Psychosocial and maternal care needs of recently delivered women during the postpartum period

Abstract

This qualitative study was conducted at a family health center in Istanbul, Turkey, and aimed to explore the psychosocial and maternal care needs and emotional experiences of women during the first six weeks postpartum. Women who could understand the local language were included in the study. Among the participants, 80% were local Turkish women and 20% were migrant women. A total of 10 women were selected through purposive sampling. Descriptive content analysis revealed four main themes: (1) Causes of stress, (2) Expression and interpretation of stress, (3) Sources of support, and (4) Areas of support. The findings highlight the crucial role of social support in addressing the psychosocial needs of postpartum women and promoting maternal and newborn well-being.

Introductıon

The postpartum period is one of the most critical and sensitive phases in a woman’s life [13]. Following childbirth, women experience profound physiological and emotional changes, along with the responsibility of caring for a newborn, which initiates a transformative process. This period involves both physical and emotional restructuring.

While mothers physically recover, they also face various emotional challenges such as hormonal fluctuations, fatigue, and anxiety [4]. These factors increase the risk of postpartum depression, one of the most common complications during this period [5, 14]. Symptoms may include loss of interest in daily activities, low mood, sleep disturbances, irritability, feelings of inadequacy, and even suicidal ideation [1].

Social support plays a vital role in alleviating both physical and emotional burdens during the postpartum period. Adequate support helps mothers better care for themselves and their newborns, reduces the risk of depression, anxiety, and stress, and promotes overall maternal and infant health outcomes [20].

In addition to physical recovery, newly delivered women often experience complex emotional processes and stress factors influenced by family dynamics, spousal support, and social conditions. Meeting the psychosocial and care needs of women during this period is essential for their well-being and successful maternal role adaptation.

This study aimed to explore the psychosocial and maternal care needs as well as the emotional experiences of recently delivered women during the postpartum period and to examine the types of support and resources available to meet these needs. In this study, ‘recently delivered women’ refers to women who had given birth within the first six weeks postpartum, including both primiparous and multiparous mothers.

Research Question

What are the psychosocial and maternal care needs and emotional experiences of women within the first six weeks postpartum?

Materials and methods

This study was conducted using a qualitative design to gain in-depth insights into the postpartum experiences and care needs of women. Descriptive statistics were used to summarize the sociodemographic characteristics of the participants (Creswell & Clark, 2015).

Data were collected using a researcher-developed interview form consisting of two parts. The first part included descriptive questions about participants’ sociodemographic characteristics such as age, marital status, and number of children. The second part contained open-ended questions designed to explore the participants’ postpartum care needs and psychosocial experiences. Example questions included: “Can you describe the main challenges you faced after childbirth?“, “What kind of support did you receive during the postpartum period?“, and “How did you feel emotionally in the weeks following childbirth?

The qualitative dimension was guided by an interpretive paradigm, which focuses on understanding phenomena in depth rather than achieving statistical generalizability (Kümbetoğlu B: A study on research paradigms and literature analysis in Turkish social sciences, unpublished) [11, 19]. Therefore, interviews continued until data saturation was reached.

All interviews were conducted face-to-face in a private room at a family health center, ensuring a comfortable and confidential environment for participants. Interviews were carried out between May and July 2024 and lasted approximately 30 to 45 min. All interviews were audio-recorded with the participants’ consent. Transcriptions were completed immediately after each interview and verified by the participants for accuracy.

The qualitative data were analyzed using an inductive content analysis approach. First, the transcripts were read several times to obtain an overall understanding. Initial codes were identified, and similar codes were grouped into categories. These categories were then organized into main themes and sub-themes. To ensure the credibility and reliability of the findings, two researchers independently coded the data, and discrepancies were discussed until a consensus was reached. Participant confirmation (member checking) was also used to enhance the trustworthiness of the study. Detailed descriptions and direct quotations were provided to support transferability. An audit trail was maintained throughout the research process to ensure dependability and confirmability.

The study was carried out with postpartum women aged 18–49 in two district health directorates in Turkey. A purposive sampling method was employed to select participants who met the inclusion criteria and could provide in-depth information regarding their postpartum experiences. The sample size was determined based on the principle of data saturation, whereby interviews were conducted until no new information or themes emerged. In total, 10 women participated in the study.

