CHILDBIRTH may be a joyful event from an onlooker’s point of view. But to a woman who has to go through it, the experience may be traumatic. Immediately after giving birth, the hormones, electrolytes and fluids in her body go haywire. She begins to experience mood swings and emotional instability.
As if she does not have enough to go through already, there is a loss of order and routine as new sets of demands crop up with regard to baby care — the sleepless nights, the endless changing of diapers and the constant feeding.
The woman thinks the whole episode an insidious thing. She feels lonely and cut off. She doesn’t realise this, especially when she has many young children to care for at the same time.
According to experts, 50 to 80 per cent of all new mothers experience brief bouts of the “blues” on the third or fourth day following delivery. Weepiness, anxiety and poor concentration are some of the symptoms.
But within two weeks most women are back to normal. The physiological and biochemical changes that occur at birth may have stabilised. No treatment other than empathy and support from the husband, family and friends are required.
For the less fortunate, making up 10 to 20 per cent of new mothers, the “blues” may deteriorate into recognisable symptoms of depression. Weeping and the feeling of anxiety may go on and on. There is a loss of appetite and sexual libido. Insomnia begins to creep in.
These symptoms may persist for months and can gravely impair the woman’s quality of life. In fact, the whole family may be affected.
A few women suffer severely and receive medical treatment. Drug therapy and family or community support may help reduce the severity, and shorten the period of suffering.
It is, therefore, best that the patient be put under psychiatric and psycho-social care at this stage. But many only suffer from moderate depression and simply wait for it to get better — which it eventually does.
While most patients will recover from depression, for a small percentage, that is one to two per thousand women, it may worsen into an even more serious mental disorder. This is known as postpartum or puerperal psychosis.
This type of psychosis is thought to occur abruptly, within 48-72 hours after delivery. Others have reported that puerperal psychotic cases may happen one to three months postpartum.
Some of the symptoms of puerperal psychosis are: feeling excited and elated, talking very fast without completing sentences, and jumping from one topic to another.
The patient is likely to be overactive, not wishing to sleep and rushing from one task to another. She may be bossy and demanding, becoming angry and aggressive if crossed.
The worst part is when hallucinations occur. She may see or hear things that are not actually there. There is also a possibility of experiencing delusions — believing that her baby is the Messiah or its life under threat.
One disturbing feature of puerperal psychosis is that the risk for infanticide, or killing a baby who is younger than six months, is as high as four per cent. Filicide, or child-killing by parents, may also be due to acute psychosis.
The message here is that parents should be aware of all the ups and downs pertaining to childbirth. They must be fully prepared so that the joy of having a baby is not replaced by agony of not being able to care for it.
The person who can give a mother the most support is, of course, her husband. It can be very difficult dealing with a mother who is unable to snap out of the maternal blues.
Besides practical help, she needs constant reassurance that she is still loved despite what she perceives as her inadequacies, that she can be a good mother, and that things will get better.
It may be hard for the husband himself to believe this. He, too, may be suffering from fatigue, even some degree of depression. But things do get better.
More than anything, mothers welcome, and need, their husbands’ moral support, someone to take over when they feel worn out, someone to talk to when things are difficult, someone who really understands what caring for more than one young child means.
While it is understandable that parents feel they have no time for anything else but the young ones, it is important that they keep in touch with the outside world.
Even if entertaining friends or family is out of the question for a time, you can still ask them around for a cup of coffee, share a take-out meal, or give you a hand with a meal or the children.
Apart from the social milieu, the sex life of a new mom will also change. She may suffer from loss of libido, due to the fear of conceiving yet another child, or fatigue, physical and emotional.
It is important for the couple to talk together about what is happening, and it may be that all that can be done is to accept that that is the way things are at the moment and they will improve, as the young ones get older.
An unsatisfactory sex life, in addition to the other stresses that the parents of young children may face, could be the last straw. If the situation becomes very tense, seek the help of a doctor or a counsellor.
As the burden of raising a number of young ones of almost similar age can put a strain on even the best of relationships, therefore it is a sign of strength, not weakness, to seek and practice family planning.
Although Islam encourages the Muslim to have children, it allows him to plan his family due to valid reasons. The most important of these is to avoid endangering the life and health of the mother.
The fear that the children’s health or upbringing may suffer is another reason for family planning. The third is the uncertainty that the new pregnancy or a new baby might harm an already suckling child.
The development of science has contributed significantly to human reproduction. The male and female reproductive systems have been well studied and understood.
A basic knowledge of biology will tell us how the process of fertilisation occurs.
Most women go through a highly predictable 28-day menstrual cycle. If the beginning of the menses is known, then it is possible to predict rather accurately the time of ovulation, which happens about 14 days later.
For fertilisation to take place, intercourse must occur some time between one day before and one day after ovulation. Thus, the period of female fertility during each menstrual cycle is short.
Planned pregnancy is not something forbidden in Islam. Neither is it too difficult to practise. It can and should be employed for our benefit.
It is certainly not going against the predestination of God, for no method of contraception is perfect. A mother could find herself pregnant if God has so willed.
But the knowledge bestowed on us by God through our own quest in science gives us the capacity to at least make an effort. Family planning is our effort — the results are in the hands of God.
There is this story of Caliph Umar who was on his way to Syria and was told of a serious plague. Thus, the Caliph decided to turn back. A companion asked him, “Are you running from God’s destiny?”
Umar soberly replied, “We run from God’s destiny to God’s destiny.”
