A Pacific Perspective on Postnatal Depression

Postnatal depression is a term that has gained momentum as research has grown over the years.

However I, as a Pacific woman, still struggle to fully understand it and maybe you do too.

We may have terms to describe symptoms but we have yet to create Pacific translations that define what Postnatal depression means or capture the essence of what our sons and daughters of the Pacific go through.

So, here is my attempt at asking questions that will hopefully start us on a journey of better understanding.

A few things we know about postnatal depression

Postnatal depression is not restricted to mothers. It also affects 1 in 10 fathers worldwide, with maternal depression the most significant link to paternal depression.

Internationally, an estimated 10% of pregnant women and 13% of women who have just given birth experience a mental disorder, primarily depression. In developing countries, this is even higher, i.e. 15.6% during pregnancy and 19.8% after childbirth.

What about PND within Pacific families?

The overall rate of postnatal depression in Pacific peoples is at the upper end compared to the general population, and still, a large proportion of Pacific women have untreated depression in the community

Intra-ethnic variations in rates vary by Pacific ethnicity with one study suggesting that in NZ, the prevalence rates differ from 7.6% for Samoans to 30.9% for Tongans.

Are Pacific parents at a heightened risk of postnatal depression?

While postpartum depression can affect anyone, perceived stress has been identified as a risk factor.  This is often triggered by low socioeconomic status, previous mental health issues, relationship problems or abuse, ethnic discrimination and stereotyping, stressful life events and unplanned pregnancy – issues, that statistically, put our Pacific mothers and fathers at heightened risk.

What does postnatal depression feel like?

In a book on postpartum depression, author Judy Dippel writes:

“Postpartum depression makes you suddenly feel like a stranger to yourself… it makes you feel like you’re in the grip of something dreaded and dark, and it’s scary. . . but you’re likely ashamed to admit it because you can’t explain it!”

American novelist, essayist, and poet Barbara Kingsolver also notes:

“There is no point treating a depressed person as though she were just feeling sad, saying, ‘There now, hang on, you’ll get over it.’ Sadness is more or less like a head cold – with patience, it passes. Depression is like cancer.”

These quotes have taught me two things.  Firstly, the depth of despair, fear and guilt attached to depression is real. Secondly, we need to capture the stories of Pacific mothers and fathers who face the same scary journey yet, for the greater part have remained voiceless.

Postnatal depression has a ripple effect on our families

While there is a paucity on direct narratives from our mothers, in a recent interview with e-tangata Tongan consultant psychiatrist Dr Siale Foliaki was quoted as saying:

“If she (the mother) was stressed or depressed, then that child has a different trajectory — just as we know that, after birth, if the mother suffers from post-natal depression, psychosis, or some serious drug and alcohol-related issues, that child will start to demonstrate abnormal behaviours by around the age of three.

If you follow those children over a long period of time, there’s good research that shows that they will have what’s called an “insecure attachment,” causing all manner of other problems. This tells me that there’s something about that formative period in the making and growing of a child that is profound.”

There is now more evidence on how postnatal depression impacts children, partners and the individual facing postpartum depression,

However, from a Pacific perspective, the potential long effects of the postpartum period is still unknown.

Did our Pacific ancestors have family support?

Retrospectively, with Pacific social structures the way they are, I am often left wondering how our ancestors dealt with depression and whether our communal way of living was a protective factor for recognising signs and working collectively to support our families.

What are the signs of postnatal depression?

Seek help if you are feeling the following, or know another who is:

• Tired
• Worried all the time
• Sleep deprived
• Easily angered
• Not thinking properly
• Having thoughts of harming your baby
• Feeling sad
• Feeling empty

It is important that you/they talk to someone early about how they are feeling in order to access the right support.

Be kind to yourself:

• Max time to relax, rest and sleep
• Ask for help
• Talk, sing and look into your baby’s eyes
• Eat healthily
• Go for a walk
• Make some alone time with your partner

We need to learn more, talk more and advocate

Unless we generate a body of knowledge on this health issue, we won’t fully comprehend how to support those who suffer from postnatal depression.

We need to learn more about PND and the science behind it. We need to learn how to best describe it so that it’s understood and talked about.

We need to advocate for policies that ensure screening for PND during and after pregnancy, for both and father.

We need to do what we can to help us move forward as a collective.

Remember, if you recognise the signs in yourself or someone you know, seek help.