental illness is seen as an isolated and specialised condition that needs to be treated separately. Mental health needs to be treated like any other illness. Primary healthcare workers are not able to distinguish some of the symptoms and they need to be trained for that," she said.
For over eight years the project has been screening pregnant women in the Western Cape for mental health conditions and offering them counselling. About 8 000 women have been screened and 1 234 women have been counselled as part of this free service.
When the women arrive for antenatal care at Mowbray Maternity Hospital, they are given questionnaires which help to establish whether they have any signs of depression or anxiety or whether they have any risk factors for mental illness. Those who show signs of depression are referred to clinical psychologist Bronwyn Evans. Evans said some of the signs of depression included lack of sleep, loss of appetite, crying a lot and feeling ashamed.
A woman who took part in the project was in her seventh month of pregnancy when she realised she was not coping. She had fallen pregnant when she was 27 and the father of the child had abandoned her. "My pregnancy was a depressing period for me. I cried all the time," she said.
"At the clinic they gave me a form to fill in. I normally would not be honest with my friends, but I decided to be honest on the form."
In the three counselling sessions she was able to accept the pregnancy. They also helped her deal with the anger she felt towards her own father for being absent when she was growing up. - Health e-news