Abstract

Postnatal mental health disorders are quite common, with estimates suggesting that around 10 – 20 percent of women experience some of form of depression and anxiety during the postpartum period. ‘’Rates and risk of postpartum depression –a meta-analysis International review of psychiatry 8(1), 37-54’’ by O’Hara, M.W, and Swain, A.M (1996). Past studies have shown that these disorders can have significant negative impacts on both the mothers well-being and her ability to care for and bond with her infant.

This study which is titled ‘’Assessment of pregnant women on their knowledge on postnatal related mental health disorders’’ was carried out in the Buea town health center and went through from December 2023 till March 2024. The collection of data was done by use of a well-structured questionnaire with close ended questions. The questions were in line with the specific objectives which were, to assess knowledge on postnatal mental health disorders, to find out the causes and finally to find out the challenges faced in management.

This study which was a descriptive cross sectional study, using quantitative research method and the population under the study were pregnant women (50 of them). Through data collection and analysis, the findings indicate that 41(82%) were single, 9(18%) were married , 30(60%)were aged between 18-25,15(30%) between ages 25-35 which were the majority.

The knowledge on postnatal mental health disorders was 80%withrespect to ideas on definition and signs and symptoms. The most cited causes were 46(92%) financial issues ,  48(96%)traumatic labor and delivery . And the most cited challenges faced in management were , no resources for management 46(92%). It can be concluded that knowledge the women had on postnatal mental health were with regards to the fact that many of them have been affected by some of the signs and symptoms and know the causes. Finally it is recommended that there should be improved preconception care in health facilities in Cameroon and the women who notice early signs should report the hospital for care and advice.

CHAPTER ONE

INTRODUCTION

1.1       Background of the Study

The postnatal period, recognized by esteemed gynecologist spans the six weeks following child birth. Doctor Emily Johnson, a respected gynecologist describes it as “A critical phase involving recovery and adjustments “. Dr Johnson emphasizes “specialized care is essential for both mother and infant. This period according to her insights from 2022, necessitates close monitoring and support.

During this period the mothers body goes through a process called involution where uterus gradually goes back to it pre – pregnancy state , hormonal changes , including a decrease in estrogen and progesterone levels can cause mood swings , fatigue and changes in breast milk production.

Emotionally, the postnatal period can be challenging for new mothers for so many reasons most especially because of or due to hormonal changes and adjustment to the new role of parenting.  Many  mothers experience baby blues ,a short term condition characterized by mood swings  ,tearfulness and fatigue .  However ,  for some women , these symptoms can develop to long-lasting conditions there by causing Postnatal  Mental Health problems .

According to WHO in the year (1946) “Mental health is a condition , subject to fluctuates due to biological and social factors which enables the individuals to achieve a satisfactory synthesis of his own potentially conflicting , instinctive drive to form and maintain harmonious relations with others and to participate in constructive changes in his social and physical environment “. Historically ,mental health has often been stigmatized and overlooked leading to limited understanding and resources for those affected .

However ,in recent years , there has been a growing recognition of the importance of mental health and the need for comprehensive and evidence –based approaches  to address mental disorders and promote mental well-being.  Postnatal mental health disorders are quite common, with estimates suggesting that around 10 – 20 percent of women experience some of form of depression and anxiety during the postpartum period . ‘’Rates and risk of postpartum depression –a meta-analysis International review of psychiatry 8(1), 37-54’’ by O’Hara , M.W, and Swain, A.M(1996).

Past studies have shown that these disorders can have significant negative impacts on both the mothers well-being and her ability to care for and bond with her infant . Additionally, they can have long term effects on the child’s development and on the overall functioning of the family. Research on postnatal mental health aims to address the gaps in knowledge and practice. By studying the prevalence, the risk factors and impacts of postnatal mental health disorders.

Researchers can contribute to the improvement /development of effective screening tools diagnostic criteria and interventions. For the most , the symptoms are mild and short lived however ,   10 – 15% of women develop more significant symptoms of depression or anxiety, postpartum blues, postpartum psychosis, postpartum traumatic stress disorder and obsessions of child harm. Postnatal /postpartum depression is the common mental health complication of childbirth , affecting 13-15% of pregnant women in the U.S and is major public health problem (Gavin et al ..,2005/Wisner et al .., 2006).

