When Elaina Grech gave birth to her son, she didn’t feel the same overwhelming surge of love she experienced on having her first child four years earlier.

As she battled to repress disturbing thoughts and overwhelming emotions, she spiralled downwards into a dark, lonely place.

“I hit rock bottom. I felt I was being a burden on my family. I was spending a lot of time alone, upstairs in my bedroom.

“One day, as I walked upstairs, I kept walking further up the stairs. Had I not looked down from the roof and seen my daughter’s face – smiling at me as she played – I wouldn’t be here today,” said Ms Grech, with a trembling voice.

She shared her story during a conference organised by the recently set up voluntary organisation – the Parent-Infant Mental Health Alliance – that offers support to mothers, fathers and the infant.

Ms Grech was one of the mothers who sought help from the Perinatal Mental Health Clinic, a multidisciplinary team at Mater Dei Hospital that offers support for parents during the perinatal period, which is the time from conception to one year after birth.

The clinic, set up by consultant psychiatist Ethel Felice in 2000, geared up its services in 2017 and 2018 when it also em-barked on educational campaigns for healthcare professionals and introduced mental health screening for new mothers – something that the clinic hopes to roll out for all mothers at booking stage, explained obstetrician and gynaecologist Rodianne Camilleri Agius.

Practice midwife Claire Zerafa elaborated that referrals to the clinic increased from 63 in 2013 – when there were no midwives and all patients were seen by Dr Felice – to 598 referrals in 2018.

Ms Grech was one of those referrals. She told a room packed with healthcare professionals how she suffered from epilepsy. When she found out she was pregnant with her daughter she was worried because of her condition.

It was a difficult pregnancy but, when her daughter was born “it was love at first sight”.

When she found out she was pregnant again she was scared as she knew what she’d have to go through.

Then, at 36 weeks, her worst fear materialised. She had a seizure.

“It’s still so clear in my mind. I remember being in the ambulance and watching my daughter crying out for me. As soon as they closed the doors I thought: I’m traumatising my daughter. I was also worried about my baby,” she says.

I hit rock bottom. I felt I was being a burden on my family. I was spending a lot of time alone upstairs in my bedroom

She gave birth to a healthy son. But it felt different.

Where was that overwhelming love? She was haunted by thoughts like: “my daughter is more beautiful”. But felt ashamed to be thinking them and kept it all bottled up inside. People kept telling her that as long as the baby was healthy, all would be alright. But it wasn’t.

“The first time I knew I needed help, my newborn was fussing and I let him cry.

“Anyone who knows me would know how out of character this is. I was never one to let a child cry it out. I let him cry for about an hour. I was thinking: you ruined my life. I only picked him up because my husband walked in and I panicked,” she says.

That day she messaged a friend who told her about the Perinatal Mental Health Clinic.

The journey was not easy. She was told she’d need to feel worse before getting better. And she did.

That was when she hit rock bottom and was about to jump off the roof, only to be stopped when seeing her daughter play in the yard.

After that she committed to treatment with the support of her husband – who carried a huge burden throughout. 

Video-interaction guidance really helped her, she says.

When her son was about six months old she saw a video recording of herself interact with him.

“I had thought he knew I didn’t feel the same way towards him. But there he was, smiling backing at me,” she says.

Disorders

One in every four women suffer from mental health issues during or after childbirth, but most cases are going undiagnosed and untreated, leaving parents to struggle alone, psychiatist Ethel Felice said.

In Malta, 8.7 per cent of women who had healthy babies suffered from postpartum depression and between 11 and 15 per cent of women suffered from depression during pregnancy. One in every four women suffer from mental health issues during the perinatal period.

Most suffer from anxiety and mild to moderate depression. These disorders, in the majority of cases, are short-lived, but sometimes symptoms persist, requiring treatment. On the other hand, cases of postpartum psychosis, considered to be on the severe end of the spectrum, are rare, with two in every 1,000 cases.

For more information visit the Parent-Infant Mental Health Alliance Facebook page.

Those who would like to share their experiences with others confidentially can visit the closed Facebook group You Are Not Alone – Perinatal Mental Health Support Malta.