ON Oct 24, a first-time mother of a 10-day-old infant died after falling 16 floors of a condominium in Bangsar South, Kuala Lumpur.
It was reported that the 30-year-old accountant was believed to have been stressed as she was unable to breastfeed her newborn properly.
Last week, two brothers, aged 5 and 3, were found with their throats and wrists slit at their home in Sungai Petani, Kedah. They were believed to have been murdered by their 34-year-old relative who was reportedly suffering from emotional distress.
Although the prevalence of postpartum depression (PPD) is relatively low in Malaysia at 3.9 per cent of the population, it is worrying that more and more young mothers are being diagnosed with the illness, largely brought on by their inability to cope with the demands of being a new mother in a stressful environment.
Mother of three, Doreen Tan, recalls her experience with PPD after her first child was born.
“I experienced PPD for a month after delivering my first born. I felt that everything was going to go wrong with my baby. It all began with a difficult start to breastfeeding. I didn’t know how to do it properly. It felt extremely painful. The baby was crying non-stop and I was extremely tired with the one to two hourly nursing. Even the nurse commented that I was not producing enough milk for my baby.
“I felt that I had failed as a mum and that my baby was going to starve to death because I was so determined only to breastfeed my child, and because no one could help me feed a newborn except myself. I was constantly exhausted and got angry with my baby for the incessant crying and felt agitated with anyone who wanted to help relieve me of my exhaustion. If they wanted to carry my baby, I actually felt that they were ‘snatching’ my baby from me.”
At that time, Doreen said any negative comment was interpreted as harsh criticism.
“One day, my husband commented about the loose maternity shirt that I was wearing to go out with my baby as I wanted to be able to feed my baby easily. But I felt he was commenting that I didn't look attractive to him anymore, so I angrily placed the baby back in the cot and had an argument with my husband about his insensitive comment.”
There was also a time when Doreen would hold her newborn and cry with him in frustration.
“It lasted for a month. I was glad as once breastfeeding became easier, I felt confident in my role as a mother.”
The 39-year-old mass communications manager says PPD is not wholly recognised as an illness in Malaysia, and is seen more as a character flaw or weakness.
“In fact, many people tell new mums to get on with it and to stop whining, not recognising that hormones are affecting the mother’s mood swings and causing depression.
“I know that PPD is hormone related, but I also feel that there’s a certain advantage to being a mother when one is older and more financially secure. With a certain maturity and economic advantage, it’s easier to educate ourselves and be prepared to accept things and do something positive, such as getting professional help.
“Also, with more experience which come from being older, I think a mother has more inner strength and resilience to face challenges and be more receptive to accepting professional help. I don’t think it’s a weakness but more about being able to educate ourselves and recognise that we need help when we are troubled.
“Postpartum blues occurs all around the world and most mothers I knows are able to recognise the symptoms, thanks to the advancement of technology,” says Doreen, who also has a blog called seven2sevenmom, which aims to connect working mothers.
“Today, most mothers get advice and encouragement concerning PPD via online forums and support groups.
“However, public support in Malaysia is still lacking. Clinics and hospitals should run pre-natal workshops on PPD before a woman gives birth. Peer-to-peer support is important, too, and mums can even share tips on online forums and Facebook support groups.”
Some of the common stressors which lead to PPB are the pressure to breastfeed and conflicting confinement do’s and don’ts, says Doreen, adding that physical changes after delivery are also a stressor.
“Nursing care after birth at the hospital is also important to ensure a newborn’s well-being.
“Also, financial stress is a contributing factor as the expense of having a baby can be high. Besides that, there is also the husband’s reaction to the wife’s changed body. Love, affirmation, support and help from a spouse will reduce stress.
“The stress of going through traditional confinement versus the Western approach for postpartum care, and even an in-law’s intercession in how a baby should be cared for sometimes goes against a new mum’s belief and can be extremely stressful.”
Rekindle Theraphy counselling psychologist Cathie Wu said PPD may be less recognised in a sense that it may be misconstrued as just “baby blues”, or fatigue and stress that normally stem from being a new mother.
“Many do not see this as an illness until symptoms worsen, such as a lack of interaction and interest in the child, fear of hurting one’s child, lack of pleasure and motivation, hopelessness and helplessness.”
She says mothers should not have to feel condemned to go through their struggle alone.
“The difficulty with PPD is that these negative feelings are often suppressed and ignored because they are deemed socially unacceptable. Societal norms often paint a happy picture of how new mothers should feel, causing a lot of shame and doubt in mothers who are going through psychological and emotional turmoil.”
Various kinds of pressure and expectations can make a difficult situation worse, she says.
“Besides caring for the baby’s needs, wives also have to deal with the pressure of making time for their husband, household chores and other responsibilities. Additionally, some new mothers are stressed over the jobs waiting for them post-maternity leave.”
Jennifer Hor, a midwife and parenting educator, says although there is more awareness in urban areas, the thought of seeing a psychiatrist can be daunting.
“At times, mothers simply do not know where to look for help. Information as to where and how to get help is necessary. This can be displayed at clinics or during pre-natal classes. Family members should be informed about when and where to get help. Emotional support and affirmative reinforcement from family members are helpful, too.
“Years ago, pressure used to come from having to follow traditional practices. Nowadays, it’s the need to be a perfect mother. Issues range from having a natural childbirth, pressure to successfully breastfeed from day one, the need to constantly increase and match the yield of breast milk, comparison and pressure from social media and chat groups and unrealistic expectations.
“Besides that, there are also expectations of losing pregnancy weight and constantly worrying if the baby is alright.”