0
0
India witnesses more than 25 million births each year, yet a significant number of women experiencing mental health challenges during pregnancy and the first year postpartum remain undiagnosed and untreated, particularly in rural regions, according to recent expert consensus presented at a national consultation on perinatal mental health. Deep-rooted social norms, including male child preference and gender inequities, exacerbate the problem by restricting women’s autonomy and contributing to mental health risks such as depression, psychosis, and even maternal suicide during the perinatal period.
Key Findings and Expert Insights
Perinatal mental health, defined as mental health during pregnancy and up to one year after birth, affects a substantial proportion of Indian women. A systematic review cited at the event revealed community-based studies reporting perinatal depression rates ranging from 14% to 24%, with meta-analyses estimating a pooled prevalence of approximately 22% for postpartum depression. Despite India’s maternal mortality ratio reducing by over 50% since the early 2000s—to 97 deaths per 100,000 live births—maternal suicide is emerging as an increasing cause of maternal deaths, signaling a critical gap in mental health care for mothers.
Prof. Pallab Maulik, Director of Research at The George Institute for Global Health India, emphasized, “Perinatal mental health is a major concern in India with a large number of women undiagnosed and untreated. This not only affects the mother but also the baby’s health and family wellbeing.” Dr. Nicole Votruba, Principal Investigator from the University of Oxford, highlighted the profound influence of social determinants such as poverty, domestic violence, and child sex preference on mental health outcomes. She noted, “Supporting women in both mental health and social challenges is essential for fostering healthier families and stronger societies.”
The PRAMH Project and Its Implications
The Perinatal Mental Health (PRAMH) Project, led by The George Institute in collaboration with the University of Oxford and supported by the UK Medical Research Council, aims to integrate maternal mental health into routine care by overcoming barriers including stigma, gender inequity, poverty, and domestic violence. Phase 2 of the project tested scalable and culturally sensitive intervention models in states such as Telangana and Haryana, working toward ensuring timely support for mothers in rural communities.
Dr. Y.K. Sandhya, Program Lead for Mental Health at The George Institute, cautioned against isolating perinatal mental health from general antenatal and postnatal care, warning that such separation could increase stigma. Instead, she recommended embedding mental health screening and support within routine maternity care to improve sustainability and reach.
Contextual Background and Social Challenges
India’s social fabric poses unique challenges to perinatal mental health. Persistent male child preference and related stigma against the birth of girls or children with disabilities contribute to domestic violence and psychological distress. Such pressures, layered with poverty and limited access to mental health services, create an environment where women often suffer silently. In Kerala, maternal suicide accounted for nearly 20% of maternal deaths in 2020, underscoring the urgent need for targeted interventions.
The experts underscored the importance of involving community leaders, religious figures, local politicians, and frontline health workers such as Accredited Social Health Activists (ASHAs) to break harmful traditions and build awareness. Capacity building through training and orientation programs targeted at men, employers, and family members was advocated as critical for shifting the social narrative.
Public Health Implications and Recommendations
Addressing perinatal mental health requires systemic changes including robust institutional support, clear screening protocols, effective referral pathways, and accessible counseling services for women and their families. The establishment of childcare facilities such as crèches was also highlighted as a crucial support mechanism for mothers balancing childcare and other responsibilities.
Though mental health is acknowledged in some national policies, experts stressed the lack of a dedicated national program or systematic screening for perinatal mental health, calling for its urgent integration into maternal health initiatives. Prioritizing both mental health and its social determinants could reduce maternal mortality, improve child health, and strengthen family wellbeing in India.
Limitations and Balanced Perspective
While the PRAMH study offers promising interventions, the experts note challenges including stigma that discourages women from seeking help, the need for culturally appropriate care models, and resource constraints in rural health systems. Ongoing research and community engagement remain essential to refine approaches and ensure equitable mental health access.
Practical Takeaway for Readers
For expecting or new mothers and their families, understanding that perinatal mental health problems are common and treatable is vital. Recognizing symptoms such as persistent sadness, anxiety, or mood swings and seeking timely support can improve outcomes for both mother and child. Families, communities, and healthcare providers must work collaboratively to create supportive environments that respect women’s autonomy and mental wellbeing.
Medical Disclaimer: This article is for informational purposes only and should not be considered medical advice. Always consult with qualified healthcare professionals before making any health-related decisions or changes to your treatment plan. The information presented here is based on current research and expert opinions, which may evolve as new evidence emerges.
References:
- https://ianslive.in/why-integrating-perinatal-mental-health-in-national-programmes-is-important–20250922175504#:~:text=%E2%80%9CIt%20is%20critical%20to%20ensure,and%20lactating%20women%20receive%2C%20thus
