Abstract
Objectives
The purpose of this study was to look at the prevalence and risk factors for postpartum depression among Pakistani women.
Methods
A cross-sectional study was conducted on 400 women who gave birth within the past three weeks to one year. The time frame for data collection was from December 2023 to April 2024, from different hospitals in Punjab, Pakistan. There were 5 sections in the questionnaire, Section 1 aimed at assessing the socio-demographic characteristics of the participants, Section 2 contained 3 questions about pregnancy and postpartum experience, Section 3 contained 10 questions about postpartum depression screening, Section 4 contained 12 questions related to risk factors and Section 5 contained 10 questions of Edinburgh Postnatal Depression Scale (EPDS). Statistical test, i.e. binary logistic regression, was employed to investigate associations between the dependent and independent variables. A significance level of p ≤ 0.05 was adopted to determine statistically significant findings. The research was carried out after approval from the University`s Research and Ethics Committee.
Results
According to the Edinburgh postnatal depression scale (EPDS), the incidence of postpartum depression in the current study population was 12.5%. We found that the education of respondents was significantly associated with an increased frequency of postpartum depression. (p = 0.002). Further, in women having a family history of mental disorders, unplanned or unwanted pregnancies, complications during pregnancy, unsatisfying relationships, and previous anxiety symptoms, the chances of postpartum depression were higher (p < 0.05).
Conclusion
The postnatal period is when women are most vulnerable to developing postpartum mental diseases, including postpartum depression and psychosis. Because there is a strong link between the prevalence of postpartum depression and particular psychosocial variables, healthcare practitioners must pay close attention to this issue and design strategies for the effective detection and management of individuals with this condition.
Supplementary Information
The online version contains supplementary material available at 10.1007/s44192-025-00225-2.
Introduction
Postpartum depression (PPD) is a moderate to severe kind of depression that is a cause of psychological health disorders among females. It arises during antepartum or the initial four weeks after delivery and may remain up to a year [1, 2]. It considerably upsets the infant-mother bond, leading to child avoidance, and emotional or physical child mistreatment. According to subsequent studies, if postpartum depression is not treated, mothers suffer from weight issues, substance misuse, marital problems, and breastfeeding problems afterward in life [3]. According to recent literature, postpartum depression is highly prevalent, 28 to 63 percent in Asia, Pakistan. [4]Three categories have been listed for postpartum depressive disorders 1. Maternity blues, 2. non-psychotic postpartum depression and 3. Puerperal psychosis.
Maternity blues affect 50% to 80% of new mothers and are regarded as a very moderate, self-limiting condition of emotional sensitivity [5, 6] are 10% to 15% of women of reproductive age experience postpartum non-psychotic depression, making it the most common severe mood illness; hence, postpartum non-psychotic depression is a significant health issue [7–9]Postpartum psychosis, with 1–2 episodes per 1000 births, is the most severe and infrequent type of postnatal depressive illness [10]. It should be treated as a mental health and obstetric emergency because of its abrupt and severe onset [11]. Each year, around 13% of women experience postpartum depression, [12, 13] but alarmingly, almost half of these cases go unnoticed and undiagnosed, highlighting the need for increased awareness and screening to ensure timely support and treatment for affected mothers [14]. Evidence suggests that developing countries like Pakistan face a much higher burden, [15, 16] attributed to factors such as poverty, increased stress, and inadequate social support.
PPDs have a complicated etiology that involves biological, psychological, and social variables, as well as the role of hereditary and environmental factors in risk [17]. Negative life events during pregnancy and delivery, history of sexual abuse, vulnerable personality traits, social isolation, and an unsupportive spouse appear to enhance the risk of postpartum depression, as several studies have shown [18].
When at least five depressive symptoms persist for at least two weeks, postpartum depression is diagnosed and the symptoms include: loss of interest or pleasure; insomnia or hypersomnia; psychomotor retardation or agitation; feelings of worthlessness or guilt; exhaustion or lack of energy; suicidal ideation or attempt, recurring thoughts of death; impaired concentration or indecision; and changes in appetite or weight [19].Evaluating women for postpartum depression requires a comprehensive approach. The Edinburgh Postnatal Depression Scale (EPDS) is a commonly used screening tool comprising a 10-item patient-completed questionnaire. A score of 13 or higher indicates a risk of developing postpartum depression [20].
