Mr Linus Koh supported his wife Anne Marie Koh through postpartum depression after the birth of their fourth child. The Straits Times/Asia News Network
SINGAPORE – After the birth of their fourth child, Mr Linus Koh noticed that his wife was unable to do simple household chores, and she often cried.
Mrs Anne Marie Koh, 37, would tell him: “I’m not good enough, I should just go and die.”
Affected by postpartum depression, Mrs Koh was unhappy even when their newborn baby smiled.
As suicidal thoughts plagued her, Mr Koh, 39, knew they needed help.
The Ministry of Health told The Straits Times that public healthcare institutions saw an average of 338 postpartum depression cases per year between 2015 and 2019.
READ: Postpartum Depression: Understanding the silent cries of mothers
This number has dropped to 248 cases a year between 2020 and 2024.
Among patients in the last five years, there was an average of fewer than one suicide per year.
On Dec 3, 2023, a 33-year-old woman and her three-week-old baby were found dead at the foot of the Housing Board block where they lived.
In February, State Coroner Adam Nakhoda said in his findings that the woman likely had undiagnosed postpartum depression.
Her suicide shocked her husband and family, who the coroner said were supportive and loving.
As for Mr Koh, he realized the future of his family depended on his wife feeling happy again.
He said: “It (postnatal depression) could destroy my family. As a husband and father, I needed to provide my family with some sense of security against the dark thoughts she had.”
Mr Koh said that as a husband and father, he needed to provide his family with a sense of security during his wife’s postpartum depression. The Straits Times/Asia News Network
The couple, who have been married for 11 years, run media company Saint Max Media – which helped the Catholic Archdiocese of Singapore record online masses during the Covid-19 pandemic.
The couple discussed counseling and made childcare arrangements so that Mrs Koh could rest.
READ: Children born to mothers with postnatal depression more likely to have depression later — study
They are now happy parents of five children aged three, five, seven, nine and 11.
The Kohs spoke to ST in March to encourage others struggling with postpartum depression, which affects about one in 10 mothers in Singapore.
Husbands stepping up
During her depression, the couple realized that Mrs Koh’s lack of sleep was exacerbating the situation.
Her children demanded her attention day and night. On some nights, she was able to sleep only for half an hour.
To help, Mr Koh did the housework, took the children out and booked a hotel room for her so she could have uninterrupted rest.
The Koh family with their children aged three, five, seven, nine and 11. The Straits Times/Asia News Network
The couple decided against going for counselling when Mrs Koh’s mood improved.
Mr Koh said: “I had to be a good listener, so she didn’t feel alone. I needed to protect her from her own voices in her head.”
The National University Hospital’s (NUH) Women’s Emotional Health Service saw 43 cases of depression disorders in 2024, up from 38 in 2023 and 31 in 2022.
Clarity Singapore, a Catholic mental health charity that specializes in maternal well-being, saw such cases in 2024 rise by about 15 per cent compared with 2022.
Doctors and counsellors said husbands play a crucial role in supporting mothers.
Dr Cornelia Chee, senior consultant and head of NUH’s department of psychological medicine, said some husbands could be adept at noticing that things are not right.
READ: Mental health month (3): Mothers matter, too
“We (have had) couples where the woman says: ‘My husband made the appointment for me, he’s worried,’” she said.
Dr Elizabeth Siak, a consultant who heads the Women’s Mental Wellness Service at KK Women’s and Children’s Hospital (KKH), said that with increasing awareness of postnatal depression, husbands have encouraged their wives to seek support.
Dr Siak said that warning signs include low mood, poor concentration, changes in sleep patterns and experiencing these symptoms for two weeks or more.
Help can be found at hospitals, including NUH and KKH, or through general practitioners at polyclinics.
Dr Chee noted that cases referred from polyclinics rose in 2024 after the National University Polyclinics (NUP) started screening for postpartum depression during regular postnatal visits.
Dr Liow Yiyang, an NUP family physician at Queenstown Polyclinic, said husbands need to be the anchor for their wives during the stressful period after childbirth.
A father of two, Dr Liow said: “Sometimes mothers may not find the will to turn up at the clinic. So (husbands), you need to be that important link person to track (her well-being).”
“What if I cannot recover?”
When Mr Ken, 40, and his wife, 41, welcomed their only son after two rounds of in-vitro fertilization, he thought it was the start of happier days.
But his wife cried continuously and was withdrawn. She became more stressed when she stopped breastfeeding after a month, as she felt she was not doing enough.
Mr Ken, a human resources consultant who wanted to be known by only one name, took a month’s unpaid sabbatical to care for his wife and son.
He said: “At the end of the day, I work for my family. What is the point of me doing my job if I can’t even look after their well-being?”
He even asked artificial intelligence chatbot ChatGPT what to cook for his baby and had their domestic helper prepare the meals accordingly.
Every day, he searched the internet for ways to overcome depression and what to say to his spouse.
One night, while out on a stroll, she broke down and asked him: “What if I cannot recover?”
Mr Ken said: “I realized it was something that was out of her control. I knew we needed help.”
He contacted Clarity Singapore. His wife’s mood improved after fortnightly counseling sessions.
Mr Ken said it helped him as well, adding: “I didn’t want to keep relying on insights from Google. I wanted to speak to a real person.”
Ms Cindy Khong, a senior counsellor at Clarity Singapore, said postpartum depression is highly treatable with psychotherapy, medication, support groups or lifestyle changes. “A therapist can help to identify unhelpful thought patterns, process feelings of shame, guilt and inadequacy, and discuss practical ways to manage their stress,” she added.
Years of suffering
Yoga teacher Ho Kin Ing (left) relied on her husband Tan Peng Yong to support her through postpartum depression. They have three daughters, including three-year-old Beatrice. The Straits Times/Asia News Network
Sometimes, it takes time for mothers to be receptive to help.
Financial adviser Tan Peng Yong, 37, supported his wife Ho Kin Ing, 33, through six years of postpartum depression before she received therapy.
Ms Ho struggled with the condition after the births of their three daughters, now aged one, three and six.
She had sudden rage outbursts and was constantly anxious that one misstep would affect her children forever.
Ms Ho also experienced suicidal thoughts. She said: “It just kept coming. I had thoughts like: ‘You’re a bad mother’ and ‘Your children don’t need you’.”
Once, she broached the topic of divorce.
Mr Tan said: “She was in a state of darkness, fear and anxiety and could not feel that she still cared for me.
“But after we talked it out, she rediscovered her feelings, and it (the conversation) ended with a lot of tears.”
Mr Tan said he learnt to listen and acknowledge his wife feelings instead of trying to think of solutions. The Straits Times/Asia News Network
Ms Ho said: “His patience to hold that conversation for me, instead of walking away, was what I needed.”
In 2024, Ms Ho started therapy sessions at Alliance Counselling. That year, she also started Kindle Space, a yoga studio focusing on maternal physical and emotional wellness.
Dr Silvia Wetherell, a psychotherapist with Alliance Counselling, said it is common for mothers to try to push through postpartum depression without seeking help.
“They feel ashamed for feeling depressed with the arrival of a baby, because they’ve been told by (everyone) that this is the happiest thing that can ever happen to a woman,” she said.
Dr Wetherell added that husbands are often the ones who can see through the facade.
“They are probably the one person in the world who knows this woman the best and are in a privileged position to get her to seek help and support.”