Anvita Nair still remembers that day from October 2017 like it was yesterday. She was unwell, down with fever, when she got a phone call from her mother. What her mother told Anvita shocked her, and continues to – Anvita’s best friend had died by suicide. In the aftermath of learning this heartbreaking news, Anvita’s own health took a hit. Sleep evaded her, and headaches became a routine part of her day for two months — until a doctor told her that it wasn’t normal. She was eventually diagnosed with mild atypical depression. These events, she recalls, became a turning point for her. “The beginning of my journey to being a mental health advocate,” Anvita tells TNM.
Though she had no medical background herself and had pursued engineering, Anvita began doing extensive research on mental health. About four years later, in June 2021, Anvita started a petition on Change.org, urging the Karnataka government to ensure mental health screening for pregnant women and new mothers. “About 12-22% women experience maternal mental health issues in their perinatal period,” Anvita wrote in her petition. The perinatal period is the time from when a person becomes pregnant to up to a year after giving birth. “And over 50% of them go undiagnosed. This puts two lives at risk at once – the mother’s, as well as the child’s. The mental health of the mother has a direct impact on the child’s emotional, physical and neurological development,” Anvita adds.
The issue of perinatal mental health hit home for the 21-year-old analyst because it went against everything that she had learnt about how motherhood is popularly portrayed – a period of bliss, excitement and love. “All our lives, we are taught that the bond between a mother and a child is the most beautiful and sacred. But it is also a period where risk factors are high, and that is often not shown in popular culture,” Anvita says.
“From the woman who was suicidal and was being pressured to have a baby early, to the woman who was too depressed to bond with her newborn — each story I read cemented the fact that these silent struggles needed to be addressed,” she wrote in her petition, which has over 10,000 signatures at the time of writing.
Two weeks ago, Anvita met the Deputy Director, Mental Health in Karnataka’s Department of Health and Family Welfare, Dr Rajani MH to discuss the issue. “She was interested in knowing more, and said that we should meet with the Health Commissioner to take this up. We are expecting that meeting to happen soon,” Anvita says.
In the meantime, she hopes to popularise the cause of perinatal mental health with the Change.org petition. “We are ultimately looking for policy change. But it will not be very effective if people are not on the same page, which is why awareness is necessary,” Anvita states.
Before she began the petition, she reached out to Dr Ashlesha Bagadia, perinatal psychiatrist and head of psychotherapy at Green Oak Initiative, Bengaluru, to plan the campaign. To understand what they were dealing with in terms of awareness, they circulated an online survey during the lockdown last year. The survey had 250 respondents who were perinatal women and those who had had a child in the last two years. “70% of them said they had never been asked about their mental health during this period, and many others said they didn’t understand what they were going through,” Anvita reveals, adding that some respondents said their families discouraged them from seeking mental health interventions like therapy or psychiatric help.
Dr Ashlesha explains that if perinatal mental screening comes into the picture, it would focus on asking questions to ascertain either risks of developing mental health issues or identifying existing ones, when symptoms are not visible. “For example, asking the women about sleep and appetite disturbances… Some of these are common during pregnancy, but the screening would involve asking them about the duration and frequency of these things. It would also include asking about risk factors such as anxious thoughts, status of emotional support from partner and/or family, past history of trauma or abuse, if she's facing violence and so on,” Dr Ashlesha tells TNM.
She adds that it is also important to educate and involve partners and families where possible or appropriate, especially because pregnant women and new mothers are often prevented from seeking mental health interventions by families due to stigma. “In India especially, it is not just the patient and doctor who need to be in the loop, but others like immediate family, partners, and other health workers also need to be educated. Families are usually willing to support the woman’s physical health needs, but we need to emphasise the importance of support in her mental and emotional wellbeing as well,” Dr Ashlesha states.
“I am nowhere close to being a mother, but I might be, one day,” Anvita says. “And I wouldn’t want my mental health to be at stake due to lack of awareness or attention when I do decide to become one.”
You can see Anvita's petition on Change.org here.