Just gave birth? Your general practitioner is the first line in helping you detect postpartum depression

Postpartum depression (PPD), also known as postnatal depression, is one of the most common postnatal mental health problems in Singapore. It affects one in 14 new mothers and often arises within the first year after childbirth.
This postnatal condition is a significant concern for new mums.  Left untreated, PPD can severely impact both mother and child, making early detection and intervention all the more critical. 
A study led by Dr Liow Yiyang, a family physician and associate consultant at National University Polyclinics, explored how primary care doctors can better support mothers with postnatal mental health problems. 
The study, published in the international medical journal Family Practice in January, highlighted the role of primary care physicians in detecting early signs of PPD.
Primary care doctors, such as general practitioners (GPs) at polyclinics and family physicians, are often the first healthcare providers to see new mothers during postnatal checkups. Many mothers have built strong relationships with their regular GPs over the years, allowing the doctors to detect subtle hints of psychological distress, such as being unusually quiet or frequently concerned about their child.
Primary care doctors also offer a familiar, accessible point of contact for mothers seeking care, the study highlighted. 
The existing doctor-patient relationship helps reduce the stigma associated with mental health issues, making it more likely that women will open up about their struggles. This is crucial in identifying early signs of PPD, especially when symptoms are not immediately obvious.
The study also found that while primary care doctors are confident in managing mild postnatal mental health issues, they need better access to resources such as psychological services, better coordination with specialists, and greater public awareness to encourage mothers to seek help.
To address these gaps, nurses at National University Polyclinics, which primarily serves the western parts of Singapore, proactively assess mothers’ mental health during childhood developmental visits. The nurses also provide breastfeeding advice, perform cervical cancer screening, and follow up with patients on their gestational diabetes.
Mothers who exhibit severe postnatal mental health issues, such as unusual irritability and intense anxiety about parenting, during polyclinic visits, will be referred to specialist services at the NUH Women’s Emotional Health Service or KKH Women’s Mental Wellness Service. These offer education on parenting, couple counselling, and psychiatric and psychological consultations.
One mum found help for her worsening PPD symptoms after an appointment with her GP at Queenstown Polyclinic.
Wong Sheau Tyan, a 41-year-old mother of three, had given birth to her youngest son just a few months ago. 
“The stressors added up and multiplied after having my third child,” Wong said. “Although I wasn’t doing well physically or mentally, as a mother, I was used to putting my needs last – it didn’t occur to me to seek psychiatric help, like counselling or therapy.”
During a follow-up visit for her gestational diabetes, Wong’s GP was concerned about her well-being. He asked her: “How is Mummy doing? How are you?”, which allowed Wong to share the stress she had been experiencing.   
Her GP, Dr Cheng Wen Li, uncovered that Wong had been struggling with low mood, hopelessness, and fatigue. Dr Cheng diagnosed her with adjustment disorder, a condition where mothers struggle to cope with the emotional and physical changes of childbirth, and referred her to the polyclinic’s in-house psychotherapist. 
Through cognitive behavioural therapy and emotional support, Wong’s symptoms improved, and after four months of therapy, she was discharged.
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