Thousands of pregnant/postpartum women at risk of mental health crisis – Research

A pilot study on maternal mental health in Ghana has revealed a troubling reality: thousands of pregnant and postpartum women are silently battling depression, anxiety, and suicidal thoughts, often without detection or support.

The findings, presented as part of efforts to integrate mental health screening into routine maternal care, show that while 6.38 percent of women screened positive for a mental health condition during the pilot, broader evidence suggests the crisis may be far deeper.

Dr Promise Sefogah, Lecturer, University of Ghana Medical School, revealed this at the launch of Ghana's first-ever Maternal Mental Health Policy (MMHP) in Accra on Thursday.

He said the pilot, conducted across five regions; Northern, Bono East, Eastern, Greater Accra, and Ashanti, screened 5,960 women using a simplified mental health tool (PHQ-4 plus a suicide-risk question).

Of these, 380 screened positive for depression, anxiety, or suicidal ideation.

Notably, suicidal thoughts were reported in 3.3 per cent of participants nearly 200 women within just four months, he said.

Dr Sefogah said studies in some communities, particularly in northern Ghana, had recorded postpartum depression rates as high as 50 per cent.

The health expert attributed the crisis to a complex interplay of biological, social, and systemic factors.

During pregnancy, women experienced elevated levels of progesterone and estrogen, hormones that stimulated "feel-good" brain chemicals such as serotonin and dopamine, he said.

"These help buffer stress despite the anxieties of impending motherhood," he added.

"However, after delivery, the sudden removal of the placenta causes a sharp hormonal drop, leaving women vulnerable at a time when stress intensifies due to physical recovery, sleep deprivation, and the demands of newborn care."

"The body's natural coping system is suddenly withdrawn, yet the burden increases. That imbalance is at the heart of postpartum mental health challenges."

He said despite those alarming figures, systemic gaps were still widespread. The current maternal health record system includes only a single mental health question, typically asking about past history, with no structured screening for emerging conditions.

The Lecturer noted that equally concerning was the limited preparedness of healthcare providers. He revealed that up to 70 per cent reported lacking knowledge or capacity to identify or manage maternal mental health disorders, largely due to minimal training in medical and midwifery education.

Dr Sefogah said stigma and cultural beliefs further complicated the situation, adding that approximately 65 per cent of affected individuals attributed symptoms to spiritual causes, often seeking help through traditional or religious practices before accessing medical care.

"These beliefs delay critical intervention," the report noted, highlighting cases where women resorted to rituals instead of clinical treatment.

"Socioeconomic pressures also play a significant role. Financial hardship, marital conflict, lack of support, and unemployment are frequently linked to poor mental health outcomes," Dr Sefogah noted.

He stated that women with disabilities were found to be up to five times more likely to experience suicidal thoughts.

The study also revealed a critical breakdown in care pathways: only about one-third of women identified as suicidal were successfully referred for further treatment and cited unclear referral systems and inadequate training as key barriers.

"Importantly, the data showed that mental health challenges do not end after childbirth. In fact, prevalence increased during child welfare clinic visits, suggesting that distress may intensify weeks or months after delivery, well beyond the typical six-week postpartum care window," he added.

Dr Sefogah warned that failure to address maternal mental health problems had far-reaching consequences.

"It doesn't just affect the mother. It impacts the child's development, family stability, and society at large."

In response, Ghana is moving towards integrating routine mental health screening into antenatal and postnatal care nationwide. The pilot demonstrated that brief tools like the PHQ-4 could be effectively administered by trained frontline workers, offering a practical pathway for early detection.

He, thus, called for scaling up community engagement, strengthening health worker training, establishing clear referral systems, and embedding mental health screening into standard maternal care protocols.

"As Ghana advances towards implementing a national policy on maternal mental health, stakeholders say the time to act is now," Dr Sefogah said.

"This is not a hidden issue anymore. The evidence is clear. We must prioritise the mental well-being of mothers as much as their physical health."

"The stakes are high: without intervention, hundreds of mothers and the families who depend on them remain at risk."