By: Vitalio Angula

Morna Ikosa’s 118-page offering titled ‘Unmasking Post Natal Depression’ delves into the unspoken reality of Post Natal Depression (sometimes referred to as Post-Partum Depression), estimated to affect one in five women on the African continent.

In Africa, where access to quality healthcare is mostly a privilege that only a few can afford, this book highlights Ikosa’s personal experience navigating her mental health diagnosis, symptoms she experienced on this journey, resources she applied to address her challenges, and the experiences of other women with similar diagnoses.

Written in simple English, with a lay audience in mind, Ikosa acknowledges the importance of connection in highlighting a lived reality experienced by many but only spoken of by a few.

Renowned Clinical Psychologist, Dr. Ute Sinkala, who is referenced extensively in the book, says Postnatal Depression (PND) is under-recognised, underdiagnosed, and therefore undertreated in Namibia, partly due to stigma, limited mental health literacy, and systemic gaps in screening and care.

“Many women present to healthcare settings with somatic complaints such as fatigue, body pain, or poor sleep, instead of identifying their symptoms as mental health concerns.

This lack of understanding and seeking healthcare treatment at a general practitioner can result in their postnatal depression being unrecognised”, Sinkala stated in an interview regarding her contribution to the book.

“They may get medication to cope with these somatic symptoms, and this can mask underlying emotional distress”, Sinkala added.

“Cultural expectations around motherhood may also discourage open discussions about depressive symptoms, reinforcing silence and suffering”, Sinkala further added.

Chapter Eight of Unmasking Postnatal Depression is titled, ‘You are not alone, A Story of a Brave Herero Woman’, delves into the stark contrast between cultural practices that have been passed on over time and modern understanding of childrearing that those more traditionally inclined labels as ‘western’.

*Uno, a woman of Herero descent, shared her retrospective realisation that the heightened suicidal thoughts she struggled with during her pregnancy and after were symptoms of depression despite an official medical diagnosis.

“I struggled with suicidal thoughts and heightened anxiety while growing up; however, these symptoms worsened especially during my pregnancy”, Uno reveals on page 92.

“I realized that those who want to commit suicide do not necessarily want to die; they want whatever it is causing them distress to stop………, or simply, to hit pause for a few months and then wake up again”, Uno shared regarding her experience with postnatal depression.

Uno recounts in the book how she relied on ‘Western’ literature to prepare her for childbirth and how the information she acquired was often dismissed by her mother (who helped her during her pregnancy and after) as being ‘White people’s things’.

“After reading the book, ‘What to expect when expecting’, I realized that what I read contrasted sharply with the advice from my mother and the traditions of my culture”, *Uno states on page 93.

Uno says she was “Confined indoors for three months as per tradition. I missed out on the benefits of sunlight exposure, particularly its role in Vitamin D synthesis, which is essential for bone health and overall well-being”.

“New mothers are not allowed to leave the house to visit anyone until the baby’s umbilical cord falls off to prevent bad spirits from affecting the child”, *Uno explained.

She had to wear a doek over her head and socks and was not allowed to visit friends, nor was she allowed to wash her hair.

“I began to resent my newborn unintentionally… no one spoke to me about Postnatal Depression…. I feel mothers and midwives are failing expecting mothers by not discussing (addressing) mental health issues adequately”, *Uno narrated.

Symptoms of Postnatal Depression include persistent sadness, anxiety, and feelings of hopelessness. It can also manifest as irritability, fatigue, sleep disturbances, and appetite.

Postnatal depression can also impact a mother’s ability to bond with her baby (babies) and may include negative thoughts about herself or her ability to care for her child.

Ikosa should be applauded for bringing the topic of Postnatal Depression to light and inviting readers into a deeply personal experience.

From Chapter One: The Genesis- When it all Began, through to Chapter 3, Ikosa gives readers insight into the birth of her three children, her struggles with sleep and anxiety, balancing a demanding job and dealing with the challenges of working in a leadership position as an executive in the corporate world.

Chapter 10, ‘Men’s Experience with Postnatal Depression’, shares very deep testimonies by *Mark (Helena’s husband) and Morna’s husband, Mario.

In this chapter, men relate the impact of their wives’ postnatal depression and how they managed to navigate the challenges their partners experienced as a result of their condition.

*Mark talks about his wife’s Partial Molar Pregnancy, which required an early termination of the pregnancy. He also relates how her (the wife’s) second pregnancy was emotional for both of them due to their experience with the first one and how they leaned on each other for support, love, and understanding.

Unmasking Postnatal Depression by Morna Ikosa allows men to have a voice in a conversation that many may regard as the domain of women. It also explores the topic of sex for couples with newly born children.

Ikosa (Morna) delivers a book that unmasks postnatal depression through a Christian lens owing to her religious faith.

Relating her personal experience and drawing on experts like Ujama Nujoma (Doctor), Raghilt Redecker (midwife), Dorle Verrinder (lactation consultant), and Juliane Courtney-Clarke (dietician and nutritionist), Ikosa delivers an impactful book that is not only a source of information and wisdom but a reference guide for expecting mothers and their partners.

According to research published by the National Health Service (NHS) of the United Kingdom, the global prevalence of postnatal depression is estimated at around 17.22%.

This means roughly one out of every five women experiences PND after childbirth.

“Prevalence rates can vary significantly based on geographic location, with higher rates often seen in low- and middle-income countries.

Southern Africa has reported the highest prevalence rates, while developed countries tend to have lower rates”. The NHS states.

Given these statistics, which are not low for a condition that is regarded by experts as underrecognized, underdiagnosed and undertreated, Ikosa’s contribution to literature on Postnatal Depression not only sheds light on a topic that has yet to receive attention in the mainstream but empowers women and their partners with information that is pertinent to understanding depression and how it impacts women and their partners.

It also helps to break the stigma associated with mental health and normalizes treatment as a necessary intervention in dealing with postnatal depression.