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Postnatal depression support issues raised after mother's disappearance

One in ten women may develop postpartum or postnatal depression after giving birth, experts say. The issue of postpartum depression and care has been raised following the tragedy with missing Anna Jansone and the death of her daughter Luīze. Specialists say that the attention paid to the mental health of young mothers in Latvia is insufficient, Latvian Television reported November 7.

Missing Anna Jansone, whose daughter was found dead in a rented car, may have had postnatal depression, the missing woman's husband has said. One in ten women who have given birth to a baby may become ill with postpartum depression, said Elmārs Rancāns, head of Psychiatry and Narcology at Rīga Stradiņš University. Depression is most commonly manifested by excessive crying, irritability, and sleep disorders.

Over the weekend, dozens of social network users have pointed to the scale and significance of the problem. Many ask – how to recognize it? Where do I look for help? Doctors acknowledge that, systematically, moms' emotional health is not the priority.

Rancāns, asked if it was the responsibility of the woman and her family to spot it, or to some extent the responsibility of the state, said: "Of course the state must look after all of us. Children and mothers, including. There needs to be a system for a woman to turn to if she needs to. At the same time, [ensure that] the number of professionals who come into contact with a woman during the post-natal period don't forget to ask the question."

When asked if we had such a system, Rancāns responded in the negative, conceding the possibility that maybe some places do.

Right now, mothers' wellness remains in the background after questions about the newborn. Six weeks after giving birth, a woman's physical health is assessed, although the psychological condition should be checked immediately at the birth facility.

Latvia also lacks guidelines for assessing the mental health condition of the new mother. But in reality, visits to doctors, such as a general practitioner, take most of the time to assess a newborn's health condition. And it often happens that the baby is in the care of a particular family doctor, and the mom is in the care of another family doctor.

General practitioner Gundega Skruze-Janava showed LTV the form, or algorithm, to be filled out on visits to which a baby's mum arrives. The visit is basically about the baby.

The doctor said: "There is a lack of time. The line behind the doors builds up as we start talking about things that aren't for the particular visit. In that case, it would actually be correct to record separately both the child and the woman herself. We have an algorithm – what needs to be done with the infant, what needs to be evaluated, what the baby needs to learn in two, four, six months. An algorithm on what to do with a woman if it's not your patient registered in your practice - we don't have one."

Although doctors should recommend at least taking a test, it is not always done.. But doing so would be very important. As explained by the Ministry of Health, a general practitioner's test in which a woman answers questions such as how often she has had difficulty concentrating in reading or watching television over the past two weeks, how often she has felt too nervous, or thought about hurting herself and others - can lead to a diagnosis. If there is a diagnosis, then a state-paid psychologist or psychiatrist is appointed. The main issue is to notice the problem.

Sanita Janka, director of the Department of Health Care at the Ministry, pointed out: "I would say that what is missing right now is the lack of that cooperation with local governments. Because not in all cases will this mum have a family, there tend to be single mums too. It may also be that the other party is not in Latvia. So a  social worker or anyone else who supervises and informs the general practitioner of their state of health should be in place."

Rīga Stradiņš University's expert emphasized that it is important to take over good world practice and put more emphasis on mental health issues also during visits to the gynecologist, also during talks with the midwife. A psychiatrist - a consultant, if remotely, would be a good example. The Ministry of Health mentions that there is a huge shortage of these specialists, which is why, at the moment, the first step is to help mothers who, for various reasons, come into the radar of the state.

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