Mothers’ Stories

“I had to leave without my children”

My name is Maria. I can still hear the sound of the gunfire and smell the smoke, feel myself running, desperate to find my children, soldiers shouting, too much screaming…

I had to leave without them, I couldn’t find them. Maybe my sister took them to safety. My chest feels like stone. I am numb.

At the border, I realise in my foggy mind that I don’t have my documents. I won’t be allowed to cross the border, leave this horrifying place. I feel the panic rising. I have to get across, I will do anything to get away from this place.

His hands are rough as they push me away – he swears at me and tells me I can go, now that he has got what he wants. Another uniform, another nightmare, I run to freedom.

I come across Lia, an older woman who lived in our village. She has a contact in a township in Cape Town, and we stay in an overcrowded room. At night I hear the rats in the kitchen. It’s hard to get work with no papers, and I struggle with the language. The refugee centre is trying to help, but it takes time.

I am dimly aware of the fact that I am pregnant from my rapist. My numbness protects my feelings as I go about surviving from day to day. I can’t go for a termination of pregnancy without legal documents. I feel trapped, powerless and alone. By the time I get my papers, it is too late to abort this baby. I am already 24 weeks pregnant, and I see the disapproval and judgement in the midwife’s eyes when she is booking me at my first antenatal visit. “Why are you here?” she accuses. “When are you going back to your country”? I feel useless, unwanted.

She asks who the father of my baby is and if I’m married. I lie to protect myself from her intrusive stare. There is a counsellor at the clinic and she invites me to talk to her. She is kind and warm. I feel I can let my guard down and the pieces of my story fall from my lips. I can see she grasps the darkness I am living in.  My past intruding on my present – flashbacks, nightmares, fear of uniforms, feeling hopeless and helpless.  The counsellor offers me support and I start to allow the baby into my mind. The start of a connection. These conversations are the beginning of my healing.

“I was struggling to accept the divorce”

My name is Annie, and I was screened early in my pregnancy but declined the offer of counselling when it was offered to me. A few months later, after I found out my husband was abusing drugs, I was back at the clinic complaining of abdominal pains. The midwife said it was stress-related and I was referred to the PMHP counsellor once again.

I felt better after the first counselling session. When the counsellor contacted me a few months later for a follow-up, I declined her offer for another session. I was divorced from my husband and I felt fine, happy even. I was working from home, which meant I could spend time with my baby. I struggled a bit with my two older children but my family tried to be very supportive which helped for a while.

I always remembered how good I felt after that first session with the counsellor and when I started feeling my mood change, I contacted the counsellor to make another appointment. After a few months of being single and raising the children on my own, I was struggling to accept the divorce and was angry at my ex-husband for being absent in our children’s lives. 

The counsellor worked with me for six sessions and referred me to a community organisation for help with single parenting. They also gave me advice on mediation with my ex-husband and supported me when my 6-year-old started experiencing psychological problems.

The counselling helped me to cope during a difficult time and gave me access to some great resources to help me with my family problems.

“You are nothing”

I am Nosipho, 19 years old and I was raped by my stepfather for the past four years. My mother is addicted to Tik (methamphetamine) and often threatens to kick me out of the house, “You are nothing” she screams at me when she sees me sitting all day on the couch watching TV.

I had a couple of short-term boyfriends, mostly older men, who come to use drugs in our home. I am pregnant and HIV positive, but I have told no-one. No-one would care.

I went to the maternity clinic and got my first mental health screening. I couldn’t make eye contact with the PMHP counsellor. When I filled in the form, Liesl, the counsellor, was so nice and explained that the questionnaire shows that I could benefit from speaking to her. She promised we would have a quiet, safe space where I could tell my story.

I told her that I will think about it and she gave me a pamphlet with simple information about social and mental health challenges faced by many women and how counselling may help. Liesl also gave me her work cell number and told me that she can book a session when I am coming for my next clinic appointment. 

The next few weeks went by in a blur. I had to start my antiretroviral medication for the HIV and it made me nauseous. My step-father found them in my bag and called me a “whore” and all sorts of words. I felt so hopeless, that I didn’t see the point of taking the medication and was thinking of taking them all at the same time to end it all. The night before my next clinic appointment, I was lying in bed after we had finally finished fighting I remembered how nice Liesl was and decided to call her and see if I can meet with her. 

