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. 2023 Aug;8(8):e011705.
doi: 10.1136/bmjgh-2023-011705.

Mistreatment of women during childbirth and postpartum depression: secondary analysis of WHO community survey across four countries

Chris Guure  1   2 , Philomina Akandity Aviisah  3 , Kwame Adu-Bonsaffoh  4 , Hedieh Mehrtash  5 , Adeniyi Kolade Aderoba  6   7 , Theresa Azonima Irinyenikan  8 , Mamadou Dioulde Balde  9 , Olusoji Adeyanju  10 , Thae Maung Maung  11 , Özge Tunçalp  5 , Ernest Maya  12
Affiliations

Mistreatment of women during childbirth and postpartum depression: secondary analysis of WHO community survey across four countries

Chris Guure et al. BMJ Glob Health. 2023 Aug.

Abstract

Background: Postpartum depression (PPD) is a leading cause of disability globally with estimated prevalence of approximately 20% in low-income and middle-income countries. This study aims to determine the prevalence and factors associated with PPD following mistreatment during facility-based childbirth.

Method: This secondary analysis used data from the community survey of postpartum women in Ghana, Guinea, Myanmar and Nigeria for the WHO study, 'How women are treated during facility-based childbirth'. PPD was defined using the Patient Health Questionnaire (PHQ-9) tool. Inferential analyses were done using the generalised ordered partial proportional odds model.

Results: Of the 2672 women, 39.0% (n=1041) developed PPD. 42.2% and 5.2% of mistreated women developed minimal/mild PPD and moderate/severe PPD, respectively. 43.0% and 50.6% of women who experienced verbal abuse and stigma/discrimination, respectively developed minimal/mild PPD. 46.3% of women who experienced physical abuse developed minimal/mild PPD while 7.6% of women who experienced stigma/discrimination developed moderate/severe PPD. In the adjusted model, women who were physically abused, verbally abused and stigma/discrimination compared with those who were not were more likely to experience any form of PPD ((OR: 1.57 (95% CI 1.19 to 2.06)), (OR: 1.42 (95% CI 1.18 to 1.69)) and (OR: 1.69 (95% CI 1.03 to 2.78))), respectively. Being single and having higher education were associated with reduced odds of experiencing PPD.

Conclusion: PPD was significantly prevalent among women who experienced mistreatment during childbirth. Women who were single, and had higher education had lower odds of PPD. Countries should implement women-centred policies and programmes to reduce mistreatment of women and improve women's postnatal experiences.

Keywords: Community-based survey; Maternal health; Mental Health & Psychiatry.

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Conflict of interest statement

Competing interests: None declared.

Figures

Figure 1
Figure 1
Predictive probability of physical abuse and postpartum depression.
Figure 2
Figure 2
Predictive probability of verbal abuse and postpartum depression.
Figure 3
Figure 3
Predictive probability of stigmatisation and postpartum depression.
See this image and copyright information in PMC

References

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