One in three women in South Africa suffers from perinatal depression and anxiety so this month the focus is on maternal mental health.
South Africa (10 May 2024) – There’s something that Serena Williams, Brooke Shields, Alanis Morissette, Adele, Behati Prinsloo, South Africa’s own actress and endurance athlete Vanessa Haywood-Sandes and Vutivi Dlamini, of The Dlamini’s Youtube channel, have in common – and it’s not just fame. All these women have experienced postpartum depression, one of the most widespread maternal mental health conditions in the world. In South Africa, as many as one in three women suffer from it – and this May, the Perinatal Mental Health Project (PMHP) is shining a spotlight on the issue.
Each year, May marks Maternal Mental Health Month, with the first of May designated as World Maternal Mental Health Day. The aim is to raise awareness around the fact that so many women – from all communities, stages and walks of life – experience perinatal mental health challenges, and to share resources for support. The term perinatal refers to the period of pregnancy and the first year after giving birth.
“Perinatal depression is common, and so is anxiety and post-traumatic stress disorder,” says Associate Professor Simone Honikman, founder and director of the Perinatal Mental Health Project (PMHP), a Cape Town-based NPO that works to support the integration of maternal mental health care in South Africa. “The prevalence here is about double that in higher-income countries, and marginalised women are affected the most.”
Perinatal depression and other common maternal mental health disorders are highly treatable when detected early. However, they often go unrecognised and untreated, with many women simply being left to push through as best they can. Symptoms of depression include crying a lot, feeling very heavy, low, finding it difficult to get going, withdrawal and feeling hopeless. Women may struggle with relationships and everyday tasks. Changes in appetite and sleep is also common. Symptoms of anxiety include overthinking, feeling afraid or nervous, worrying a lot. Women may have physical symptoms which include sweating, trembling and feeling one’s heart racing. This can lead to serious consequences for both the woman and her baby.
“We are talking about a higher probability of preterm delivery, low birth weight, self-medication with harmful substances, negative impacts on the child’s development, and even an increased risk of the mother’s death,” says Professor Honikman.
“There are also economic impacts,” Professor Honikman adds. “In South Africa, the lifetime costs of untreated maternal depression and anxiety alone add up to R51.8 billion per annual group of pregnant women and their infants,” she explains. “There is a very real need for high quality, integrated mental health services within maternity care.”
With appropriate care, women can learn to optimise challenging circumstances and navigate a way forward. However, access to treatment is a key challenge – particularly for the most vulnerable women, living in low-income communities. In 2019, just five percent of the country’s total public health budget was allocated to mental health expenditure. Of the population without private medical insurance who needed mental health care, less than 0.9% received inpatient mental health care, and less than ten percent (7.8%) received outpatient mental health care.
Globally, the World Health Organisation has called for mental health care to be integrated into maternal and child health services through a recently published guide (read it here: https://www.who.int/publications/i/item/9789240057142). In South Africa, this is reflected in the new National Maternity Care Guidelines, which we are waiting to be released. These guidelines provide evidence-based and practical approaches for maternity care workers to provide mental health as part of holistic maternal care. Honikman and her team at PMHP played a core role in the creation of both these guidelines.
All parents dealing with perinatal mental health challenges are encouraged to seek support. The Perinatal Mental Health Project website is a good place to start – a good go-to site for information and to source useful materials, in multiple languages. PMHP itself does not have a helpline or provide support, other than to the women who visit its service at Hanover Park Midwife Obstetric Unit. However, Professor Honikman recommends the Masiviwe website, which has a map of mental health resources across the country.
Additionally, anyone can contact the following organisations for free assistance:
- South African Depression and Anxiety Group (SADAG): 0800 21 22 23 (general) or 0800 567 567 (suicide crisis helpline) https://www.sadag.org
- Lifeline: 0861 322 322 (general) or 0800 012 322 (AIDS helpline)
- SANCA, for alcohol and drug problems: 076 535 1701 (WhatsApp line)
- Childline: 0800 055 555
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