Chantal Neza, a resident of Kimironko, welcomed her baby boy two months ago, but the joy of motherhood has come with unexpected emotional struggles. Despite having support from family and friends, she says there are times when she feels completely overwhelmed and alone. ALSO READ: Mother’s Day: Fighting postpartum depression “There are moments I wonder if I am doing enough or if I am even deserving of being a mother. Sometimes it feels like the baby came and took my life away, and that feeling is the hardest. When things don’t go as planned, I feel overwhelmed and start doubting myself,” Neza said. She adds that the most difficult part has been taking care of herself while learning to care for her newborn. Neza noted that it is important having someone available to help, like changing diapers, holding the baby to sleep, taking walks, or even feeding him, for her to rest and heal. Even in moments of doubt and exhaustion, she noted that she is learning her baby’s needs, discovering routines and small joys in the process. She added that she is learning to cope with the emotional highs and lows of motherhood, while managing the constant effort of balancing her own well-being with caring for her child. Like Neza, many women go through postpartum depression (PPD) after giving birth. It brings extreme sadness, anxiety, and exhaustion. According to the World Health Organization (WHO), PPD is a serious health concern that can make it hard for a mother to care for her baby and may affect the child’s development. “Postpartum depression affects about one in ten mothers in Rwanda, but it is often hard to detect. It is common, but difficult to identify,” said Dr. David Tuyisenge, a gynecologist at Kabgayi Level 2 Teaching Hospital. He said mothers most at risk include those experiencing their first pregnancy, women from middle-class backgrounds, and those who had difficult labour or traumatic deliveries. Dr Tuyisenge explained that symptoms usually appear between two and 12 months after delivery, though many start within the first two to four weeks. He said that for families with limited resources, the struggles of everyday life can mask depression, and many women stay at home without realising it is a medical condition. Dr. Tuyisenge explained that support from partners, family, and the community is important, noting that the woman should choose who accompanies her during hospital visits. “From admission, delivery, to discharge, the mother should receive full support. This includes visits, conversation, moral and financial support, psychological encouragement, and care for both her and the newborn,” he said. Postpartum depression affects many mothers in Rwanda, with studies showing that about 20.9 percent of women experience depressive symptoms after delivery. Women with limited social support, especially from partners, those who perceive their health as poor, and those facing stressful life events are more at risk. According to Dr. Jean-Damascene Iyamuremye, Director of Psychiatric Care at the Rwanda Biomedical Centre (RBC), postpartum depression is often overlooked, yet it affects both mothers and families, and recognising it early and providing support can have an impact. He noted that mothers with postpartum depression can get help through Rwanda’s mental health services, which have been distributed into primary health care, adding that community health workers provide guidance and refer mothers to health facilities when needed. Dr Iyamuremye added that at health centers, trained mental health staff offer more advanced support. RBC data shows that 77.3 percent of health centers have mental health professionals, while others rely on nurses trained in mental health care. “District hospitals, provincial hospitals, teaching hospitals, and specialised Level Two Teaching Hospitals provide access to psychiatrists, psychologists, and mental health nurses, along with other staff suited to the patient’s needs. Private clinics and NGOs, such as Solid Minds, also give care to mothers experiencing postpartum depression,” Dr Iyamuremye explained. He noted that RBC has prioritised mental health by integrating services into health centers and hospitals and training community health workers to recognise mental health problems and refer patients. Public awareness campaigns encourage families and communities to support mothers seeking help and reduce stigma around mental illness, he added. Dr Iyamuremye said that programmes like the mobile mentorship initiative “MobiMenta,” launched with partners including the United Nations Population Fund (UNFPA), support maternal, neonatal, and reproductive health care in health facilities, which can benefit mothers’ mental health. “RBC and partners have also introduced group-based Resilience-Oriented Therapy to treat depression and trauma and expand access to mental health services outside main hospitals,” he noted. The mental health expert said research shows a high prevalence of depression during and after pregnancy, with one study indicating antenatal depression rates of about 26.6 percent. He added that strong social support is linked to a lower risk, noting the need for family and community involvement. Dr. Tuyisenge explained that treatment in Rwanda begins with evaluation by gynecologists, who involve family members and a team of mental health nurses and psychologists. Care often includes sessions to discuss the mother’s feelings, thoughts, and behavior. In some cases, antidepressants are used, and recovery can take from two weeks to a year, depending on the severity. Most mothers recover within eight weeks postpartum, but some remain at risk of postpartum psychosis, Dr. Tuyisenge added.
