Postpartum Depression in African Women: Causes, Symptoms and Treatment
By Adebowale Bello. B.Tech Microbiology, Freelance Health Writer. Medically reviewed by the DLHA team.
Close up black and white portrait of an African woman holding her baby outdoors. Image credit: Freepik
When Ada gave birth to her first child in a small town in southeastern Nigeria, everyone around her expected her to be full of joy. The naming ceremony was colourful, visitors came with gifts and neighbours congratulated her husband on becoming a father. But beneath Ada’s smile was a growing sense of fear, exhaustion and sadness she couldn’t explain.
At night, while her baby cried, Ada cried too, not from the noise but from a deep emptiness she couldn’t name. She started feeling like a failure, avoiding friends and even struggled to bond with her baby. When she mentioned her feelings to an older woman in the family, she was told, “You just need to be strong. Every woman goes through this.”
Just like Ada, for many African women, the days and weeks after childbirth bring more than sleepless nights, they bring unexplained sadness, anxiety and emotional pain. This condition is known as postpartum depression (PPD) and prevalence statistics range between 6.9–43% across several African countries.
In Africa, however, PPD is often hidden behind cultural silence, societal expectations and limited access to mental healthcare. Hence, countless mothers suffer in silence as their struggles are either misunderstood or outrightly dismissed.
In this article, you’ll learn about what postpartum depression really is, why it happens, how to spot the signs and what kind of support and treatment can help. You’ll also discover why so many African women suffer in silence and what families, health workers and communities can do to change that.
After giving birth, many women go through something called the "baby blues". It’s a short period, usually in the first few days after delivery when a new mother might feel moody, teary or overwhelmed for no clear reason.
This happens because of the sudden drop in hormones, lack of sleep and the stress of adjusting to a new baby. One minute she might feel happy, the next minute she’s crying. She may feel anxious, easily irritated or just emotionally all over the place.
The baby blues are very common and usually go away on their own within 1 to 2 weeks without any treatment. But if the sadness or emotional struggle lasts longer, feels heavier or gets worse instead of better, it might be something more serious like postpartum depression.
Postpartum depression (PPD) is a type of depression that occurs after childbirth. “Unlike the baby blues, PPD is more intense and long-lasting. It can start within the first few weeks after delivery but sometimes symptoms can appear even up to a year later”, says Dr Azuka Chinweokwu Ezeike. FWACS, FMCOG, MSc (PH), a Consultant Obstetrician and Gynaecologist in Abuja, Nigeria. It’s more than just feeling tired or stressed, it’s a deep, ongoing sadness or emotional struggle that doesn’t go away on its own and when left untreated, it can interfere with a mother’s ability to care for herself or her baby.
A mother with PPD might feel very sad, hopeless or empty. She may cry often, feel like she’s failing as a mother or lose interest in things she used to enjoy. She might also feel disconnected from her baby or worry that she’s not bonding properly. This doesn't make her a bad mother, rather it makes her a mother who needs support and care, just like anyone facing a health challenge.
Postpartum depression does not have a specific cause, rather it results from a combination of physical, emotional and social factors, many of which are intensified by the realities of life in many African settings.
Here are some common factors that may lead to postpartum depression: (See fig. 1)
Fig, 1: Common risk factors for postpartum depression in new African mothers. Click on image to enlarge.
After childbirth, a woman’s body goes through a lot of changes, not just physically but also in terms of hormones. After delivery, there is a sudden drop in important reproductive hormones, like estradiol and progesterone and this affects the brain and mood, especially in women who are already vulnerable, leading to feelings of sadness, anxiety or even depression.
Another hormone involved is cortisol, also known as the stress hormone. High levels of cortisol, along with low levels of tryptophan (a chemical the body uses to make “feel-good” hormones), have been linked to postpartum depression.
Related: 10 Common Hormone-Linked Disorders in African Women
Hormones like oxytocin and prolactin, which help with breastfeeding, also play a big role. These hormones are responsible for the milk "let-down" reflex and breast milk production. When a mother is unable to breastfeed properly or stops breastfeeding earlier than planned (known as early weaning), it’s often seen alongside symptoms of depression. In fact, low levels of oxytocin have been found in mothers going through postpartum depression.
Related: 6 Breastfeeding Tips for New African Moms
14 Breastfeeding Challenges African Nursing Mothers Need To Know
A woman who has struggled with depression, anxiety or premenstrual syndrome (PMS) in the past may be more likely to face postpartum depression. Additionally, if she has a negative feeling about the baby or was disappointed by the baby’s sex, this could add to her stress. Women with a history of sexual abuse may also be more vulnerable after childbirth due to emotional triggers.
