Becoming a mother is a life-changing moment that comes with strong emotions, from joy to anxiety. It is common for most new mothers to experience ‘baby blues’ or postpartum anxiety, which under normal circumstances lasts for several days, but for some women this can last several weeks, causing feelings of anxiety, inadequacy, and , and often leads to postpartum depression (PPD), a more severe form of postpartum psychosis.
Postpartum depression affects many women. The World Health Organization’s (WHO) Global Mental Health Report 2022 found that globally, more than 10% of pregnant and newly born women experience depression, and this figure is higher than in low- or middle-income countries. (LMIC). When mental health disorders are detected in pregnant women or women who have just given birth, they have serious implications for both mother and child.
At the same time, prenatal mental disorders make women more susceptible to negative outcomes in pregnancy and childbirth. Mothers who experience depression and anxiety are at risk for a variety of problems, from labor complications and placental insufficiency to low birth weight for their babies. Children born under these physiological conditions are 50% more likely to be underweight and have a 40% higher risk of stunting in early childhood, in addition to the risk of developing behavioral disorders later in life. there is.
Discussions about mental health have increased significantly in recent years. The WHO report noted that in 2019, an estimated 970 million people were living with a mental disorder worldwide, 82% of whom were from LMICs. Most alarmingly, the report points out that over the course of a lifetime, depression and anxiety disorders are about 50% more common in women than in men. As this debate grows, we need to better understand and amplify the narrative around antenatal and postnatal depression in order to effectively address it.
A correlation between prenatal depression/anxiety and PPD has also been reported. In India, approximately 22% of mothers suffer from her PPD, which significantly affects both the mother-child relationship and the child’s developmental indicators. Furthermore, the prevalence of perinatal depression is 14–24%.
Many cultures prescribe a period of rest and recovery after childbirth. Many of them include traditional rituals and proper nutrition, and a healthy diet is an integral part of them. This is because nutrition acts as an important variable in postpartum recovery, with certain studies revealing that women with anemia have a higher risk of her PPD. According to UNICEF in 2023, approximately 19 million infants are at risk of permanent brain damage and cognitive decline because their mothers do not receive iodized salt to prevent iodine deficiency.
Extensive research has shown that a high-quality diet, including fish, intake of polyunsaturated fatty acids (PUFA), vitamin supplements, calcium, vitamin D, zinc, and selenium, has a protective effect against maternal depression. It has been reconfirmed that it will bring. The 2021 report by the Federation of Indian Obstetric and Gynecological Societies details the scope and extent of nutrition required to ensure the health of mother and child. It contains ingredients such as docosahexaenoic acid (DHA), which is essential for baby development and the prevention of premature birth and pre-eclampsia. DHA is found in many different types of fish, but even people who don’t eat fish can still get a minimal amount of omega-3 DHA.
It is clear that nutrition, mental health, and pregnancy outcomes are interconnected, but efforts to address them must keep in mind the context, not just the clinical solutions. Recognizing social determinants is essential in countries like India, where gender roles can negatively impact women’s access to health services. A 2018 report on gender and tuberculosis in India found that on top of the ‘normal’ risks faced by undernourished women, their situation is made worse by social norms that prioritize health. . Survey participants reiterated that it is common for women in a household to eat the last remaining food.
India has undertaken several initiatives that will help address the above issues. POSHAN Abhiyaan has been instrumental in improving the nutritional status of pregnant women, lactating mothers, adolescent girls and their children below 6 years of age in a holistic manner. In 2016, the Ministry of Health also launched the Pradhan Mantri Surakshit Matritva Abhiyan, which aims to provide quality and free antenatal care to all pregnant women every month. There are also comprehensive national and local mental health programs (NMHPs and DMHPs, respectively) that can and should be strengthened and utilized.
While it is possible to strengthen existing systems, more targeted approaches need to be developed to address mental health during pregnancy or newborns. For example, could mental health services for women, especially pregnant women, be better integrated or approached within the NMHP or DMHP? There is also a very effective RMNCH+A program. How can this program more acutely address the intersection of women’s pregnancy, mental health, and nutrition? Especially given the degree of pressure women face regarding their sexual roles during pregnancy It is also important to develop community-level approaches that address patriarchal biases and help establish a more empathetic understanding of women’s lived experiences in society. society. For example, in the last mile is the Village Health, Sanitation and Nutrition (VHSNC) Committee. Interventions could leverage VHSNC to enhance messages about the intersection of the issues listed above and strengthen existing activities already present in the program.
Policy tools exist to alleviate this crisis. We need to unpack specific nuances and challenges to better understand that women often struggle with a set of larger, interconnected issues. By doing so, we will be able to help the many women who are bearing the brunt of postpartum mental health complications. It will also ensure that India fulfills its commitments in the G20 Declaration formed under its Presidency on food security, nutrition and welfare of women.
This article was written by Anjali Nayyar, Executive Vice President, Global Health Strategy, New Delhi, and Suchi Mahajan, Vice President.
