Beyond the Celebration: Addressing the Hidden Physical and Mental Struggles of Postpartum Mothers in Nepal

A child's birth is a festival for a Nepali home and courtyard. Auspicious tunes resonate, Pancha Baja music plays, congratulations pour in, and the entire society rejoices in welcoming a new human being. However, amidst this fanfare and celebration, there is a corner where the new mother's silent pain, physical discomfort, and tears are often overlooked. Rarely does anyone consider the storm raging inside the mother who is smiling while breastfeeding.

Our society tends to view the postpartum period only through a lens of happiness and joy. In reality, it is a critical and risky juncture where a woman's body and mind are both fragmented and trying to piece themselves back together. Until we understand the mental and physical conflicts a mother endures during this process of new birth based on statistics and human empathy, our society can never become mother-friendly.

Physical Hardship: An Invisible War

After childbirth, a mother's body is exhausted and broken, much like a soldier returning from a fierce battle. Our society, focused on the arrival of the new baby, often fails to realize that labor pain is considered the most difficult pain in the world!

According to the Nepal Demographic and Health Survey (NDHS 2022), 151 mothers still die for every 100,000 live births in Nepal. This is not just a dry statistic, but the bitter reality of a family's backbone being broken. The pain from stitches, anemia, sleepless nights, pain during breastfeeding, and changes in body parts leave her physically weak. However, our customs often dismiss this by saying, 'You had to endure this much after becoming a mother,' and in the name of this 'tolerance,' the mother's physical health is neglected.

The Wound of the Mind

The wound of the mind is many times deeper than the external wounds. 'Will I be a good mother?', 'Why am I not immediately feeling attached to my baby?', 'Why am I crying for no reason?'

These and similar questions eat away at her from the inside. According to various studies, about 18 to 22 percent of new mothers in Nepal experience postpartum depression. This means that one in every five new mothers around us is suffering from severe mental stress and depression. Yet, our society has failed to accept this as a health condition or problem. Instead, by elevating her to the status of a goddess, calling the mother a god, they deprive her of the right to cry, get tired, or feel irritated like an ordinary person. When a mother tries to express her loneliness and sadness, she is silenced by comments like, 'You are lucky, you had a son,' or 'Why cry now?' or by adding another responsibility like, 'You have such a beautiful daughter, now you need a son.'

Social Pressure and the Burden of the 'Super-Woman'

Nepali society often pressures women to always be 'multi-taskers' or 'super-women.' Even in the postpartum state, there is an expectation that she must perfectly manage household chores, entertain guests, and care for the baby. Often, these mothers live two lives—acting 'I am fine' and smiling in front of guests and family, while feeling lonely inside.

When a mother tries to share her difficulties, her pain is minimized by comparisons such as, 'In our time, this is how it was; we gave birth in the cowshed and went to cut grass the very next day; I had this youngest one while planting millet...' Times have changed, lifestyles have changed, but our thinking is still stuck in the era of our grandmothers. Comparison never provides a solution; it only increases pain and guilt.

Family: Support or Mental Pressure?

We feed postpartum women plenty of spices, ghee, and nutritious broth, but have we given them the mental peace and love they need? The pressure of having a son or daughter still persists in Nepali homes. In many places, the attitude towards the mother and the care provided still differ if a daughter is born.

Furthermore, constant interference from elders in the household regarding childcare styles often leaves the mother mentally distressed. Numerous pieces of advice and constant questioning or suspicion—'The baby shouldn't be held like that, why so many clothes? Is your milk not enough? You shouldn't do this, you shouldn't do that'—shake the new mother's confidence. She starts to wonder if she is enough for her baby.

Gaps in the Health System

The rate of institutional deliveries in Nepal has increased to 79 percent, which is a positive development. However, while these health institutions check the mother's physical condition, the practice of asking 'How are you feeling?' regarding her mental state has not yet begun.

Hospitals check if the mother's uterus has shrunk or if the stitches have healed, but the arrangement for counselors to understand the turmoil in her mind is almost non-existent. The bitter reality is that both the government and private hospitals have failed to prioritize postpartum mental health.

The Father's Role: Mere Spectator or Participant?

The father's role, currently limited to paying hospital bills or fetching medicine, needs to be expanded. In our society, there is still a misconception that feeding, clothing, oiling, putting the baby to sleep, and cleaning are the mother's tasks. While it's fun when the son plays, the tendency is to forget the son momentarily after he soils himself. They often hand the baby over to the mother saying, 'Look! Your son peed,' but a mother needs her husband's support the most at this time.

A small effort, such as changing the baby's diaper, holding the crying infant to let the mother sleep, or simply saying, 'I am with you, you are doing great,' can alleviate half of the mother's pain. However, due to patriarchal thinking, many men still associate these tasks with their prestige, which adds to the mother's burden of work and mental stress.

Reality of Nepali Mothers in Statistics:

– Maternal Mortality Rate: 151 per 100,000 live births (2022).

– Mental Health: Approximately 20% (1 in 5 mothers) suffer from postpartum depression.

– Health Access: 21% of women still give birth at home unsafely.

– Sustainable Development Goal: Nepal faces the major challenge of reducing the maternal mortality rate to 70 per 100,000 by 2030.

Let's Break the Silence and Find Solutions Now

The birth of a baby is not just the beginning of a child; it is also the new birth of a woman as a mother. In this transitional time, let us see her not as a god, but as an ordinary human being who gets hungry, needs sleep, gets angry, and sometimes wants to cry alone.

In the coming days, we need to focus on the following points:

Be a Companion: Talk to her. She needs sympathy and an ear to listen, not advice.

Share the Work: She needs complete physical and mental rest during the postpartum period. Other family members must share the household chores.

Do Not Pressure: Instead of giving instructions like 'Do this, do that,' ask, 'What makes you feel easier?'

Professional Help: If the mother experiences excessive sadness, lack of interest in the baby, or suicidal thoughts, seek immediate consultation with a psychologist or doctor. Do not treat it as 'silly anger' or a matter of 'superstition.'

A mother's smile will only be genuine and lasting when a society is built that wipes away the tears inside her heart and understands her silent pain. Being a mother is a matter of pride, but the responsibility to protect this pride belongs not just to the mother, but to the entire family, society, and the state. For the child to be healthy, the mother must be healthy, and for the mother to be healthy, her 'mind' must be healthy.

Let us now change the narrative that mothers must be tolerant after childbirth and develop a mindset that it is our duty to keep the mother happy and safe. Let us learn to recognize the hidden tear behind the smile.