Some pregnancy-related medical issues can be physically and emotionally draining. These include:
Related: Obstructed Labour in Africa – An Overview
Essential Guide to Labour for African Women and Men
These stressful experiences can leave a new mother feeling helpless, scared or overwhelmed, which may lead to depression.
Lack of support from a partner, family or friends can leave a woman feeling isolated. Some mothers also face abuse at home, whether it’s physical, sexual or verbal which makes the postpartum period even harder.
Young mothers, especially teenagers or women in their early 20s, may struggle more because they might not be emotionally or financially prepared for motherhood.
When a new mom isn’t eating well, doesn’t get enough exercise or barely sleeps, it can affect her mood and energy levels. Lack of vitamin B6 and poor physical activity can increase feelings of sadness and low self-esteem. On the other hand, regular movement, even simple walking can naturally lift mood and boost confidence.
Related: Health Effects of Exercise in African Females: Myths, Facts and Benefits
Money problems can put a lot of pressure on a new mother, especially when she’s already trying to adjust to caring for a baby. The cost of baby items, food, and transportation to clinics or even paying hospital bills can become overwhelming. In low-income families or communities, mothers may have to return to work too early or skip medical checkups just to save money.
This kind of constant financial stress can lead to feelings of hopelessness, fear about the future and emotional burnout. When basic needs like food, shelter or healthcare aren’t guaranteed, it becomes even harder for a new mother to focus on her mental well-being.
Living in poverty can also reduce access to healthy food, clean water, emotional support and other things that help mothers recover after birth, all of which increases the risk of depression.
7. Gaps in Healthcare and Support Services
In many parts of Africa, there are serious gaps in maternal healthcare, especially when it comes to mental health. After childbirth, most mothers are checked for physical recovery, but their emotional or mental state is rarely discussed. Postnatal visits may be rushed or skipped altogether and mental health screening is not part of routine care in most clinics.
Even when a woman speaks up about feeling sad or overwhelmed, she may be told to “just rest” or “pray about it,” rather than being referred to a trained counselor or psychologist.
On top of that, there is a shortage of mental health professionals in many regions. Rural areas, especially, may have no psychologists at all and even in urban areas, the cost of seeing a private therapist is out of reach for many. All of this means that many mothers are left alone to figure things out, without professional help or even basic information about what postpartum depression is.
Postpartum depression doesn’t look the same in every woman but its symptoms often go beyond fleeting "baby blues". These emotional, physical and behavioural changes can persist and make it harder to bond with your baby or manage daily life.
Fig. 2: Some common symptoms of postpartum depression in new African mothers. Click on image to enlarge. Adapted from: Source.
Here are some of the most common symptoms that new mothers may experience: (See fig. 2)
Some women may also have difficulty breastfeeding or feel like they’re not good enough to be a mother.
Postpartum depression (PPD) when it begins during pregnancy is more than just a passing low mood. Doctors use specific criteria (considerations) to make a diagnosis and ensure that you get the help that you need.
A healthcare provider will seek information from you to check if:
The diagnosis also takes into account how these symptoms are affecting your daily life, whether you care for yourself and the baby, how you function at home and if you’re at risk of harming yourself.
Many women don’t know if what they’re feeling has a name or that help is available. This is why early screening for PPD during postnatal visits is so important, even if a new mother doesn’t mention anything upfront.
Fig. 3: Reasons why postpartum depression is underdiagnosed and undertreated in Africa. Click on image to enlarge.
Despite how common postpartum depression (PPD) is, it often goes unnoticed, undiagnosed and untreated across many African communities. For thousands of women, the emotional struggles they experience after childbirth are explained away, brushed aside or hidden entirely leaving these women suffering in silence, feeling isolated, overwhelmed and ashamed, all while trying to care for a newborn.
Dr Ezeike explains that “many cases go undiagnosed due to factors such as non-recognition of symptoms, non-disclosure, fear of stigma or the misinterpretation of symptoms as having a spiritual cause. A lack of antenatal education on possible complications after childbirth also contributes to the delayed recognition of symptoms.”
Here are some of the reasons why postpartum depression goes untreated in Africa:
In many African societies, mental health is not openly discussed. People are more likely to talk about physical illnesses like malaria, high blood pressure or even childbirth complications but not emotional or psychological struggles. Depression is often misunderstood or completely ignored.
