Traditionally, new mothers in Tajikistan were taken care of for 40 days after giving birth, kept from household chores and even brought food in their room, where they spent all their time bonding with and caring for their newborn.
As life has sped up, however, these traditions have slowly disappeared. New mothers are quickly expected to return to their duties cleaning and cooking for the entire family, and they often receive little support adjusting to life with their new infant. These pressures, combined with a cultural aversion to mental health issues, has led to incredibly high rates of postpartum depression (PPD) here.
While the illness is said to affect approximately 13 percent of new mothers worldwide, our assessments showed that women in rural Taboshar and Shahristan districts are suffering from PPD at rates of 58 and 79 percent, respectively.
Treatment begins with awareness
“In the past, we did not know a problem like postpartum depression existed,” Dr. Eralova Lola said. “In general in our country, mental health is not considered or accounted for. If a woman was crying, was irritated and did not want to feed or care for her child, we did not understand her and scolded her instead, saying that she was being unreasonable. But now we have a completely different approach to women in such situations.”
In 2011, Mercy Corps began new trainings to educate medical professionals and health care volunteers about the symptoms of PPD, how to identify the problem and treat the issues. Now they’re spreading the knowledge to their colleagues and visiting new mothers at home to encourage their families to better support them during the postpartum period.
New mothers can't do it alone
Dr. Lola performed a complicated delivery last month and visited the mother at home soon after, finding her lethargic and uninterested in spending time with her baby, who was often colicky. The woman’s husband and mother-in-law accused her of being a bad mother. It turns out her first child had died in infancy, and she was terrified it would happen again. Dr. Lola was able to explain the reasons behind the woman’s state of mind and found that her husband became more gentle and attentive, even promising to help with housework, once he better understood the situation.
Indeed, divorce rates have also been high in the area as couples struggle to understand the unique emotional transitions that happen around pregnancy and giving birth. The most important lesson that Mahmadjon Razokov, a local healer in Taboshar, shares is that a woman can be helped by her spouse’s and family’s support. Talking to each other is key.
"People can get sick from bad thoughts, too"
But first, the women and their families need to know that there is no shame in acknowledging mental health concerns. Those sorts of problems have traditionally been ignored, and Mercy Corps-trained health workers like Dr. Lola and Mahmadjon are working to bring awareness to their communities by treating the mind just as importantly as the body.
Since he went through the training last December, Mahmadjon has been spending time talking to mothers during his home visits, in addition to providing his usual herbal remedies. When he met Nazira, she was constantly crying and had no appetite; lonely since her husband left to work in Russia, as many Tajik men do, she locked herself in her room when anyone tried to talk to her. Mahmadjon advised her mother-in-law to look after her three-month-old grandson, encourage Nazira to rest and have her son call often to stay connected.
“I myself could not believe that my advice would help. But a few weeks later I found Nazira and her mother-in-law drinking tea together. She said she needed some extra care and attention since her husband left,” Mahmadjon said. “Now when people come to me for help, I first and foremost pay attention to their mood, because I know that people can get sick from bad thoughts, too.”
As new as the acknowledgement of postpartum depression is in Tajikistan, the idea of supporting new mothers after giving birth is still familiar to some elders in these communities. Modern medicine is certainly key to improving maternal and infant health, but simply bringing back older cultural traditions can work wonders as well.