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Childbirth can be a traumatic and scary experience for many women, resulting in significant psychological and physical distress. It can cause some mothers to feel extremely depressed and make it challenging to take care of their newborn babies.
When mothers suffer from depression after giving birth, it is known as Postpartum Depression (PPD), and results from a dynamic interplay between biological, psychological and social factors caused by several childbirth-related physical and emotional factors.
But research published in 2020 by UK's National Health Service has shown that caring for more than one infant increases stress, which can lead to postnatal depression.
Although this doesn't mean you'll certainly get depressed after having your babies, it means that mothers of multiples may be more at risk than moms who gave birth to one baby at a time.
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We spoke to Zainunessa Petersen, who has five children, including two sets of twins. After her first child was born, she shares with us that she was diagnosed with Polycystic Ovary Syndrome (PCOS), and was told that her chances of having more children were very slim.
Seven years later, she fell pregnant with twins. Sadly, one baby died while she was pregnant, but the other was born healthy. Three years later, she found out she was pregnant with twins, and she gave birth to them via C-section at 36 weeks. Just a few months later, she learned that she was pregnant again.
After her fifth baby was born, Peterson started showing signs of depression, and shares that her husband was the one who spotted the signs.
She tells us, "My husband kept telling me I was depressed, but I didn't want to see it. He noticed my mood change, saw me crying all the time, not wanting to do anything: all I kept doing was taking care of the kids."
"I felt something was wrong when I kept thinking of hurting myself and feeling that I wasn't good enough for my kids or my family. From then, my behaviour started to change, and when my suicidal thoughts started, that's when they knew it was postpartum depression," she says.
She began treatment and therapy to manage her life better from there onwards.
"Here and there I still get that overwhelmed feeling, but I wont say it's depression. It's just difficult working with the little ones, but when I can I'll send them to daycare so I can work better and focus better on them," she says.
"I do feel like there are days when I just want to shout. I wont say I take care of myself the way I should, but I do love myself more. I found love for my creator, my family and my business," she admits.
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Multiple babies may introduce stress
News24 also spoke to Tsholofelo Jood, a psychologist based in Johannesburg, about the connection between postpartum depression and giving birth to multiple infants.
Jood shared that caring for an infant can be stressful and requires several resources from the caregiver. With multiple births, she said this might pose an increased risk in PPD because the caregiver needs to be attentive to each infant's unique needs and respond accordingly. That can be overwhelming if there are multiple infants to care for simultaneously.
Jood said, "Multiple births may introduce stressful health concerns for both the infants and the mother, exacerbating stress for the parents. These stressful concerns around childbirth and childcare can be overwhelming and result in PPD."
"This, however, does not mean that multiple births inevitably result in PPD, but the stressors associated with caring for multiple infants can lead to PPD," added Jood.
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Bonding with the child
Research from the US's National Research Council published in 2009 states that maternal stress negatively impacts mother-infant bonding.
"Maternal bonding or mother-infant bonding is the connection between a mother and her child. This bond starts in-utero and continues after birth," explained Jood.
She said that this bonding is an essential aspect of overall attachment, which encompasses the infant's responses to the care provided.
"During bonding, the parent attends to the infant's physical and emotional needs through reassuring interactions with the newborn. These initial moments are essential for cognitive development since caregivers' playful behaviours stimulate the child. A caregiver with PPD may struggle significantly with these playful interactions," said Jood.
"Having to care for multiple infants can be overwhelming without the support, and result in an increased risk for PPD," added Jood.
She said that parents may be concerned that they cannot respond to their babies needs properly, and they may also feel disappointed that the experience may not be as rewarding as they anticipated.
These complicated feelings, according to Jood, may result in a low mood, feelings of hopelessness and helplessness, among other symptoms of depression.
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The dangers to children
Jood stressed that "PPD needs immediate intervention, or the effects on both the parent and the baby can be disastrous, resulting in long-term mental health difficulties. The parent who may be experiencing symptoms of PPD will be compromised, and this will inevitably affect how they care for the child."
She said parents might struggle to figure out what their children need and to respond with the necessary empathy, adding that they may have a limited range of emotions, as their mood is consistently low. The baby may also sense that the parent is having a difficult time, which will affect the baby's emotional well-being.
"The unwell parent may be aware of these significant difficulties caring for the newborn, which then exacerbates the symptoms of depression. In a very cyclical nature, the parent's ability to care for the child is further compromised because of the awareness that they are not coping," said Jood.
"For the developing infant, this disruption in care can have dire consequences. These bonding experiences become the building blocks for cognitive, emotional and social development," added Jood.
Jood said that the infant's brain grows exponentially, and the foundations of later critical developmental processes are formed.
Because of this, Jood said that children who have experienced disruptions in care due to parental PPD tend to struggle with certain developmental milestones.
She said that these effects on both the compromised parent and child underscore the importance of seeking help as soon as possible if someone is at risk for developing PPD.
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