South Africa is grappling with a severe perinatal depression crisis, with women in the country being three to four times more likely to experience this condition compared to the global average.

“Statistics indicate that between thirty and forty percent of South African women will experience perinatal depression, compared to a global rate of ten percent,” says Psychiatrist Dr. Bavi Vythilingum from Netcare Akeso Kenilworth, Cape Town. This staggering difference highlights a growing health concern that demands urgent attention and action.

Perinatal depression encompasses both depression during pregnancy and postnatal depression. Dr. Vythilingum explains, “We use the term perinatal depression because many women who suffer from depression during pregnancy continue to struggle after giving birth. Additionally, postnatal depression can increase the risk of depression in future pregnancies.”

The impact of perinatal depression on both mother and child can be devastating. “Mothers endure extreme emotional pain and difficulty bonding with their babies, which can lead to thoughts of self-harm or suicide,” Dr. Vythilingum warns. The repercussions extend to the baby as well, with increased risks of high blood pressure, preterm delivery, and developmental issues. If untreated, postnatal depression can also predispose children to mental illness as they grow.

**Risk Factors**

Several factors increase the risk of perinatal depression. A history of

**South African Women at Higher Risk of Perinatal Depression**

South Africa faces a perinatal depression crisis, with mothers three to four times more likely to be affected than their global counterparts. This alarming situation requires urgent attention and action to support affected women.

“Statistics indicate that between thirty and forty percent of South African women will experience perinatal depression, compared to a global rate of ten percent,” says Psychiatrist Dr. Bavi Vythilingum from Netcare Akeso Kenilworth in Cape Town. This disparity underscores a growing health concern that demands immediate intervention.

Perinatal depression encompasses depression both during and after pregnancy. “We refer to it as perinatal depression because many women who experience depression during pregnancy continue to suffer postnatally. Additionally, postnatal depression increases the risk of depression in future pregnancies,” Dr. Vythilingum explains.

The consequences of perinatal depression are profound. “Mothers endure extreme emotional pain, difficulty bonding with their babies, and at its worst, thoughts or acts of self-harm and suicide,” Dr. Vythilingum warns. “For the baby, maternal depression during pregnancy is linked to risks of high blood pressure, preterm delivery, and poor growth and development. Untreated postnatal depression is one of the biggest risk factors for mental illness in the affected mother’s children, particularly as they become young adults. It disrupts the mother’s ability to bond with and respond sensitively to her baby, which can have significant effects on the child’s development. Perinatal depression impacts the whole family and can affect mental health across generations.”

**Risk Factors**

The most significant risk factor for perinatal depression is a previous episode of perinatal depression. Other risks include a history of mental health disorders such as depression or anxiety, substance or alcohol abuse, especially if continued during pregnancy, and having an unwanted pregnancy. “It’s crucial to recognize that an unwanted pregnancy is a significant risk factor, but this doesn’t mean that all unplanned pregnancies are unwanted. Many unplanned pregnancies are joyfully welcomed. Additionally, having an unsupportive partner or experiencing intimate partner violence can also contribute to the risk of perinatal depression,” notes Dr. Vythilingum.

**Recognition and Hope**

Despite the severe implications, there is hope. Perinatal depression can be treated effectively. “The first step is to recognize perinatal depression. This is why it’s important for all women to be screened during pregnancy and after giving birth. There are simple, accurate screening tools available to identify signs of perinatal depression,” Dr. Vythilingum emphasizes.

Once diagnosed, treatment should be holistic and multidisciplinary, involving all healthcare providers such as the gynaecologist, paediatrician, and clinic nurse. Treatment can include psychotherapy (talk therapy) and medication. “Talk therapy is very effective for mild to moderate depression. However, for moderate to severe depression or if a mother has thoughts of suicide or harming herself or her baby, medication is necessary,” Dr. Vythilingum advises.

“Many medications are safe to use during pregnancy and breastfeeding. Taking prescribed medication for moderate to severe perinatal depression is better for the mother and baby because it helps the mother recover and take better care of herself and her child.”

Support from family and friends is also crucial. “Mothers need practical help, like cooking meals or looking after the baby, but they also need emotional support and reassurance that they are good mothers despite their illness,” Dr. Vythilingum stresses.

Recognizing perinatal depression as a serious health issue and raising awareness can help affected mothers receive the treatment and support they deserve.

For mental health emergencies or advice, contact Netcare Akeso’s 24-hour crisis line at 0861 435 787 or the South African Anxiety and Depression Group’s 24-hour suicide crisis helpline at 0800 567 567. Trained counsellors are available to offer judgment-free guidance and support.