Effective treatments for postpartum depression (PPD) include a range of psychotherapies and medications, as demonstrated by randomized trials. Healthcare providers often turn to selective serotonin reuptake inhibitors (SSRIs) as the initial medication treatment [21], this is because SSRIs have a favourable safety profile, with a lower risk of toxicity. A neurosteroid antidepressant, zuranolone, is considered a prompt-acting oral treatment for PPD [22]. Chlorpromazine, haloperidol, and risperidone may also be used with caution and under medical supervision. When managing postpartum depression, close monitoring of lithium levels, thyroid function, kidney function, and hydration is crucial [23]. However, it's important to note that these oral agents should not be relied upon as the sole treatment for postpartum psychosis, and additional therapies or medications may be necessary to manage the condition effectively [24].
Proactive measures can be taken to prevent postpartum depression and anxiety, aiming to reduce the severity, duration, and likelihood of these conditions [25].Throughout postpartum periods, healthcare professionals should routinely check women, using general and specific tools (Depression Scale of the Centre for Epidemiological Studies, the Beck Depression Inventory, and the Edinburgh Postnatal Depression Scale) [26].
The rationale of our research is to examine the prevalence of postpartum depression, identify risk factors, and assess the effectiveness of treatments addressing this disorder among women in Punjab (Pakistan), with the ultimate objective of providing tailored and culturally responsive preventative and support programs. The definitive objectives are described:
To find out the prevalence of post-partum depression among women of Punjab, Pakistan.
To identify potential risk factors associated with postpartum depression and to highlight the need for timely intervention based on identified risk factors.
To find the relationship between sociodemographic factors (age, education level, socioeconomic status, and risks of postpartum depression among women of Punjab, Pakistan.
Methods
Study design and participants
A cross-sectional questionnaire-based study was conducted. The survey duration was five months from December 2023 to April 2024. A total sample size of 400 women was determined using the Raosoft sample size calculator, using a 95% confidence interval (CI) and 5% margin of error (d). All women (both primigravida and multigravida) presenting to the outpatient department within three weeks to one year of giving live birth were eligible to participate. The assessment of mothers over the weeks to one year was done through face-to-face screening. All women who had stillbirths, abortions, or were treated for a past psychiatric illness or neurological disease were excluded from the study. Before data collection, written consent was taken from every participant. All personal information was kept confidential throughout the study to ensure participant privacy.
Data collection instrument
Five separate sections of a self-administered questionnaire were created and properly validated. Various standard national and international guidelines that were in effect at the time of the study were used to inform the development of the questions. First of all, the participants' socio-demographic data were taken, including age, marital status, education, and occupation. The second section contained obstetric history variables, including the number of children, gestational age, and mode of delivery. The third & fourth sections contained 20 questions regarding postpartum depression screening and associated risk factors. The fifth section contained the Edinburgh Postnatal Depression Scale, consisting of 10 questions. The result of each item can range from 0 to 3, with a total score ranging from 0 to 30, based on the feedback given by the participant. A score of 12 or higher was considered indicative of significant symptoms. The Edinburgh Postnatal Depression Scale (EPDS) [27] was used to assess symptoms, with specific items targeting depressed mood, anxiety, and functional impairment. Items 1 and 2 evaluated the presence of a gloomy outlook and inability to experience pleasure, while items 8 and 9 further assessed depressed mood. Additional items explored self-blame and guilt, excessive worry, panic feelings, daily functioning, sleep quality, and suicidal thoughts. This widely used and validated measure is specifically designed for the postpartum period, providing a comprehensive evaluation of mental health symptoms during this critical time.
Statistical analysis
The data was meticulously recorded and analyzed using Excel and SPSS version 19.0. Continuous variables such as patient age, EPDS score, and number of children were summarized using mean and median. Categorical variables like educational status, marital status, mode of delivery, complications during pregnancy, and postpartum depression were presented as frequencies and percentages. The primary outcome of interest was postpartum depression, which was examined of various socio-demographic factors (independent variables). Statistical test, i.e., binary logistic regression, was employed to investigate associations between the dependent and independent variables. A significance level of p ≤ 0.05 was adopted to determine statistically significant findings. This rigorous analysis aimed to uncover meaningful patterns and relationships within the data.
