Postpartum Pain: Why Maternal Mental Health Is Failing in West Africa

By Azeezat Modesola Abereijo

Social media often portrays motherhood as pure bliss, but the reality for many women is far from this ideal. In West Africa, thousands of women silently suffer from postpartum depression, anxiety, and psychosis, conditions that are often misunderstood and dismissed by the public health system.

Maternal mental health remains one of the most underfunded and under-researched areas globally, and West Africa is a significant part of this crisis. Cultural stigma, gaps in healthcare, and weak policy responses contribute to the burden faced by mothers in the region.

Silent Crisis

The World Health Organization (WHO) reports that 1 in 5 women worldwide experiences maternal mental health disorders, with rates higher in Sub-Saharan Africa. In the region, up to 25% of mothers may experience postpartum depression (PPD), which can last over six months. In Africa, approximately 18% of new mothers suffer from depression, with varying rates across countries. In Nigeria, studies show PPD prevalence ranging from 10.7% to 44.5%, depending on the region.

PPD is the most common maternal mental health disorder, but postpartum psychosis, though rare, affects 1 in 1,000 mothers. Despite these alarming statistics, maternal mental health remains neglected, overshadowed by physical health concerns.

Mental Health Disparities Among Mothers in Osun and Kwara

In Nigeria, regional disparities in maternal mental health care are evident. In Osun State, cultural norms delay medical intervention, with many women relying on traditional caregivers who dismiss mental health symptoms. In contrast, Kwara State has made strides by integrating mental health services into primary healthcare, though these services are mostly limited to urban areas.

Cultural stigma remains a significant barrier. Mothers are often expected to suppress personal struggles, leading to silent suffering. The lack of trained mental health professionals, with fewer than 300 psychiatrists for over 200 million Nigerians, exacerbates the crisis. Ghana faces a similar challenge, with just 20 psychiatrists per 1 million people.

Consequences

Untreated maternal mental health disorders can have far-reaching consequences. Children of depressed mothers are more likely to face developmental and behavioral issues, perpetuating cycles of disadvantage.

Marital relationships often suffer, leading to conflicts and family breakdowns. The economic cost of untreated mental health disorders is also staggering, with lost productivity exceeding $1 trillion globally each year. In West Africa, these costs strain already fragile economies.

Existing Interventions: What’s Working?

Despite the challenges, some promising interventions are emerging:

1. Community-Based Models: Programs like Zimbabwe’s Friendship Bench, which trains lay health workers to deliver problem-solving therapy, could be adapted for rural Nigerian communities.
2. Digital Innovations: Ghana’s mHealth programs, which use SMS for health education, could be expanded to address maternal mental health. Similarly, Nigeria could develop platforms like Hello Mama and integrate tools like the MomMoodBooster app for cognitive behavioral therapy.
3. Policy Efforts: Ghana’s 2012 Mental Health Act provides a framework for mental health integration, though its implementation has been slow.

Recommendations

To address the maternal mental health crisis in West Africa, key steps include:

1. Awareness Campaigns: Governments, NGOs, and the media must work to reduce stigma and normalize seeking help.
2. Integrated Healthcare: Mental health services should be integrated into antenatal and postnatal care, with community health workers trained to screen for depression.
3. Sustainable Funding: Governments must allocate funds for maternal mental health, with support from NGOs and the private sector.
4. Digital Tools: Expanding telehealth and mobile apps can help reach rural areas.
5. Policy Implementation: Existing mental health policies must be fully enacted and monitored.