Participants were approached during their routine visits to the family health center. They were provided with both written and verbal information about the study, including its purpose, confidentiality, and voluntary nature. All participants gave written informed consent and were informed of their right to withdraw from the interview at any point without any consequences.

Inclusion criteria

• Being between 18 and 49 years of age.

• Being within the first six weeks postpartum.

• Being able to speak and understand Turkish.

• Having no officially diagnosed mental health condition.

• Providing informed consent and voluntarily participating in the study.

Exclusion criteria

• Presence of a documented mental health condition.

Data Collection

sixth weeks postpartum, a researcher-administered form was applied to randomly selected participants via face-to-face interviews. After data collection was completed, the analysis phase was initiated.

Data analysis

• Qualitative data were analyzed using inductive content analysis based on the transcribed interviews.

• Descriptive quantitative data were analyzed using SPSS version 22.0.

Results

This study included a total of 10 women who were within the first six weeks postpartum. Participants ranged in age from 25 to 41 years, with a mean age of 31.10 ± 4.84. The age of their spouses ranged from 29 to 45, with a mean of 34.10 ± 5.15. The duration of marriage varied between 2 and 15 years, with an average of 7.50 ± 4.50 years. Among the participants, 80% were Turkish citizens and 20% were migrant women from Syria. All participants were able to speak and understand the local language (Turkish) (Tables 1 and 2).

Table 1.

Sociodemographic characteristics of the participants

	N	Minimum	Maximum	Mean	Std. Deviation
Age	10	25	41	31,10	4,841
Spouse’s age	10	29	45	34,10	5,152
Duration of marriage	10	2	15	7,50	4,503
Total	10

Table 2.

Themes and codes identified through thematic analysis of postpartum women's experiences

Themes and Codes
Causes of Stress	- Spouse - Family - Inability to care for my other children - Responsibilities of baby care - Jealousy of the other children - Being a migrant-
Expression and Interpretation of Stress	- Hatred - Helplessness - Anger - Nervous breakdown - Loneliness - Inadequacy - Guilt-
Sources of Support	- My spouse was the most supportive person - No one - My mother was the most supportive person-
Areas of Support	- I want to take care of my other children - Self-care needs - Sleep - I want to feel like a family - They should help my spouse - Baby care

Theme 1: Causes of Stress

The first month following childbirth is often a physically and emotionally intense period for mothers. In addition to physical recovery, psychological adaptation and the need for attentive care of the newborn contribute to maternal stress. Hormonal changes, concerns about the infant’s health, being in a foreign country, interference in nuclear family dynamics under the guise of social support, and the lack of sufficient and consistent support are among the key sources of stress reported by participants:

• “I had crying spells because of my husband. This child is not just mine! (Angrily) He doesn’t even care. I feel alone.” (Participant 1).

• “My mother-in-law interfering in everything was honestly my biggest source of stress. This is my second child. Her making decisions without respecting me even caused me to have breakdowns. She’s not here to help but to control. She interferes in everything, including my private time with my husband. She doesn’t let us have time alone.” (Participant 9).

• “This is our second baby. We also have a four-year-old son. I don’t even remember the last time I held him with affection. I feel inadequate. After I finish caring for the baby, I have to cook dinner or clean before my husband comes home. I can handle the baby, but my older son doesn’t get motherly affection. I can’t give him the attention he needs. I feel guilty.” (Participant 5).

• “I’m terrified that my other kids will get jealous and hurt the baby. I’m constantly tearful or having anger outbursts. This is our fourth baby, and this time there’s no one to help. I’m alone. My days and nights have blended together for a month—I can’t sleep. These should be the happiest days, but I only feel sadness.” (Participant 4).

• “There are too many people in the house—my children, my in-laws, my sister-in-law. It’s crowded. Sometimes I cry at night. So many children, and in a foreign country—it’s scary. Being a migrant is very hard. I think about my children all the time. The house is constantly full. I’m always cleaning and organizing, but I can’t take it anymore. Sometimes I think about dying. I keep going for my children.” (Participant 10).

