How 27 Nigerian CS Mothers Survived Postpartum Depression Through Emotional Communication Supports

As social animals we are, we encounter daily happenings that either teach us realities or emphasise to us the realities we had already known. One of such realities is the state of our mental health and how we cope with mental health symptoms. For example, in April 2020, I documented the experiences of twenty-seven (27) Nigerian mothers whose children were delivered of through a Caesarean Section (CS). I was interested in their experiences for two cogent reasons. One, to find out how they coped with postpartum depression, for research indicates that many women show symptoms of postpartum depression (such as mood swings, loss of sleep and concentration, personality disorder, etc.)  after childbirth, particularly when the child comes to the world through a CS. Two, to establish the role of empathic communication, experiential learning and peer social support in managing postpartum depression symptoms.

A WhatsApp CS Community and How It Helped CS Mothers Fight Depression

It was during one of the phases of COVID-19 lockdown in Nigeria that Mrs Oluwajerimi Adewale created CsectionMum Community, a WhatsApp group aimed at providing professional information to nursing mothers who had passed through a CS and expecting mothers who are likely to pass through a CS birth. She, herself, had passed through four different successful CS births. Thus, she created the group to serve as a social support group for mothers on CS-related and maternal health issues at a time when mothers found it difficult to visit hospitals because of COVID-19 measures on social gathering.

Most of the women I spoke with through three Online Focus Group Discussions (OFGDs) revealed that they stayed put in the WhatsApp community because it offered them emotional support throughout their depressive stages, provided them with relevant information on how to manage their post-CS activities, and assisted them in meeting their post-CS goals. For instance, some of them told me:

I wanted a support group filled with women who had gone same experiences that I have and passed through…

My reason for joining this group is to express my fear and ask questions concerning CS or belly birth. Also, to be emotionally balanced because people think birthing through CS makes those who gave birth through CS less of a mother.

I joined because right from (the) day when I knew I was pregnant, I was going for elective CS and wanted to be with other moms who had gone through/were going for same for me to learn the dos and don’ts of CS…

Then, the question of security of their information arose. That is, why did they self-disclose their personal information despite that members of the group were/are socio-culturally and ethno-religiously diverse? According to them, the expertise of the professionals who always educated them, the experiential support they did receive from the online community alongside the heterogeneity of the group facilitated their self-disclosure. Two of them stated:

I feel so safe because those who gave birth through CS know the feelings and tend to care more because they have passed through it. Also, questions are answered on the group without delay and our admins and other group members are also coordinated.

First, hearing from an experienced person about what you are going through gives hope. Secondly, talking to an experienced person reduces depression in many ways, because one will be anticipating to hear and learn new things.

How Interpersonal Empathic Communication, Experiential Learning and Peer Social Support Helped the CS-Mothers Manage Their Mental Health

Research shows that when a depressive mother does not enjoy empathic care and social support which are largely achieved through effective communication, such a woman can harbour complicated mental health symptoms. If not for the empathic communication, social support and learning from other women’s experiences that the women got through the CS community, they would not have been able to get out of their depressive moods easily after childbirth. Some of them shared these perspectives with me:

It (interpersonal empathic communication) is very effective because I could remember when I have my emergency CS, I was totally down but hubby and my mom noticed my new behavior and they keep cheering me up and giving me word of encouragement- e.g., You are the strongest person I’ve ever met. With those words, I get my real self back.

I just used to stay in my room all the time and stay online to keep me happy to an extent, used to be angry at my baby and felt like I was forcing myself to love my baby. Then, I’d feel guilty for not naturally loving and transferring aggression to an innocent baby. It was a very difficult time for me.

The group has helped a lot especially the aspect of medical checkup. I chatted through the Admin about feeling pains in the suture after some months. She advised me and still posted on the group where members shared their experiences. At least, I felt relaxed that day.

Now, Where Do We Go From Here?

The findings of this study show that the CS WhatsApp group empowered CS mothers, as they had deeper information and sensitisation about CS births, social affinity with members, access to emotional support and experiential learning from their fellow mothers. Nonetheless, I suggest two significant points. The first point is that it is time that hospitals (that operate on patients) empower adult mental health nurses or clinical psychiatrists whose main responsibility would be to engage CS mothers and their caregivers (family members, spouses, etc.) in psycho-education before discharging the mothers. The psycho-education should emphasise the significance of interpersonal empathic communication in the post-CS healing of the mothers, as well as the roles of core family members of the mothers in that regard. Although this support system is available in many developed nations, we have scanty of such in our healthcare. Then, these hospitals should operate a sustainable virtual support service like the WhatsApp group for CS mothers who had used their hospitals; the service would be used for post-CS interactions between the mothers and the surgeons or/and adult mental health nurses. The second point, however, is that future research should consider documenting the experiences of unlettered CS mothers who are off-WhatsApp and reside either in the rural or urban areas with a view to investigating their coping mechanisms for postpartum depression after CS births.

The full paper from where this summary was written can be found and downloaded here.

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