Postpartum Depression – A hidden psychological misery for the struggling women of Pakistan

Abstract

Dear Editor,

Postpartum depression is a psychosomatic barrier that mothers may experience within six weeks of giving birth. The condition is far more common in resource-limited countries, impacting 15% mothers every year globally, and, with a prevalence of 28 to 63% in Pakistan. (1)

The risk factors for postpartum depression can be categorized into five groups: biological, psychiatric, obstetric, lifestyle, and social. A study conducted by Ghaedrahmati et al. suggests that women who experience hospitalization and emergency caesarean section are at a greater risk of developing postpartum depression. (2) Pakistan has shown an increase in the trend of caesarean sections over the past 20 years, rising from 3.2% in 1990 to 20% by 2018 (3). Women living in joint families are more likely to develop postpartum depression than those living in nuclear families. (1) Pakistan has a trend of joint family systems, with most of the population (80.9%) living in this manner. (4)

Factually, women tend to suffer from mental health disorders at twice the rate of men, which puts them at a higher risk of developing postpartum depression. Given the quality of healthcare in Pakistan and the stigma associated with the mental and reproductive health of women, most cases remain undiagnosed. In a country with a population of 220 million, there are only 500 psychiatrists available to meet their psychiatric needs. (5)

It is crucial to shed light on this critical issue that remains neglected in Pakistan. Awareness should be raised through social media and other multimedia platforms. Campaigns should focus particularly on rural areas, as two-thirds of Pakistan’s population resides in these settings. Healthcare professionals should be trained to provide basic psychosocial support. Conferences and seminars should be organized to inform physicians about the link between reproductive and mental health. Additionally, during antenatal check-ups, equal attention should be given to the psychological well-being of the mother, and any previous history of psychiatric illnesses should be addressed with care. Regular postnatal check-ups should be encouraged to facilitate the early diagnosis of postpartum depression and ensure timely treatment. Furthermore, physicians should prioritize vaginal deliveries over caesarean sections unless contraindicated, and all pregnancies should be given a trial for vaginal delivery. This can be achieved by implementing strict guidelines for the performance of caesarean sections to prevent malpractice.

Ultimately, the important issue of postpartum depression must be emphasized both nationally and internationally, not just for the welfare of women but also for the benefit of future generations.