Theme 2: Expression and Interpretation of Stress

Motherhood is a turning point in a woman’s life, marked by intense physical and emotional changes. Although it brings joy, it also introduces significant emotional challenges such as feelings of inadequacy, loneliness, helplessness, hatred, prolonged tension, and guilt:

• “Hatred. I think I hate my husband. I wish I could leave everything and just go.” (Participant 1).

• “The strongest emotion I’ve felt in the past month is helplessness. I wish I were in my own country and unmarried. If my mother were alive, maybe I wouldn’t have married and would have continued studying. We came here from Syria. As women, we are undervalued in many parts of the world. In my country, I was treated like a commodity. Childbirth is seen as the most valuable thing a woman can do.” (Participant 10).

• “Anger and constant tension—those are the words I would use. I have no patience left for anything…” (Participant 3).

• “Guilt. Not being able to be with my other children.” (Participant 8).

• “The most dominant feeling is inadequacy. I know I’m not a bad mother, but I can’t keep up with anything. If someone came to help, maybe I could also spend time with my older son.” (Participant 5).

• “Loneliness is the strongest feeling. If my mother hadn’t died, I wouldn’t be alone. I wish she were here with me.” (Participant 4).

Theme 3: Sources of Support

Mothers who have recently given birth need physical, emotional, and social support during this challenging time. The early weeks of a newborn’s life require constant attention and regular care, making this a period of heightened stress and anxiety for mothers. The support provided by spouses, mothers, or others in the social circle plays a critical role in the mother’s well-being and the healthy development of the infant. Many mothers expressed a strong desire for spousal support, which, when present consistently and actively, made them feel safer and more supported:

• “Despite my anger at him, the most supportive person has been my husband. After work, he tries to help secretly without his family knowing. If his parents see him helping, they scold him. They expect me to do everything. I feel like their servant.” (Participant 10).

• “My husband is my biggest support. He is everything to me. He tries to be there for every moment. The minute he gets home from work, he tries to do things to make me feel better without taking a break. I wouldn’t have survived without him.” (Participant 6).

Family members, especially experienced figures like grandmothers, can help alleviate the physical and emotional burden on new mothers. Their prior experience and emotional support positively contribute to the well-being of both mother and baby:

• “My mother is the only one who supports me when she visits. I wish I could feel affection from my husband, to know that he’s there for me… My mother is currently staying with us. She’s the one taking care of my other child. Without her, I could have fallen into depression.” (Participant 1).

• “I think the most supportive person during this period has been my own mother. There’s no one like your own mom. My husband tries to help—but only when my mother-in-law allows it, of course.” (Participant 3).

While new mothers often experience joy from motherhood, they also go through a stressful adjustment period. Sleep deprivation, physical recovery, and helping the newborn adapt to life outside the womb create ongoing challenges. A lack of social support can negatively impact maternal mental health and increase the risk of postpartum depression and anxiety. Additionally, insufficient support can lead mothers to feel inadequate, which may harm the bonding process with their babies:

• “What a good question. My only answer is: no one!!! (Angrily and tearfully) No one at all. When my husband comes home from work, he just says he’s tired and falls asleep in front of the TV. He was the one who wanted this baby the most. Since giving birth, I’ve only had a few minutes of alone time while showering.” (Participant 2).

• “The real question should be: Is there anyone who supports you? (With a bitter smile) There is no one. I don’t love my husband. I married without love. He doesn’t love me either. He doesn’t support me. We’re two strangers sharing a home. He brings money and does the shopping. He doesn’t let me go hungry—but that’s all. I don’t even think he loves our daughter. He doesn’t help.” (Participant 7).

Theme 4: Areas of Support

While motherhood brings great joy, it also involves significant physical and emotional demands. Newborns often require frequent feeding and care, which results in fragmented sleep for mothers. During this time, mothers may neglect personal care and other needs. Without assistance, this situation leads to increased maternal stress:

• “I just want to sleep… I want to sleep for hours. My needs are actually very simple—taking a bath, eating calmly… I wish I could. But I feel like a worker brought in just for housework. I don’t feel like I matter.” (Participant 1).

