Depression was predicted to rank as the second most prevalent cause of disability globally in 2023 [1]. A kind of mood illness known as postpartum depression (PPD) is linked to delivery and may afflict people of either gender [3]. PPD, a severe issue that affects 6% to 26% of women after delivery, is prevalent in all cultures [2]. Disabling symptoms such as poor mood, irritability, exhaustion, sleeplessness, changes in appetite, worry, guilt, incapacity to cope, feelings of worthlessness, and suicidal thoughts may be experienced by women suffering from postpartum depression [3]. Unrealistic expectations of parenthood, poor self-esteem, and lack of confidence are common aggravating factors of symptoms. Even while postpartum depression is becoming more widely acknowledged as a disorder associated with delivery worldwide. Globally, PPD has deleterious effects on the health of the mother and the newborn, the impact is more in sub-Saharan Africa will limited resources, poor access to care and frail healthcare systems [1]. Understanding the predictive factors will aid in the development of relevant interventions and policies in order to enhance positive maternal and newborn outcomes towards universal Health Coverage (UHC) of 2030. In Ghana, there are few literature on postnatal depression varying from studies on psychosocial determinants [4], prevalence and key predictors [5], association between probable post natal depression and increased infant mortality and morbidity [6]. However, most of the studies are from rural Northern areas of Ghana with very little information from Urban centers such as Kumasi which is the second most populous city and located in the middle of Ghana. This serves as a strategic and demographically diverse setting for the diagnosis and treatment of the condition [7]. The repercussions of PPD, such as an elevated risk of suicide and infanticide, make it a significant societal concern. Because PPD is often underdiagnosed and mistreated, initiatives to enhance maternal perinatal mental healthcare are required, which is why this study is necessary.
There isn’t much data to support postpartum depression’s biological cause. Nevertheless, steroid and peptide hormone levels dramatically change throughout pregnancy and the postpartum period, affecting the mothers’ hypothalamic pituitary adrenal (HPA) and hypothalamic pituitary gonadal (HPG) axis [8]. Because mood disorders are linked to dysregulations in these endocrine axis, pregnancy and the postpartum period may have a significant impact on a mother’s mood [8]. Postpartum depression (PPD) has been linked to several variables, some of which include intimate partner violence, a history of mental illness, poor mother literacy, stress, maltreatment in early life, anxiety, and a prior history of depression [9]. A history of sexual abuse, a negative attitude towards the baby, a preference for a specific gender, a history of depression and anxiety, a risky pregnancy that included an emergency caesarean section, an umbilical cord prolapse, a preterm or low-weight infant, a lack of social support, poor eating habits, sleep cycle disruption, a lack of physical activity, and exercise are additional risk factors for postpartum depression [10]. Furthermore, mother-infant interactions which are crucial for a child’s development are hampered by postpartum depression [8]. A baby’s social, cognitive, and behavioural skills must mature in a healthy way, and this depends on the mother’s attachment, sensitivity, and parenting style. Depressed moms frequently exhibit less attachment, sensitivity, and harsher or disrupted parenting behaviours, which can have a detrimental effect on the child’s development [8]. In an environment where poverty, overcrowding, poor sanitation, malnutrition, diseases, and a lack of appropriate medical services may be common, a mother with an underlying mental illness in a low-resource setting runs the risk of giving her children sub-standard care [11].
There is a lot of variance in the published study on PPD prevalence [12].This may be because the DSM-IV and the majority of epidemiological research utilise different criteria for the period of onset [7]. Because moms themselves underreport, it has also been challenging to determine prevalence [7]. Poor people and women are more at risk. According to research, within a year after giving birth, one in seven women get a postpartum depression diagnosis [13]. Only 20% of women who suffer PPD symptoms are thought to disclose such symptoms to their medical professionals. Mothers and carers often downplay PPD symptoms as typical, inevitable side effects of delivery [7].
Numerous studies have identified a number of physiological and psychological factors that contribute to postpartum depression [14]. The degree of schooling, heavy workload, unemployment, multiparity, and marital difficulties are these factors. According to a number of research, newborns of depressive moms exhibit less engagement with their peers, slower cognitive development, more behavioural issues, and a greater chance of developing a mental disease as adolescents [15]. Although postpartum depression may affect women in any group, it is more common among young, low-income, minority moms due to the many obstacles they confront, including lack of understanding, stigma associated with mental illness, and transportation [16].
Merely 15% of women who have this illness obtain professional care, despite its severe consequences. This is due to the rarity of regular postpartum depression screening in hospitals. Following childbirth, women’s follow-up appointments often focus on the medical aspect of things, such as nursing and contraception [17]. Another factor contributing to underreporting is women’s incapacity to identify the illness. Mothers are discouraged from getting assistance from a psychiatric hospital because they fear being stigmatised and are sometimes regarded as being mentally ill [18]. Few people who seek expert assistance don’t follow their treatment plan [19]. This research aims to explore postpartum women’s awareness, prevalence, and predictors of postpartum depression in Kumasi, Ghana, in order to gather baseline data on the illness, particularly in women.
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