The next day, after I saw the midwife, I waited outside Liesl’s office until she was finished with another client. Liesl recognised me and she invited me to her nice room. We just sat there and I started crying. Liesl didn’t seem to be in a rush and just waited and said I can tell her anything I want to.

Since that first day I have seen Liesl four times while I was still pregnant and a couple of more times after I gave birth. She helped me to realise that I was worth something, that nobody has the right to abuse me, with words or with violence. She reminded me of how well I did in business science at school and how my friends asked me for help with their studies and personal problems. Liesl encouraged me to reach out to some of my old friends – I don’t know why I didn’t contact them for the past couple of years. 

They were all very supportive and so glad to hear from me again. I felt like I can solve my problems with their help and I had more energy to do things. With Liesl, I learnt to explore my options and started thinking I can change things in my life. I started to enjoy my baby’s movements inside me and to look forward to his birth. I also learnt how to avoid the conflicts at home – and moved out when one of my friends offered me rent-free accommodation in return for help with her start-up business. I am now sharing childcare with another friend who has a baby of a similar age. And I know, if I have a dark moment or feel like nothing again, I can always go back to see Liesl and talk to her. 

“The atmosphere in the house was tense”

“The atmosphere in my house was tense”

My name is Johanna. When Sr. Matsha examined me at the clinic, she noticed that I was very quiet during the examination. Although everything was fine with my pregnancy, Sr. Matsha knew that something was wrong with me. I had filled in a mental health screening questionnaire, which is routinely offered in the clinic. I had a high score but didn’t understand what it meant. When Sr Matsha approached me to offer a referral to the PMHP counsellor, I started crying and couldn’t talk. Sr Matsha arranged for me to see the PMHP counsellor right away because she did not feel comfortable sending me home in such a state. The counsellor saw me immediately.

I had woken that morning with a feeling of dread. My partner had come home in a bad mood from work the night before and the atmosphere in my house was tense.

Before I left for my appointment at the clinic, I needed to prepare breakfast, get my 7-year-old ready for school, and arrange for my 3-year-old to stay with a neighbour. My partner was not satisfied with the porridge I had made for him and started yelling at me. I kept quiet and continued getting the children ready. After I had taken my younger child next door, my partner asked me if I had gossiped about him to the neighbour. I said no, and started walking out my house with my older child. He began hitting me on the arms and face, pushing me against the wall and calling me a liar. My child ran away, crying.

While I was telling my story to the counsellor, I already started feeling better. Over the next few sessions, the counsellor focused on the ongoing cyclical nature of abuse in my home. Eventually, I felt empowered to leave my partner. When he would not accept my decision and threatened to kill me, the counsellor assisted me in taking out a police protection order against him. I ensured my family’s safety by arranging to stay with my cousin, who had experienced a similar situation and was supportive. With the help of the counsellor, I was able to cope with this situation and have a healthy pregnancy.

“Adjusting to my HIV diagnosis”

A few weeks ago, my boyfriend lost his job. He disappeared for long periods and I thought he was out looking for a new job. But then I noticed him coming home drunk more and more. I was angry and we were fighting a lot. After a while, we had to move in with my mother. She was very supportive but I could tell that all the fighting with my boyfriend was stressing her out.

With all of these problems at home, I did not expect my first visit to the antenatal clinic to go so badly. Not only did I find out that I was pregnant, but I also found out I was HIV positive. For a while, I think I was in shock, not really knowing what to think or how to feel. The midwife offered me a mental health screening and I was immediately referred to the PMHP counsellor.

At first, I felt embarrassed that I was speaking to a complete stranger about my problems, but for some reason, I could not stop talking and crying. The counsellor listened and together we agreed that my and my baby’s safety was a priority. Over the next few sessions, I was able to come to terms with my HIV diagnoses and the counsellor and I spoke about ways that I could tackle the conflict with my boyfriend. I was able to see things from my boyfriend’s point of view and was able to talk to him without becoming angry.

