Pregnancy causes physical and emotional changes in a women’s body. It is normal for women to feel emotional during pregnancy. Mood swings are a normal part of pregnancy. But if a woman is feeling depressed and nervous all the time it could be a sign of a deeper problem. Hyderabad has one of the best records of maternal and reproductive care in the country. Its maternal mortality ratio or MMR is 42 against India’s average of 122. However, a new statistic has become a cause for concern – 15 pregnant women have ended their lives in Hyderabad from April to November 2019 as opposed to 4 in 2018. This translates to 2 women committing suicide every month in the last eight months. To combat this trend the state health department started Amma Manas Program to prevent these suicides.

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According to a study conducted by the state health department, a majority of suicides happened during early pregnancy. Only 2 women killed themselves postpartum and only 2 of the women who committed suicide had a previous history of mental problems.

Maternal depression is a term that is used to describe depression in mothers and mothers-to-be. This depression can include prenatal depression, postnatal depression, and postnatal psychosis. Maternal depression is now being recognized as a public health issue around the world. Maternal depression can lead to pregnancy complications and cause permanent and long-lasting damage to the child. Depression often gets under-detected and under-treated during pregnancy. There can be several causes for depression during pregnancy

History of depression though some women experience depression for the first time during pregnancy.
Physical, hormonal and psychological changes linked with pregnancy
Risks associated with depression

History of depression
History of abuse and trauma
Lack of family support
Unplanned pregnancy
Marital problems or domestic violence.
Financial problems associated with pregnancy
Problems with a previous pregnancy or an abortion
Depression during pregnancy is associated with possible complications such as

High blood pressure
Postpartum depression
Complications during delivery such as premature delivery or low birth weight of the baby.
Depression can also lead to the baby being crankier than a baby whose mother was not depressed,
Taking antidepressants during pregnancy could prove detrimental to the mother and child. Side effects include pulmonary hypertension and premature births.

Prenatal or antenatal depression is completely treatable. You must discuss your symptoms with your obstetrician. Depression can be treated psychological or by medication. Psychological treatment may include cognitive therapy and interpersonal psychological therapy. Some antidepressant medication is completely suitable for pregnant women.

The Hyderabad government has decided to tackle this problem head-on. They have increased the engagement of health workers with pregnant women in the state. The state health department wants to encourage planned pregnancy. These workers can also flag cases of depression and refer these women to a primary health center or family health centers.

The Hyderabad Federation of Obstetrics and Gynecology have suggested prenatal classes and psychologists be made part of every OB-GYN clinic in the state. These classes will help pregnant women cope with social and emotional issues. This will also help in removing the stigma associated with mental healthcare. Three prenatal and postnatal screenings have been planned to be synchronized with a women’s regular OB-GYN appointment.

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