In Kerala’s Kochi, a 23-year-old woman has been accused of suffocating her newborn and hurling the infant’s body onto the road out of her apartment. The incident has triggered many kinds of debates, and while some of them blatantly moral police the woman who birthed the child in the bathroom of her parent's apartment without their knowledge, police sources say that she is still under mental shock from the childbirth and the incidents that followed.
Though the reasons that led to the brutal murder of the newborn have not been fully established yet, an important topic that goes dangerously overlooked is the mental health of new mothers, especially those who give birth under distressing conditions. In this case, police officials suspect that the woman is a survivor of rape, and an investigation into this is underway.
In 2022, the topic of postpartum mental health was propelled to headlines after former Karnataka Chief Minister BS Yediyurappa’s granddaughter Soundarya, a doctor herself in her 30s, lost her life to postpartum depression. Dr Anupama R, managing director and chief consultant gynaecologist at a private hospital, told TNM that many new mothers experience different kinds of mental turbulence of varying degrees due to the intense hormonal and psychological changes during pregnancy and childbirth. “Most women are not diagnosed because of a lack of awareness or stigma surrounding mental health,” she pointed out.
She explained that mental stress after childbirth can be broadly called postpartum syndrome, which can be further divided into three segments – postpartum blues, postpartum depression, and postpartum psychosis.
Postpartum blues or baby blues often starts right after childbirth and is a self-limited condition involving emotional disturbances like mood swings, irritability, negative emotional surges, and tearfulness. Dr Anupama said that postpartum blues are very common but relatively milder, and they usually go away within a few months with good support from family and doctors. “Anxiety, bad moods, sleeplessness, loss of appetite, and many other symptoms may be present. This definitely needs care and attention, but it is not a severe psychiatric condition like postpartum depression or postpartum psychosis,” she said.
Postpartum depression, on the other hand, is a more intense mental health disorder that may persist for several years. In India, at least 22% of new mothers experience postpartum depression, and many more, as Dr Anupama said, remain undiagnosed due to conflict in privacy and unwillingness to disclose the condition to others out of shame. Postpartum depression triggers changes in the mother’s relationship with the child and herself. The symptoms include severe mood swings, depressive episodes, aversion to feeding the child, disinterest in doing personal upkeep, crying spells, bouts of anger or sadness, insomnia, feelings of dissociation from the self, extreme helplessness, self-isolation, and so on.
Postpartum psychosis is an extreme psychiatric condition that involves hallucinations about the child and the mother herself. “Here, the mother may constantly feel fear, like somebody might harm her or kill her. She may eventually pin the blame of all this on the infant, leading to harming the child or even committing murder,” Dr Anupama elaborated.
Postpartum psychosis may also manifest in the form of psychiatric conditions such as schizophrenia or other personality disorders that require the intervention of doctors and prolonged treatment. “There was a case I once heard of where the mother intentionally rocked the child’s cradle at high speed, intending it to crash against the wall and harm the infant. The mother was generally withdrawn and quiet, but the family only recognised that there was a problem when this happened,” Dr Anupama recalled.
Many causes are attributed to postpartum mental conditions, especially the sudden withdrawal of hormones –a dip in serotonin leading to sadness and a spike in dopamine triggering psychosis– after childbirth. The intensity of the experience in each mother depends on various factors like her history of mental health disorders, physical health, family support, spousal support, and financial conditions, among others.
Dr Anupama said that pregnancy and childbirth can trigger existing mental health conditions, or initiate new conditions in mothers. “These are major life events and some can manage them, while others need more support. In the case of young girls, the beginning of menstruation is a major life event, and many girls develop mental stress at the time. The same applies to marriage, childbirth, menopause, and even divorce. Individuals and their social conditions also play a major role in determining how far they can cope with these experiences,” she said.
She also added that the intensity of a woman’s postpartum syndrome is heavily dependent on her relationship with her partner. “For example, in cases of domestic abuse, or the recent death of a loved one, the woman may already be in severe distress, exacerbating or triggering extreme postpartum mental conditions. Similarly, childbirth itself is an exhausting process, and if the woman is shocked by the labour at any point, the trauma may lead to postpartum depression or psychosis,” she said.
In cases like the one in Kochi, the desperation to hide the childbirth may also cause psychic stress, catalysed further by the “moral burden” of having gotten pregnant out of wedlock.
As mentioned before, police sources also said that the woman was in a state of panic throughout, though a medical evaluation is yet to be made. Her mental health may not be enough to defend her alleged crime, but as a society, we must take more cognisance of the trauma new mothers experience.
If you are aware of anyone facing mental health issues or feeling suicidal, please provide help. Here are some helpline numbers of suicide prevention organisations that can offer emotional support to individuals and families.
Tamil Nadu
State health department's suicide helpline: 104
Sneha Suicide Prevention Centre - 044-24640050 (listed as the sole suicide prevention helpline in Tamil Nadu)
Andhra Pradesh
Life Suicide Prevention: 78930 78930
Roshni: 9166202000, 9127848584
Karnataka
Sahai (24-hour): 080 65000111, 080 65000222
Kerala
Maithri: 0484 2540530
Chaithram: 0484 2361161
Both are 24-hour helpline numbers.
Telangana
State government's suicide prevention (tollfree): 104
Roshni: 040 66202000, 6620200
SEVA: 09441778290, 040 27504682 (between 9 am and 7 pm)
Aasara offers support to individuals and families during an emotional crisis, for those dealing with mental health issues and suicidal ideation, and to those undergoing trauma after the suicide of a loved one.
24x7 Helpline: 9820466726
Click here for working helplines across India.