History has taught us that every mother should get proper care and rest during the post-partum period, which is from the birth of the child to up to one year.
In the iTaukei context, this special period is marked by giving complete rest to the mother.
Maternal relatives take turns in caring and raising the baby, except for feeding time, for four straight nights, followed by a special feast.
The husband is forbidden by tradition to have any sexual contact with the mother for a period of six months after delivery and grandmothers are generally the custodian of this traditional custom by lying next to the mother and the baby. If the mother is not rested or given adequate support, she may be vulnerable to developing mental distress.
This disturbance is referred to in theiTaukei language as tadoka ni tina ni gone or the derogatory term cavuka and in Hindi may be referred to as mansik tanau prasuti ke badh.
In psychiatry, the psychological changes that may occur after giving birth include the common and usually mild depressive symptoms known as the "blues", psychosis (being out of touch with reality), and post-natal depression. There may be many causes, which include individual or social circumstances, genetic and hormonal changes.
This is a critical period of motherhood and it is important that we in society, community members and families, are able to recognise the signs and symptoms of a mother suffering from mental distress.
Post partum or maternity "blues" is not considered a disorder as it is mild with no impairment of functioning.
It generally occurs in 50-80 per cent of women in post partum and is characterised by crying, irritability, rapid mood shifts, and even euphoria.
It usually appears after the third day and spontaneously resolves within one week.
Post-partum psychosis or psychotic depression occurs in one in 500 primiparous (women who have given birth for the first time).
The risk of recurrence in a previously affected woman is one in three. It is characterised by agitation, highly changeable psychosis during the post partum, which may begin with confusion and insomnia, then rapidly progressing to delirium with prominent hallucinations and transitory delusions.
Post-partum depression begins insidiously during the second to third week after delivery with mostly physical symptoms such as excessive fatigue, poor appetite and inability to sleep.
There is often excessive and unfounded worry about the health of the baby; feeling depressed and unable to cope. Early recognition of these signs and presentation to the nearest health facility will allow treatment of the disturbance hence reducing the risk of progression to a lifelong mental disorder.
Such disturbances in the post-partum period usually last up to six months and may resolve spontaneously, however, the chances of developing the disturbance again either during or after the next pregnancy increases.
Preventative strategies would include revisiting some of our traditional practises during maternal care, which could be easily discarded in our rapidly changing society, to prevent such mental onset from happening to mothers. Social support is the key to ensuring that mothers are given proper support and care by immediate family members, extended families and the wider community at large.
Fiji is fortunate that new policies on maternity leave for working mothers is beneficial to their cause but more could be done in terms of extending it to paternity leave for fathers and having harsher penalties for companies and firms that disadvantage working mothers by not adhering to the Labour Decree of giving them longer maternity leave.
Considering that women do make a huge contribution to our economic well being here in Fiji, both directly and indirectly according to a UNDP report, it is a small investment in ensuring that they are well looked after during this post-partum period. The economic, social, physical, emotional and psychological burden of a mother with postpartum distress is a huge price to pay, otherwise.
* Dr Amelia Andrews is a senior medical officer at St Giles Hospital and a committee member of FAMH. This month is Mental Health Month.