• “I wish I had more time to sleep and care for all my children. The baby takes up all my time. There’s no time left for either my other children or myself. I can’t take it anymore… I’ve been putting off personal care for a long time.” (Participant 4).

• “I haven’t slept in days. I can barely find time to shower. My husband says I smell sometimes. But I just don’t have the time…” (Participant 7).

The burden of caring for a new baby is already significant, but having additional children can make the process even more difficult. Breastfeeding, maintaining hygiene, and caring for other children require constant attention, which often results in mothers feeling overwhelmed, guilty, and stressed:

• “I wish I could spend time with my other children and enjoy a proper meal. I eat in three minutes or just grab bites while standing. No one helps me. I feel like I’m alone in this big world with two children. The feeling of inadequacy is awful.” (Participant 5).

• “I really want to be more involved with my other children. Just feeding them and leaving them aside makes me feel so guilty.” (Participant 2).

Discussion

The postpartum period is a challenging and complex phase for mothers, encompassing significant physical and psychosocial changes. During this time, women face hormonal fluctuations, sleep disturbances, and the responsibilities associated with adapting to the new role of motherhood. Our study highlights the multifaceted nature of postpartum stressors, emotional responses, sources of support, and areas of care needs experienced by postpartum women. The considerable stress experienced by participants appears to stem from both structural and cultural factors. Migrant women described feelings of isolation, displacement, and fear associated with living in a foreign country, reflecting the psychosocial burden of migration. However, even among Turkish participants, stress was often linked to limited support, traditional gender roles, and expectations related to motherhood. These findings, derived from a small sample of women in Turkey, indicate that patriarchal family structures and gendered caregiving norms contribute significantly to postpartum stress among both migrant and non-migrant women.

Participants identified inadequate spousal and family support, the burden of caring for multiple children, and experiences related to migration as primary sources of stress. Furthermore, differences in postpartum experiences between primiparous and multiparous women emerged in participants’ narratives, although this study did not conduct a formal comparative analysis. Primiparous women frequently expressed emotional fragility, uncertainty, and feelings of loneliness as they navigated motherhood for the first time. In contrast, multiparous participants often described overwhelming caregiving responsibilities, divided attention among children, and associated guilt. These findings highlight the need for differentiated postpartum support strategies that consider parity-specific challenges. These findings align with existing literature emphasizing the critical role of social support in mitigating postpartum depression and anxiety [16, 17]. Migrant women, in particular, face unique challenges such as sociocultural isolation and language barriers, which intensify feelings of loneliness and exclusion, adversely affecting their psychosocial well-being (Lugina, Christensson & Massawe [10]),. Furthermore, excessive interference or lack of support within the family exacerbates maternal stress, increasing the risk of psychiatric conditions [3]. The difficulty mothers face in balancing attention among their children and the resultant guilt further complicate their psychological health [8].

Emotional expressions reported by participants—such as loneliness, helplessness, guilt, anger, and inadequacy—mirror common symptoms of postpartum depression and anxiety described in the literature [2, 5]. Robertson et al. [14] noted that these emotional challenges can impede a mother’s ability to care for herself and her infant. The intensity of these psychological struggles observed in our study corresponds with previously documented psychosocial difficulties during the postpartum period [4]. Feelings of guilt, especially related to the inability to divide attention equally among children and lack of personal time, may undermine mother-infant bonding [4]. Emotional exhaustion and outbursts of anger can also disrupt social relationships and lead to social isolation, marking significant psychosocial risks that require intervention.

Social support was found to be a pivotal factor in safeguarding maternal mental health. Participants emphasized the critical role of their spouses and family members in providing emotional and practical support. This is consistent with numerous studies illustrating the positive influence of social support on maternal psychological well-being and infant development [15, 20]. Conversely, lack of such support heightened feelings of loneliness and despair, elevating risks of depression and anxiety [18]. Inadequate spousal support was strongly linked to marital dissatisfaction and family conflicts, which negatively impacted maternal psychosocial health [3, 6]. Therefore, postpartum care programs must incorporate approaches that engage families and bolster social support networks.