Results
Table 1 presents the socio-demographic variables of the participants involved in the study. Among 400 participants, 36.75% fell under the age group of 15–24 years, 46.25% were between 25–32 years, and 17% were in the age group of 33 to 40 years. As far as marital status is concerned, 5.75% were divorced. On the contrary, 67% were married, and 27.25% of females were separated. The majority of participants (43.75%) had education levels below matric (under-matric), while 24.75% had completed intermediate education and graduated women were just 10%, which indicates that a higher level of education is of minimal population. Respondents were asked about their employment. Most of them were unemployed (housewives) while 1.25% were employed, and 22.25% were students.
Table 1.
Socio-demographic data (n = 400)
| Demographics | Frequency | Percentage (%) |
|---|---|---|
| Age (years) | ||
| 15–24 | 147 | 36.75 |
| 25–32 | 185 | 46.25 |
| 33–40 | 68 | 17.00 |
| Marital Status | ||
| Divorced | 23 | 5.75 |
| Married | 268 | 67.00 |
| Separated | 109 | 27.25 |
| Education | ||
| Graduate | 40 | 10.00 |
| Intermediate | 99 | 24.75 |
| Matric | 86 | 21.50 |
| Under-Matric | 175 | 43.75 |
| Employment Status | ||
| Employed | 125 | 31.25 |
| Housewife | 186 | 46.50 |
| Student | 89 | 22.25 |
According to the survey analysis in Table 2, about 50% of women had 4 to 6 children, reflecting a larger average family size. A considerable 35.25% had 1 to 3 children, while 14.75% reported having 7 to 9 children. About half of the women, 43%, delivered between 36–39 weeks, which is considered full-term, 31.75% were delivered between 40–43 weeks, indicating that they were post-term. On the other hand, 25.25% of women experienced premature births between 33 and 35 weeks. Respondents were asked regarding their mode of delivery. In most Females, 60% had caesarean section delivery however40%had a vaginal delivery.
Table 2.
Pregnancy and Postpartum Experience (n = 400)
| Questions | Frequency | Percentage (%) |
|---|---|---|
| No. of Children | ||
| 1 to 3 | 141 | 35.25 |
| 4 to 6 | 200 | 50.00 |
| 7 to 9 | 59 | 14.75 |
| Gestational Age | ||
| 33–35 | 101 | 25.25 |
| 36–39 | 172 | 43.00 |
| 40–43 | 127 | 31.75 |
| Mode of Delivery | ||
| Caesarean section | 240 | 60.00 |
| Vaginal | 160 | 40.00 |
Table 3 provides information on postpartum depression screening. Respondents were asked about their physical and mental health. Out of 400 participants, 38% rated their physical health as poor, while 25.50% of females had poor mental health. The table also showed that only 7% of the participants never felt down for extended periods, while 31.50% often went through lengthy periods of low mood. 51.25% of females hadn't found enjoyment in any of their previous activities, 27% stated that they just did not have time, and just 21.75% were still able to engage in certain activities. Among women with frightening thoughts, 39.25% had frequent thoughts of child and self-harming, and 38.50% experienced these thoughts sometimes. The mental health of 12.75% of participants did not affect their relationships. 14% reported some impact, although seldom, while 35.25% indicated that their mental health frequently affected their relationships.Regarding eating habits, 30% of participants stated that they did not feel hungry. However, 22.50% of females reported eating more than normal, and others noticed minimal change. Most of the participants (49.75%) said their symptoms started after 2 to 3 weeks of delivery, 19.00% of subjects reported experiencing symptoms before giving birth 52.75% reported symptoms lasting less than a month, 37% claimed that their symptoms persisted for one month while 10.25% had symptoms for more than a month. Maximum participants (57.50%) had a mental health assessment a year ago, and 18.50% got their mental health exam less than six months.
Table 3.
Postpartum depression screening (n = 400)
| Questions | Frequency | Percentage (%) | |
|---|---|---|---|
| Overall how would you rate your physical health? | |||
| Excellent | 144 | 36.00 | |
| Good | 63 | 15.75 | |
| Not sure | 41 | 10.25 | |
| Poor | 152 | 38.00 | |
| