A woman’s attitude to her pregnancy will usually depend on her age, whether the pregnancy was planned, whether the baby is wanted, the relationship with the baby’s father and the socio-economic status of the mother, among others.

A woman’s psychology during pregnancy may also be affected by her sense of realisation of her femininity, the extent her own mother served as a role model and her projections onto her own baby.

Whether the pregnancy is terminated before viability outside the womb (abortion) or carried to full-term of pregnancy is very stressful. Even criminal abortion is traumatic and needs support. The demand of labour is usually enough to precipitate a mental illness in a predisposed person.

Many women do get mild symptoms of depression referred to as “baby blues”. These symptoms include loss of appetite, loss of energy, lack of drive and lack of interest in pleasure (such as caring for the new baby) all with an associated depressed mood. Baby Blues is self-limiting and usually lasts only some few weeks.

Some women will unfortunately develop full blown depressive illness within six months after delivery, called post-partum depression. This is similar to baby blues, but in a more severe form and an associated pessimistic view of life.

The new mother feels guilty of her past, believing she is responsible for every bad thing that has happened; feels worthless, believing she is inadequate as a mother or even human; and thinks there is nothing more at stake in life for her. This thought of hopelessness has been shown to be the strongest indicator of suicidal behaviour.

Depression in a new mother is more serious because the illness threatens not only suicide but homicide as well. The depressed mother can project her thoughts arousing from her depressed feeling onto her baby and children if she has them. She may believe her baby and/or children may suffer worse plight than her and therefore, do not deserve to go through life suffering. She can then commit infanticide, homicide or suicide.

Other women too develop bipolar disorder when their moods swing from an elated, expansive or irritable mood to a depressive mood. During the depressed mood, their thinking and behaviour is basically like that of post-partum depression. Unlike the depressed mood, the elated mood referred to as mania, is characterised by restlessness, easily getting angry, little need for sleep, full of energy and risky behaviours.

 They may develop abnormal beliefs such as the baby being evil, the baby not being their own and suspicion of other people seeking to harm her baby. These abnormal beliefs tend to strain relationships and sometimes results in dissolution of their marriages with a man who does not understand the changes in their lives. The abnormal beliefs and odd behaviours are referred to as psychosis, hence the condition, post-partum psychosis.

Self-blame and blame from partner can spark a vicious cycle of psychological distress affecting processes in the body that decrease libido during pregnancy. Sex is safe during pregnancy, except in the last four to five weeks of pregnancy and when the woman bleeds vaginally in the first three months of the pregnancy.

Emotional support throughout the pregnancy and support from the father of the unborn child has been shown to significantly reduce the duration of labour, the need for assisted delivery and the likelihood of a woman requiring operation for delivery.

This support may be all that is needed to prevent the onset of a mental illness in the post-partum period. Social support from the relatives such as the mother and in-laws (as is practised culturally) can protect against the development of some mental illnesses such as post-partum depression and psychosis.

For those who develop the disorder, a referral to a psychiatrist is necessary. These conditions are managed with medication, psychotherapy (helping them to review their pessimistic thinking) and electroconvulsive therapy (a treatment regime when a little current is passed through the brain to restore chemical imbalances in the brain). Usually, a combination of two or all three is employed.

With adequate treatment, the response is remarkably satisfying. Most women are able to return to their normal and regular social functioning. Medication is usually maintained for many months to years, depending on the condition to prevent a relapse of the symptoms.

It is important that as a nation, as we provide free ante-natal services, we should also look at the post-natal services and give a holistic and comprehensive care. Our mothers suffer enough to bring forth and the little we can do to ease their suffering should be done to make child bearing a pleasure and not a threat to our existence.

Probably too, it may be about time we repeal the law that makes attempted suicide a crime and rather provide help lines for people to call for help when going through such trying moments. Suicide attempt is a cry for help and need not be criminalised.

Dr Eugene Dordoye is a psychiatrist and a member of the health education and advocacy unit of the Ghana Medical Association.