Before my baby was born, my relationship with my boyfriend improved. My mother was also less stressed, and I was able to disclose my HIV status to her and talk to her about my treatment. She was worried about me infecting the baby but we spoke about all the feeding options the counsellor told me about.

My baby was born healthy and HIV negative. Despite ongoing challenges in my life, I was able to bond with my baby because I had healthy ways to approach my problems. I saw the counsellor a few times after my baby was born until I felt confident in my adjustment to motherhood. It was reassuring to know that I could go back to the counsellor if I felt I was not managing.

“I started spending days in bed”

My name is Aziza and I have just given birth to my second child. My first pregnancy was very tough as we were struggling financially and I felt unwell – I started spending days in bed and neglected the housework. Jacob got a casual job just before I went into labour, and he could not come with me to the hospital. The nurses were impatient and angry at me because I had missed a few clinic visits. I was alone and felt scared. I felt weak and ashamed, and like a bad mother.

For the first few months of my baby’s life, I continued to feel tired, unhappy and unmotivated. Jacob didn’t understand what was happening, and our relationship went through a bad patch.

In my second pregnancy, the nurses were so gentle and they referred me to the PMHP counsellor at the clinic, who was able to settle my nerves and reassure me that many women feel anxious in pregnancy. The counsellor told me about depression and anxiety, describing some of the exact feelings I had experienced. I felt supported and understood. The counsellor helped me think about how I could talk to Jacob about what I was feeling, and our relationship really improved. It helped him to know that I was not being lazy or difficult. I felt more open after speaking with the counsellor, and I made a friend with another mother at the clinic.

The counsellor called when my baby was eight weeks old. She checked up on how I was feeling, and how things were going with my baby. I felt I was managing even though looking after two children is very challenging. She reminded me that if something changed, and I did not feel okay, I could come back to talk to her. It really helped knowing she was there.

“I talk about this depression with everyone”

“When I first became a mother, I didn’t know about depression. Now I would like to let everyone know about this problem so that people can stand up and do something about it.” Ntombomzi*, former PMHP client – pictured with her daughter Liphiwe. 

I was born, one of twins. My parents divorced when I was only two months old. Because my mother was alone she couldn’t do what she was supposed to do as a mother and I grew up with her family. There was really no one to talk to or to discipline us and I became pregnant at the age of 14. I have suffered depression since then.

Having a baby at such an early age was really hard. I had to leave school and was forced to work as a domestic worker, which I couldn’t really do because I was so young. I tried very hard, but I just couldn’t do it. So, I decided to go back to school when my baby was three years old. I passed my standard nine [penultimate year of high school] but didn’t have enough money to register for my final year. I was forced again to go back to work as a domestic worker; which I am still doing to this day.

When I was twenty-one years old, I got married to my husband. He is not the father of my first child. A couple years after being married, we had a child together. I again suffered very much from postnatal depression, although I did not know what it was called at the time. The clinic I went to in the township did not know anything about depression. So, I was unable to get help from them. Luckily, my husband was always there for me and supportive throughout my depression, even though he didn’t always understand what I was going through.

Since then, I suffered from depression until I was able to get help from the Perinatal Mental Health Project in 2004. This was the first time I heard about perinatal or postnatal depression. I had suffered from depression all these years, but I didn’t really know what it was. Finally, I was able to get help.When I was pregnant with my last baby, I was working for Linda, a psychologist. I was not at all happy to be pregnant. I was just very stressed and worried about telling her. I knew it was not the right time for me to become pregnant and I was very concerned about my job and all the things that I needed money for. But I realised that I needed to tell Linda, not only because she was my employer, but because I needed help. Everything was very hectic for me and nothing that I was experiencing seemed to be good. I knew that I was becoming more and more depressed.

I finally told Linda when I was 5 months pregnant. It turns out that she specialises in women who have perinatal and postnatal depression and when she heard my history she thought I was suffering from it. She decided to take the step to get help for me by sending me to the Mowbray Maternity Hospital which provides the Perinatal Mental Health Project.

