# Prevalence and factors associated with postpartum depressive symptoms among mothers who gave birth within the past 12 months in Ghana: mixed-method study

## TL;DR

This study found that nearly 30% of mothers in Ghana experience postpartum depressive symptoms, linked to factors like lack of support and low self-esteem.

## Contribution

The study combines quantitative and qualitative methods to explore PPDS in Ghana, revealing psychosocial pathways and modifiable risk factors.

## Key findings

- 29.3% of surveyed mothers screened positive for postpartum depressive symptoms.
- Factors like lack of partner support and low self-esteem were strongly associated with PPDS.
- Thematic analysis identified social isolation and emotional stress as key themes influencing PPDS.

## Abstract

Postpartum depressive symptoms (PPDS) are mental health concerns, characterised by sadness, anxiety and suicidal ideation.

We aimed to estimate the prevalence of PPDS, identify its associated factors and explore the lived experiences of individuals with PPDS, to understand the psychosocial mechanisms involved.

We surveyed 400 women aged 18 years and above and conducted in-depth interviews among 19 women who screened positive for PPDS at two urban hospitals and one peri-urban polyclinic in Ho, Ghana. We used multivariable binomial generalised linear models to identify factors independently associated with PPDS. We used thematic analysis (qualitative) to identify themes that highlight pathways through which these factors influence PPDS.

Overall, 117 (29.3%) women screened positive for PPDS. Being unmarried (adjusted prevalence ratio (aPR) 1.33, 95% CI 1.02–1.72), lack of partner support (aPR 1.60, 95% CI 1.21–2.12), history of depressive or psychiatric disorders (aPR 2.44, 95% CI 1.84–3.25), unplanned pregnancy (aPR 1.63, 95% CI 1.18–2.25), low self-esteem (aPR 2.38, 95% CI 1.79–3.16) and low birth weight (aPR 1.87, 95% CI 1.33–2.65) were independently associated with PPDS. The thematic analysis revealed four key themes: (a) social isolation and limited support, (b) emotional stress and vulnerability, (c) self-image and identity challenges, and (d) resilience resources.

PPDS were common in our sample and were significantly associated with modifiable factors such as prior mental health history and low self-esteem. These findings underscore the importance of prioritising maternal mental health through the integration of depression screening and psychosocial care into routine antenatal and postnatal services.