When a mother says she feels sad, lost, or “not herself,” she may hear things like, “You should be happy, you just had a baby,” or “Plenty of women have children and they’re fine.” These comments, although often meant to be encouraging, can make the mother feel guilty or ashamed. Instead of feeling supported, she may start to believe that something is wrong with her and try to push through the pain alone, which only makes things worse.
In African cultures, motherhood is celebrated but it also comes with heavy expectations. New mothers are often seen as pillars of strength. They’re expected to take care of the baby, cook, clean, host visitors and go back to their duties as quickly as possible, often with little rest or support.
Admitting that you’re struggling emotionally may be seen as weakness. Some women are afraid that if they open up about their mental health, they’ll be seen as ungrateful or lazy. So, even when they’re hurting inside, they put on a brave face for the family, the community and tradition.
In many hospitals and health centers across Africa, postpartum care focuses mostly on physical recovery. A mother may be asked if her bleeding has stopped, if her baby is breastfeeding well or if she’s healing from any tears or stitches. Rarely is she asked how she’s feeling emotionally.
The sad truth is that many frontline healthcare workers have not been trained to look out for signs of postpartum depression. Screening for mental health is not part of routine postnatal care in most clinics. So even when mothers visit the hospital, their emotional struggles are often missed, not because no one cares but because the system doesn’t prioritize it.
Even when a mother recognizes that something is wrong, finding help can be difficult. In many rural or low-income areas, mental health professionals are few and far between. Psychologists, therapists and counsellors are mostly found in big cities or private hospitals, where services are often expensive.
Public health facilities are often overstretched and mental health is rarely included in basic maternal care. For many women, especially those living in poverty, getting emotional support may feel like a luxury they simply can’t afford.
Postpartum depression is treatable and recovery is possible. With the right support, most mothers begin to feel like themselves again. Treatment often depends on how severe the symptoms are and what’s available locally.
Here are the most common and some emerging treatment options:
This is usually the first-line treatment for mild to moderate postpartum depression. Talking with a trained therapist gives mothers a safe space to express how they feel, work through negative thoughts and learn new ways to cope.
Two types of therapy that work well are:
Even a few sessions can make a big difference. In areas with limited access to trained therapists, community health workers or peer support groups can offer basic counselling support.
For moderate to severe depression or when therapy alone isn’t enough, antidepressants may be recommended. These help balance mood-related chemicals in the brain.
Some antidepressants are safe to use while breastfeeding but it’s important to get proper medical advice to find the right type and dosage. Medication often works best when combined with therapy or emotional support.
A newer treatment option, mainly used in high-resource settings, is neurosteroid therapy, specifically a drug called brexanolone. This medication is given through an intravenous fluid in the hospital for about 2½ days. It works by calming certain brain pathways affected by hormonal changes after childbirth.
While it’s a promising option for severe postpartum depression, it’s costly, not widely available and currently out of reach for many women in Africa. Still, it signals progress in how seriously maternal mental health is being taken.
In addition to professional care, certain lifestyle based approaches can help improve mood and mental wellbeing, especially when used alongside therapy or medication. These include:
These lifestyle changes may seem small, but they can have a big impact when done consistently.
Recovery from postpartum depression isn’t just about doctors or medications, it’s also about support systems. “Women experiencing these symptoms should speak to trusted family and friends. Connecting with other women in support groups who are going through similar challenges can be beneficial as well”, concludes Dr Ezeike.
Postpartum depression isn’t a foreign issue, it’s also an African problem. It lives silently in our homes, in our clinics, in our communities. Many new African mothers carry the weight of this invisible struggle while caring for their babies, managing households and trying to meet everyone’s expectations. But postpartum depression is not a weakness and it is never the mother’s fault.
Mothers deserve more than survival after childbirth. They deserve support, healing and peace of mind and the earlier conversations occur about postpartum depression, the sooner the shame and silence around it can be broken.
If you’re a mother reading this and these words sound familiar, please know you’re not alone. Talk to someone you trust. Speak to a health worker at your local clinic because you deserve to be heard and helped.
If you’re a partner, friend, sister or neighbour, you can be part of the solution. You don’t need special training but you need awareness, education and basic skill to care about PPD, to be present, patient and compassionate in caring for your loved one. Ask how she’s really feeling, help with the baby, listen without judging, because behind every newborn is a mother who also needs healing.
Source: Carlson K, Mughal S, Azhar Y, et al. Perinatal Depression. [Updated 2025 Jan 22]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2025 Jan. Available from here
Published: August 5, 2025
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