At Mowbray, I met with a counsellor. It was very good to speak to her about how I was feeling and to just talk out about everything. That was what was killing me, having to keep all my feelings inside of me for a long time. I was so lonely and there were so many things that I needed someone to listen to. I needed to express my feelings and to be heard when I was saying something. I needed someone who could understand and who could listen when I was talking. Meeting with this counsellor gave me that chance to finally speak out, which helped so much. They also sent me to a psychiatrist to get medication for my depression. Now I am doing just fine and coping very well with motherhood. Dealing with perinatal and postnatal depression is a very difficult thing.

When you are depressed there are so many things that are affecting you. You may not be able to tell exactly what it is that is making you feel so bad, but just that you can’t get out of the fog you are in. Everything can feel like it is just falling apart, that nothing is happening right or according to plans. You may not know to take it seriously when you are first suffering from it, but it is very important to address it and to find a way out. There are so many women who are dying inside from this thing. They don’t know how to deal with it or how to cope. Everything in their lives is turning upside down. And they need someone who will understand and not judge them.

That is why I talk about this depression with everyone. I even talk to mothers I see on the bus. I want everyone to know about this problem. I want the mothers to listen. If I could have my way, each and every one of the hospitals would have these kinds of counsellors, especially the government hospitals which are for everybody. That way everyone, including women who really don’t know anything about this depression, could get help. Until that happens, I hope that all the mothers out there, who are suffering from perinatal and postnatal depression, will take care of themselves and find support. You only live once, and it does not have to be a life filled with depression!”

* Ntombombzi has given consent to tell her story and use her photo, pictured together with her daughter Liphiwe

“I was not as excited as I had anticipated”

My name is Samantha* and my story begins in 2004 when I was told that I was pregnant with my first child. After extensive consideration, my husband and I decided that we would use the public healthcare facility, a Maternity Hospital, closest to our home, as private users. This facility happened to be the site of the Perinatal Mental Health Project (PMHP). Although my pregnancy was planned, and eagerly awaited, I noticed that I was not as excited and happy as I had previously anticipated. Not knowing what to expect, however, I kept these feelings to myself.

During a routine antenatal visit, I was asked to complete a questionnaire that screened for symptoms of depression. This part of the service was initiated and run by the PMHP. A high score on this questionnaire, led to a suggestion from the midwife, that I consult the PMHP counsellor, which I agreed to do. My visits to the counsellor, thereafter, coincided with my antenatal follow-up visits. During the first and follow-up session with the counsellor, I was provided with an opportunity to speak freely to someone who seemed to understand my experience, without judgement, which allowed me to process and understand my negative and anxious response to my pregnancy. My experience of not feeling the joy others were expressing for our baby, intense emotionality, and a reluctance to leave familiar spaces, suddenly made sense, and I felt less lonely.

The level of antenatal care, including, the routine screening for a common mental health problem, depression, was excellent. Similarly, the sessions with the counsellor, which coincided with my routine antenatal visits, also worked well. During one such routine antenatal visit, I was admitted after raised blood pressure and the presence of protein was detected. I started receiving medication for this as well as being monitored closely for any changes. It was decided to induce my labour after a few days. I was still being treated for hypertension, and I was given instructions to lie still and not move, through labour and birth and finally gave birth to a healthy baby girl.

After this experience of labour, I was left feeling traumatised and powerless.  I had to stay in the hospital for several more days for my condition to be deemed stable. I was, however, able to see the counsellor again. Through the provision of information, empathy, understanding, respect and dignity, she was able to assist me in processing and understanding my traumatic experience. This assisted my healing and recovery emotionally.Psychosocial support can often be seen as a “nice-to-have”, add-on service. Through my traumatic experience, however, I was able to see how necessary psychosocial support is, and what a huge impact it can have on the quality of care provided to healthcare users.I would like to advocate that psychosocial support form an integral part of basic healthcare services so that health-care users receive holistic care. More importantly, however, as my story indicates, healthcare workers are in an ideal position to influence a patient’s experience of care. Healthcare workers need to understand that patients are more than just their illness, and “work” for them. Medical procedures that seem standard and routine to healthcare workers are often new and extremely anxiety-provoking for patients. Physical needs and wellness cannot be separated from emotional and psychological needs and well-being. Psychosocial support should not be a specialised service running alongside healthcare services. Instead, it should be integrated into the routine treatment of patients.

