Beyond childbirth: hidden determinants of postpartum depression among mothers attending an immunization clinic at a tertiary healthcare center in Nagpur city

Authors

  • Priyanka Singh Department of Community Medicine, Government Medical College, Nagpur, Maharashtra, India
  • Ujwala Ukey Department of Community Medicine, Government Medical College, Nagpur, Maharashtra, India
  • Jyotsna Deshmukh Department of Community Medicine, Government Medical College, Nagpur, Maharashtra, India
  • Pratik Padyal Department of Community Medicine, Hinduhrudaysamrat Balasaheb Thackarey Medical College and Dr. Rustom Narsi Coopper Municipal General Hospital, Mumbai, Maharashtra, India

DOI:

https://doi.org/10.18203/2394-6040.ijcmph20262745

Keywords:

Edinburgh postnatal depression scale, Postpartum depression

Abstract

Background: Postpartum depression (PPD) is a common mental health disorder affecting women during the postnatal period and has adverse consequences for both maternal and child health. Despite its public health importance, routine screening remains limited in many healthcare settings. Immunization clinics provide an opportunity for early identification of mothers at risk. This study aimed to estimate the prevalence of postpartum depression and identify its associated determinants among postnatal mothers attending an immunization clinic in a tertiary healthcare centre in Central India.

Methods: A hospital-based cross-sectional study was conducted among 143 postnatal mothers attending the immunization clinic of a government medical college in Nagpur, Central India, from January to March 2026. Participants were selected using convenience sampling. Data were collected through face-to-face interviews using a pretested structured questionnaire covering sociodemographic, obstetric, psychosocial and environmental factors. Postpartum depression was assessed using the edinburgh postnatal depression scale (EPDS), with a score of ≥10 indicating probable depression. Data were analysed using Epi Info software. Associations were assessed using the Chi-square test, with p<0.05 considered statistically significant.

Results: The prevalence of postpartum depression was 12.59% (18/143). Maternal age, education, occupation, family type, socioeconomic status, previous history of depression, family history of psychiatric disorders, domestic violence and husband’s support for childcare were not significantly associated with PPD (p>0.05). Significant associations were observed with chronic illness (p=0.025), lack of support from other family members for childcare (p=0.009), stressful family events such as death or serious illness (p=0.001), financial crisis (p=0.049) and breastfeeding challenges (p<0.001), the latter showing the strongest association with postpartum depression.

Conclusions: Approximately one in eight postnatal mothers experienced postpartum depression. Routine screening using the EPDS at immunization clinics, along with targeted psychosocial support and breastfeeding counselling, may facilitate early identification and management of mothers at risk, thereby improving maternal and child health outcomes.

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Published

2026-07-31

How to Cite

Singh, P., Ukey, U., Deshmukh, J., & Padyal, P. (2026). Beyond childbirth: hidden determinants of postpartum depression among mothers attending an immunization clinic at a tertiary healthcare center in Nagpur city. International Journal Of Community Medicine And Public Health, 13(8), 4570–4576. https://doi.org/10.18203/2394-6040.ijcmph20262745

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Original Research Articles