08 Sep 2011
By: LEA WEE
Ms Joanne Lim (not her real name), 38, could not understand why she felt moody after she delivered her son last year.
She had a caesarean section because of pre-eclampsia (high blood pressure) and her baby stayed in intensive care for two weeks.
But even after they were safe at home, she found she could not focus in the day and slept poorly at night. There were even times when she found her son ugly and had thoughts of hurting him. She thought she was going crazy.
When she returned to KK Women’s and Children’s Hospital (KKH) for a post-natal check-up a month after delivery, she was relieved and surprised to find she could talk about her feelings to a case manager stationed at the clinic.
She was referred to a psychiatrist and through a combination of counselling, medication and support from her husband, she recovered from her symptoms of depression within three months.
Under the KKH post-natal emotional health screening programme, which was started in 2008, all women returning for post-natal visits are offered the option of having a face-to-face session with a case manager before they see the doctor.
The case manager takes them through the Edinburgh Post-natal Depression Scale and fills in their verbal responses.
Using this method, it has screened about 5,400 – four in every five – women who turned up for their post-natal check-ups at KKH, said senior case manager Ch’ng Ying Chia.
About 7 per cent were found to be at risk of depression. Two in five accepted a referral to see a psychiatrist.
Those who rejected a referral said they had no time or they wanted to wait and see if they could cope by themselves.
Some were concerned about the extra costs involved or feared the stigma of seeing a psychiatrist.
Ms Ch’ng said the case manager would make it a point to call these women to find out how they were coping. A few women, whose condition later worsened, subsequently agreed to see the doctor.
She said: “We find that women are generally willing to talk to someone they have met before.”
Among those who accepted the referral and were seen by a psychiatrist, more than 80 per cent recovered and no longer had symptoms of depression, while the rest are still being treated.
The Singapore General Hospital (SGH) also started a post-natal screening programme in 2004. Under the programme, obstetricians ask women a series of questions derived from the Edinburgh Post-natal Depression Scale and fill in their verbal responses. Almost 4,400 patients have been screened since 2007.
At the National University Hospital, post-natal women fill in a similar questionnaire on their own. Those with high scores are referred to a psychiatrist. More than 2,300 women have been screened since 2008.
Post-natal screening programmes are more established than antenatal ones here and overseas, largely because the detrimental effects of post-natal depression on the mother and child are well documented.
Dr Tan Lay Kok, a senior consultant obstetrician gynaecologist at SGH, said studies have shown that mothers with post-natal depression are more likely to have children with delayed developmental and behavioural problems.
They also have a three-fold higher risk of having children with serious emotional problems and a 10-fold higher risk of having poor mother-child relations, compared to mothers who do not have symptoms of depression.
Click for jpeg format
« Back to previous
page
back to top