This example describes how the Perinatal Mental Health Project was able to implement just such a service and it made such a difference to my experience. In caring for women who are pregnant and are about to embark on the journey of labour and supporting a new life, this is especially necessary. Growing a life inside your body is a life-changing experience each and every time. A mother typically will visit a health facility often during this time and receives screening and treatment for all types of preventative and pregnancy-related medical treatment. This would also, as in my experience, be an ideal opportunity to intervene with emotional as well and psychological interventions to support mothers. Mental health concerns at this time can have serious consequences to both mother and baby for the rest of both their lives. I was screened for depression and given treatment and support during this time. This enabled me to support my baby during the first few months of her life. I was also made aware of my own needs and could receive the help I needed. Without the treatment and support, I was given, this would have been a far more painful time for me.As a result of my experience of having had support during a difficult time, I have a good understanding of the emotional support women need during pregnancy and birth. This understanding led to me continuing my studies and choosing to qualify as a counselling psychologist. When the opportunity came to work for an organisation focusing on pregnant women and children affected and infected by HIV, I took it. This organisation works closely with the Department of Health, which allows me to work with staff at primary health facilities and raise awareness of the importance of psychosocial support in the area of HIV, specifically for pregnant women, their children and families.

* Samantha has given consent to tell her story and use her photo.

 

“I found out I was HIV positive”

My name is Phumza and my baby’s father abandoned me when I became pregnant. It was hard because it was also the time that I found out that I was HIV positive. I was scared that my baby might also be affected by the virus. At my first antenatal visit, I was offered the PMHP mental health screening and was referred for counselling. I attended a few sessions with the PMHP counsellor.

After my baby was born I lost my job because my employer would not allow me to take time off work when my baby was sick. I also had to take care of my older son, who was 6-years-old at the time.

I thought to myself: “I don’t know what is wrong with me. My memory is very poor. On Monday I lost money in the taxi. Yesterday, I lost my jacket. I don’t know what I’m doing these days. And I’m sad. Maybe this virus works in my mind, and I’m suffering. I’m always thinking about my future and my children. What if I can’t take care of them?

I grew more desperate about my financial situation. I was unemployed and received no support from my baby’s father. I felt hopeless about my future and I could no longer afford transport costs to attend counselling sessions at the clinic. I sent a text message to the PMHP counsellor: “I just want it all to end.

The counsellor began providing sessions telephonically and arranged for me to receive medication for my depression. She also referred me to the community clinic which was within walking distance from my house for on-going psychiatric care. The counsellor also helped me to connect with a community project for assistance with food and child grants.

It wasn’t a lot, but it helped improve my situation. I stayed in touch with the counsellor and called to share the good news that my baby was HIV-negative. Although there are still many challenges for me, I feel that I am cared for and supported. Today, I feel better able to cope.

I finished my job application today. I want to say thanks for everything you did for me. You must continue to help other people, other people who are suffering, just like I was.SMS from Phumza to the PMHP counsellor

“I knew very little about my husband”

My name is Jeanette and I came from CAR (Central African Republic) to live in peace away from my village torn apart by war and atrocities. I am a teacher by profession and the breadwinner of my family. My parents gave me away in marriage to a man originally from my region, who lived in South Africa.

As in many arranged marriages, I knew very little about my husband. Soon after arriving in Cape Town my world turned upside down. My husband was physically and emotionally abusive and incapable of supporting me. After a short while, I became pregnant and all my hopes faded. Desperate, lonely and confused, I became very anxious. The language barrier I faced in my neighbourhood, the lack of resources and social isolation fuelled my anxiety.

At the antenatal clinic, I attended three PMHP counselling sessions with a French-speaking counsellor during my pregnancy and two sessions after my baby was born. My anxiety was acknowledged and contained. By looking at my history, the counsellor was able to point out examples of my natural resilience and I came to feel supported and empowered.

