Trauma: The dangerous phobia among pregnant women

Quinter Apondi is seated in her cosy living room waiting for the 9pm news bulletin as she enjoys a snack of popcorn.

As she moves her huge but beautiful baby bump, Quinter is convinced that the political temperatures in the country have risen and that no media station can air any human interest stories.

In her seven-month pregnancy, Quinter who is also anxiously scouting for a good hospital to deliver, increases the volume on the TV after a case of medical negligence at a hospital is aired.

According to the news item, a woman gave birth to a baby on the floor in Machakos county after the nurses took long to help her deliver.

Shocked at the bulletin, Quinter (37), an urban-based woman, stops enjoying the popcorn and listens carefully to the news item.

As time goes by, Quinter becomes shaken and is not sure about where she will deliver and whether she will experience the same negligence by hospital staff.

"I felt really scared. In fact, I kept on asking my 40-year-old husband to assure me that he will be present when I give birth,” a shaken Quinter told the Star at her house in Kibra.

“That night I could not sleep, What if I found myself in the same situation, what if my baby died of medical negligence?”

As I listen to Quinter, I realise that she has more fear than just the news on television.

She narrates how she was forced to change hospitals after a social media post by a lady.

In the post, the lady who named a private hospital for delaying the birth of their child which led to fistula made Quinter cry.

“Tell me, as a first-time mum, if you hear such stories about a hospital you have booked, would you still go there? Are you crazy enough to go to a deathbed while you can avoid it?” she posed.

As tears streamed down her cheeks, Quinter noted that she kept changing hospitals as her due date drew closer.

“I told my husband about my fears but because he is God-fearing, he told me there was nothing to worry about. But this did not help the situation. I felt that my husband was not concerned. It was a horrible feeling,” she said.

Nairobi clinical psychologist Riziki Ahmed said the trauma in pregnant women is known as 'vicarious trauma'.

Vicarious trauma is the emotional residue of exposure that counsellors have from working with people as they are hearing their trauma stories and become witnesses to the pain, fear, and terror that trauma survivors have endured.

"Most pregnant women go through this, especially if they have an underlying issue. For example, if they have issues to deal with at home or even at work," Ahmed told the Star.

"And during pregnancy, a woman becomes vulnerable to all these issues. So the best thing is to just avoid watching television and social media."

When asked about counselling, Quinter, who successfully delivered her triplets, notes that she had to get the assurance of her private gynaecologist that all would be well.

Chief gynaecologist at the Kenyatta National Hospital John Ong’ech told the Star that some of the cases on social media by some women are not a cause for concern.

“Many women have successful deliveries in hospital and are happy. Cases highlighted in the media are not the norm but are isolated cases. There are always risks in everything in life, even carrying a pregnancy is a risk and some people die from it,” he said.

Ong'ech said that if anybody can afford it, then they can choose a good doctor that can walk with them through the journey and advise on the best hospital on the basis of his/her experience.

“A lot of things are exaggerated out there, especially on social media. Some cases may be genuine but some people, let me say, bloggers are paid to tarnish some of these good hospitals," he added.

I decide to visit Lucy Njeri who also gave birth recently at Coptic Hospital just to get more insight into the matter.

“Of course I got worried all the time. And I played out all the worst-case scenarios of what would happen before, during and after delivery. This took a toll on me. ..Something I alone could understand,” she said.

Lucy, who gave birth to twins, notes that in her case, she became extremely cautious after learning of the case where Kakamega twins were switched at birth.

“ What if they switched my babies? Our health system is worrying.. I made sure that my hubby and sisters-in-law were waiting for the babies in the surgery room. I could not take chances,” she said.

Lucy, who opted for epidural anesthesia, notes that she was able to see her babies and asked the doctors to call the husband to look at them before being taken to the nursery.

“To be honest I'm generally apprehensive and maybe my worry will only reduce once my babies have grown because by then, most of the critical stages will be over,” she says.

Not only women go through this trauma, even men go through the same but keep quiet about it.

I meet Paul Wekesa (29) who says he could not stand the trauma on behalf of his wife.

"From when I learnt my wife was pregnant, I started putting resources together towards her delivery. I wanted her to deliver at a facility where I was assured of her security. It was stressful. Seeing news items of hospital negligence and the aftermath, as an upcoming parent, I got scared," he said.