In addition to infant care, mothers’ needs for personal care and rest were pronounced. Participants reported sleep deprivation, compromised personal hygiene, and insufficient time to attend to other children, which adversely affected their physical and psychological health, contributing to burnout [8, 9]. Such conditions may weaken mother-infant relationships and reduce overall well-being. Effective postpartum care programs should therefore address mothers’ individual care and rest needs to mitigate these negative effects [15].

Social and cultural factors such as migration add further complexity to postpartum psychosocial health. Migrant women’s struggles with cultural adaptation, language barriers, and limited access to support systems place them at increased risk during the postpartum period [7, 12]. This underscores the need for culturally sensitive and socioeconomically informed postpartum support interventions.

Health professionals and policymakers should design postpartum care services that are responsive not only to individual needs but also to familial, societal, and cultural contexts. Comprehensive, multi-dimensional strategies that include educating spouses and family members, strengthening social support networks, and fostering psychosocial well-being are essential to improve postpartum outcomes.

Conclusion

This study provides detailed insights into the psychosocial and maternal care needs of women during the first six weeks postpartum. Our findings demonstrate that stress is a significant and pervasive theme affecting women’s postpartum experiences. Participants frequently reported inadequate social support, especially from spouses and family members, which intensified feelings of loneliness, helplessness, and guilt. The responsibility of caring for multiple children alongside a newborn further contributed to maternal stress.

Moreover, migrant women faced unique challenges, including cultural adaptation difficulties and social isolation, which exacerbated their psychosocial burdens. The insufficiency of support systems negatively impacted maternal mental health and the mother-infant bonding process. These results underscore the critical need for comprehensive social and emotional support to improve postpartum outcomes.

Recommendations

Based on these findings, we recommend the following actions to enhance postpartum care.

1. Strengthening Social Support Networks: Health programs should actively involve spouses and family members, educating them on the importance of emotional and practical support during the postpartum period.

2. Tailored Support for Migrant Women: Develop culturally sensitive and linguistically appropriate services to address the unique challenges faced by migrant postpartum women.

3. Holistic Postpartum Care Programs: Implement multi-dimensional interventions that address both psychological and practical needs, including managing care responsibilities for multiple children and ensuring mothers’ self-care and rest.

4. Community Engagement: Foster community awareness and create support groups to reduce social isolation and promote shared caregiving responsibilities.

5. Future Research: Conduct larger-scale studies with diverse populations to further understand postpartum needs and refine care strategies.

Limitations

This study has several limitations inherent to qualitative research. First, the sample size was limited to ten participants, which restricts the generalizability of the findings. However, the primary aim of the study was to obtain in-depth narratives rather than statistical representation, and data collection continued until saturation was reached. Second, although the inclusion criteria covered women aged 18 to 49, the actual participant ages ranged from 25 to 41. As such, the experiences of adolescent mothers and women of advanced maternal age are not represented in the findings. Future research should consider age-stratified sampling to explore how maternal age may influence postpartum psychosocial needs. Additionally, while the study included both Turkish and migrant women, the migrant group was limited to two participants. This may have constrained the diversity of migrant perspectives, and further studies with larger and more varied migrant samples are recommended.

Authors’ contributions

All authors contributed equally to the design, implementation, data analysis, and writing of the manuscript.

Funding

This research received no specific grant from any funding agency in the public, commercial, or not-for-profit sectors.

Data availability

No datasets were generated or analysed during the current study.

Declarations

Ethics approval and consent to participate

This study was approved by the Non-Interventional Clinical Research Ethics Committee of a foundation university (Approval No: 398, Date: April 18, 2024). The study was conducted in accordance with the Declaration of Helsinki. Written informed consent was obtained from all participants prior to their inclusion in the study.

The study received no external funding, and all expenses were covered by the researchers. Ethical approval for the study was obtained from the Non-Interventional Clinical Research Ethics Committee of a foundation university, under decision number 398, dated April 18, 2024.

Consent for publication

Not applicable. All data presented in the study were anonymized, and no identifiable personal information was published.

Competing interests

The authors declare no competing interests.