I reconnected with my family from whom I had withdrawn in shame, I started learning English and got to know my environment better. I made friends with a neighbour who had a toddler and in whom I found both practical and emotional support.  In the counselling session, I was able to disclose the abuse I was experiencing. The counsellor provided me with information to protect myself and I become more assertive. After my baby was born, I felt more hopeful about being able to care for her. I now feel happy as a mother.

“I started using alcohol heavily”

Annie grew up with a mother who verbally and emotionally abused her and her siblings. They moved from home to home. One of her step-fathers sexually abused Annie when she was 14. After that, Annie went to live with her aunt, dropped out of school and found a job in a factory. She started using alcohol heavily two or three nights a week and was pregnant, unplanned, at the age of 18, without a partner.

At 3 months, she booked at a Midwife Obstetric Unit, was screened for mental ill-health by one of the clinic staff and then referred to see the PMHP counsellor as her scores indicated she had symptoms of depression and anxiety.Annie was initially suspicious that she would be judged by the counsellor and that her baby would be taken away from her at birth. She arrived at the first appointment sad and reluctant to talk.

The counsellor gently developed a rapport with Annie, treating her with dignity and care. Annie, not being used to this type of relationship, broke down and was able to tell much of her life story in the first session. The counsellor was able to acknowledge and contain Annie’s anger at her mother, her fear of abandonment and her overwhelming anxiety that she would not be able to care for her baby without damaging him like what happened to me.

The counsellor was also able to identify where Annie had shown evidence of resilience and good decision making in her life – her seeking out a place of safety with her aunt, her strong work ethic at the factory which had earned her a promotion, and her courage in coming to speak with a counsellor. Over the next few sessions, together with the counsellor, Annie was able to identify a work colleague, an old school friend and her aunt as people with whom she could link more closely to be a support for her. With Annie’s improved self-esteem and a sense of agency, the counsellor was able to work with her to address her drinking problem. At birth, Annie had been sober for 4 months. Her aunt was present throughout her labour. Annie was able to breastfeed her baby for 5 months.During the first few months of her son’s life, Annie made a few appointments with the counsellor to work through some of the challenges of being a mother. She was also able to celebrate the joys in her relationship with her baby. 

“I felt so ashamed”

Bongi was raped by a “friend” who offered to help her with her schoolwork. She had not been sexually educated by her aunt, who had raised her from age 8, after her mother had died. Bongi didn’t know she was pregnant for several months.

I can’t get the pictures out of my mind. I wake up with my heart beating, sweating, I keep seeing his face, laughing. I hate him, and I’m so scared the baby will look like him. I wish my mother were still alive. Then I’d be okay. But right now I just want to die or kill him.

Bongi was referred to a PMHP counsellor who helped her contain her desperation and anger. The counsellor was able to affirm Bongi’s sense of self-worth and together they were able to identify a reliable source of support for her.

I couldn’t tell my aunt … I felt so ashamed. And I thought she wouldn’t believe me anyway because I went to his house. I didn’t know what kind of person he really was. I was right. At first, she didn’t believe me. She said I was asking for it. She said she would send me back to the Eastern Cape to live with my good-for-nothing father. But now she’s not too bad with me.

Bongi then moved in with her older cousin. After she gave birth to her baby girl, she continued to attend the PMHP for counselling. Her confidence and parenting expertise grew. She began to plan for the completion of her schooling and beyond.

“After hitting me, he’d apologise”

When Maria was 9 years old, her mother divorced her father, whom she was very close to. They moved to another city and Maria lost contact with him over the years. Maria was a sex worker for a while and had a son, now 3 years-old. She used tik (methamphetamine) for 4 years before making a decision to stop. Feeling vulnerable to relapse, she met a man who seemed stable to her. They married after only knowing each other for one month. After three months, the marriage deteriorated. He became emotionally, physically and financially abusive. 

But it was never okay. After hitting me, he’d apologise and be “good” for a few weeks. I always thought I wasn’t good enough and that somehow it was my fault. He would throw my past in my face. But he was good to my son. My friends tried to make me understand that I was worth more than this treatment. I was getting stronger and was planning to leave him. Then I found out I was pregnant with this baby.