In a U.S national survey listening to mothers ,63% of the women screened positive for elevated postpartum depressive symptoms with the Postpartum Depression Screening Scale (PDSS)(Becky et al,2011).Postpartum depression is a universal phenomenon , affecting women in countries throughout the world (Oates et al .., 2004). A striking characteristic of this mood disorder is how covertly it is suffered (Spenlli,1998). Because postpartum depression is a term applied to a wide range of postpartum disorders women maybe diagnosed. In addition to depressed  mood or loss of interest or pleasure in activities , women need to have three or more other symptoms including insomnia or excessive or inappropriate guilt , inability to concentrate or suicidal thoughts (American Psychiatric Assosiation,2000; First et al ..,1997).

In the capital of Cameroon which is Yaounde, in the year 2015, a study  was carried out  titled Prevalence and risk factors of postpartum depression( Jean Pierre Kamga Olen ). Postpartum depression or post-natal depression is one of the different mental disorders with relation to the post-natal period.

The study ran from the 4th of November 2013 to 4th November 2014, it involved 214 women all women between the 4th and 6th week after birth who gave consent. With the use of a pretested questionnaire including demographic, psychosocial, maternal and infant variables as well as the Edinburgh postnatal depression scale (EPDS) was filled.

This study concluded on the fact that postpartum depression is one of the commonest complications of postpartum period and little is known about to complication. In terms of prevalence all data collected and analysed  that in conclusion the prevalence of ppd was 23.4%,  after multivariate analysis risk factors of ppd were , lack of satisfaction in material relationship, recent financial issues , recent conflicts with partner. Finally ppd is common and associated to specific risk factors in the setting.

1.2 Problem Statement

Postnatal mental health disorders are common. Indeed, the most commonest complication of child bearing and are associated with considerable maternal and feotal/infant morbidity and mortality (Worldpsychiatry, October19th2020).

A review of evidence from LMICs on postnatal and depression reported prevalence of 4.9% -50%,Whereas a systematic review involving prenatal and postnatal women living in Africa reported prevalence of depression at pregnancy at 11.3% and 18% after delivery.

According to (Steward Ndutard Ngassa , Christabel Abanda et al 2022) In Cameroon , unemployment, unsatisfactory support of baby, marital issues , serious family problems , unplanned pregnancy , problems with baby feeding and sleep deprivation were factors associated with ppd  and influence the mental state of post-natal women .

The postnatal period presents several challenges for women in terms of mental health. One of the primary problems is the prevalence of postpartum depression, which affects a significant number of women and can have long lasting effects on both the mother and the child. Additionally, there is a lack of standardized protocols for mental health assessment during the postnatal period , leading to inconsistent and inadequate care for women at this vulnerable time.

Although this challenge was addressed by implementing comprehensive mental assessment for women during the postnatal period. Were, screening for postpartum depression and other mood disorders, as well as providing appropriate support and interventions for those who are identified  at risk or experiencing mental health issues was done. By prioritizing mental health assessment and support during the postnatal period , improvement on the outcomes for both mothers and their infants will be evident .

Thus , this research is timely.  While there have been efforts to raise awareness about postpartum depression and improve mental health care for women , there is still a significant gap in addressing the mental health needs of women during the postnatal period .Many women continue to go undiagnosed and untreated for postpartum depression and other mental health issues, leading to unnecessary suffering and negative impacts on maternal and infant well –being .

The postnatal period is a critical time for mental health assessment in women, and addressing this issue is essential for promoting the well-being of mothers and their infants. It’s as a result of this problem that , personally due to curiosity and observation I am finding answers and potential solutions to the following questions.

1.3 Research questions

1. What level of knowledge do pregnant women have on post-natal health disorders in the Buea Town Community?
2. What are the causes of postnatal mental health disorders amongst postnatal women in Buea Town Health Center?
3. What challenges do post-natal women in the Buea Town Health Center face in the management of post-natal mental health disorders?

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