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

Background Postpartum depressive symptoms (PPDS) are mental health concerns, characterised by sadness, anxiety and suicidal ideation. Aims 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. Method 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. Results 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. Conclusions 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.