After receiving counselling at the PMHP, Maria was able to anticipate and avoid violent encounters with her husband. She was equipped with skills to negotiate conflict.Although the physical abuse subsided over time, Maria felt stuck in an emotionally abusive relationship. She felt she needed to sacrifice her own happiness in order to let her children grow up in an intact family. She felt that if she left her husband, her children may choose a “wrong path in life”. She knew that she would feel responsible for this. Maria continues to see the PMHP counsellor as she works through her difficulties.

“I felt useless as a mother”

Christine arrived in South Africa from the Democratic Republic of Congo four years ago. She struggled to get work and stay employed due to language difficulties. When Christine became pregnant for the second time, her partner did not want the child. He became verbally and emotionally abusive and was controlling with finances. She was forced to live on his meagre handouts.Eight hours after giving birth to her second daughter, Christine was discharged from hospital and returned home. Despite her pain and exhaustion, she had to continue, alone, with her domestic obligations – washing clothes, cleaning the house, and cooking for her partner and children.

Maybe it wasn’t a wise decision to bring this child into the world. I am a failure. How am I going to take care of this baby?

Christine’s relationship with her partner deteriorated, and without any friends or family to support her, Christine felt completely alone. She became increasingly sad and stressed. Feeling despondent, isolated and helpless, Christine found it difficult to bond with her new baby and had no energy to meet the demands of her 2-year-old daughter. She wanted to ‘run away from it all’, but then was consumed with guilt for having such thoughts.

The baby didn’t stop crying. I couldn’t do anything to make her feel better. I felt useless as a mother and thought that it may be better if I ended my life.

Cultural norms added to Christine’s desperation. At the time of her pregnancy, her partner’s parents had not yet paid lobola (dowry) for her. She was therefore not recognised as being married. Consequently, her baby could not be named, making it more difficult to bond. Christine’s stress and depression caused her breast milk to dry up. She was referred to Charlotte, the PMHP’s French-speaking counsellor. At the time, she was 31 years old and unemployed. Her daughters were 2 years and 2 months old.

At first, help was like a slap in my face. But with counselling, I recognised that I had a problem and that it was not my fault. I now have time with my children and the milk is flowing. The heavy cloud over my head has been swept away. I now take things one step at a time.

Charlotte worked with Christine on acknowledging her feelings and building a sense of her own self-worth and capabilities. Christine started to develop solutions to some of her problems and felt empowered to negotiate a healthier way to communicate with her partner. She also accepted the help of a breastfeeding advisor. Today, Christine loves being a mother. She is more able to manage stress effectively and to care for her own and her children’s physical and emotional needs.

“What if I get sick?”

Zukiswa’s score on the mental health screening questionnaire suggested that she was very distressed: she had not been able to get hold of her boyfriend since she found out she was pregnant and had just learnt that she was HIV positive.

I haven’t been able to get hold of my boyfriend. He won’t take my calls. And his friends say he has gone to Joburg where the mother of his other two children is living.Worst of all, I found out two weeks ago that I am HIV positive. I’ve been going through hell. I am so worried about my baby. I am afraid the baby will get the virus. And what if I get sick? Who will support this child? I’m afraid to ask my mother because she never liked my boyfriend – said he was too old for me. I regret ever meeting him, and trusting him and not using condoms.

Zukiswa was referred to the PMHP counsellor. The first sessions focused on containing her emotions, through active listening, reflection and empathy. After a few sessions, Zukiswa’s mood started to change. She no longer felt as depressed and anxious. With the counsellor, Zukiswa worked on solutions to her problems. She identified the resources she had around her and thought of ways to use these in the best way. The counsellor also referred Zukiswa to the HIV peer advocates at the clinic. Through the weeks of her growing pregnancy, Zukiswa learned about HIV, feeding options for her baby and how to protect her own and her baby’s health.

Eventually, Zukiswa felt ready to disclose to her mother. This helped her to get more support and understanding at home, which gave her the strength to cope with her status, her pregnancy and her plans for the future.

The PMHP is committed to client confidentiality in keeping with the ethical requirements of professional mental health practice. The client stories reflect common scenarios or sets of circumstances faced by many of our clients. Pseudonyms are used and details are changed. The stories are not based on any one particular woman's experience, unless an individual explicitly chooses to share her story with or without her name attached.