Wekesa said he was forced to visit various health facilities as he inquired of their procedures.

"I asked my female colleagues who had recently delivered and their stories were even scaring. At that moment, I was only banking on my NHIF card," he said.

As the days passed, Wekesa said he became more stressed.

"What was even more shocking is that a majority of the health facilities told me they could not book my wife because it was her first time delivery," he said.

"My wife was even more scared, she couldn’t watch news nor follow social media because of the negative information on deliveries. Every time I came into the house, she would ask what has happened or what have you heard."

Wekesa's wife Baraka, would send him to Nehema Uhai several times to assess the facility just to assure her of her safety.

"Since I wanted the best for her, I went to the facility, assessed the wards and asked a few questions. Three months to her due date, she made up her mind that she would not undergo a CS. She was so scared but I assured her I would walk with her," Wekesa said.

She later delivered a bouncing baby boy.

But what are the stress dangers during pregnancies?

During pregnancy, stress has specific dangers for the physical and emotional well-being of the baby, mother and family unit.

Stress during pregnancy is rampant and sometimes it can be related to specific events that take place in the surrounding environment.

PRE-TERM BIRTHS

In pregnancy, stress exposure is associated with a higher risk for pre-term delivery and lower birth weight.

Pre-term births are deliveries that occur before the period of 37 weeks, and in most cases, the babies weigh less than 2.5kg.

Out of the 1.5 million babies born in Kenya annually, around 134,000 are early births, according to the Ministry of Health’s Division of Family Health.

Globally, the World Health Organisation estimates that each year one in 15 (15 million) babies are born too early or die due to premature-related complications.

In Kenya, more than 180,000 children are born prematurely each year and more than 10,000 die annually due to complications.

PRE/POST-NATAL DEPRESSION

Similar to postpartum depression, prenatal depression is accompanied by feelings of worry, sadness and anxiety.

Depression symptoms include;

• Having a lasting sad, anxious, or “empty” mood.
• Feelings of hopelessness or pessimism.
• Feelings of guilt, worthlessness, or helplessness.
• Feelings of irritability or restlessness.
• Loss of energy.
• Problems concentrating, recalling details, and making decisions.
• Difficulty falling asleep or sleeping too much.
• Overeating or loss of appetite.
• Suicidal thoughts or suicide attempts.
• Aches or pains that do not get better with treatment.

Mothers who were stressed or anxious during pregnancy are more vulnerable to developing postnatal depression.

Stress during pregnancy can have long-lasting effects for the family as a whole.

Post-natal depression is depression that occurs after having a baby.

Psychologist Riziki Ahmed said women and men who become traumatised need to talk to their doctor.

"These are the professionals who will advise you accordingly. If not you might have prenatal depression," she added.

"The depression can lead to you harming your baby and even being hostile to the environment around you."

The World Health Organisation report 2017 notes that globally, African women have the highest rate of depression, standing at 5.9 per cent. This tells us that about 6 out of every 100 women in Africa is suffering from depression.

In Kenya, the report notes that about 1.9 million people have some form of depressive disorder. This accounts for 4.4 per cent of the population.

Is pre/post natal depression a mental illness?

In pregnancy and the postnatal period, women are vulnerable to having or developing the same range of mental health problems as other women, and the nature and course of the large majority of these problems are similar in women at other times of their lives.

However, the nature and treatment of mental health problems in pregnancy and the postnatal period differ.

According to the World Health Organisation, about 10% of pregnant women and 13% of women who have just given birth, experience a mental disorder, primarily depression. 

WHO notes that in developing countries this is even higher - 15.6% during pregnancy and 19.8% after childbirth.

In severe cases, mothers’ suffering might be so severe that they may even commit suicide.

SOLUTIONS

Psychotherapy, such as cognitive behavioural therapy, in which a skilled therapist teaches new approaches to manage thoughts and emotions.

Light therapy, in which patients are exposed to artificial sunlight at specific times of the day to help relieve depression symptoms.

Finding support and specialists. If you're pregnant and you're having depression and/or anxiety symptoms, talk to your gynaecologist. She should be able to treat you directly or connect you with the appropriate mental health care provider. 

If you have severe depression, you may be referred to a mental health team made up of psychologists, psychiatrists, specialist nurses and occupational therapist

Depression puts a negative spin on everything. The trick is to replace negative thoughts with more balanced thoughts.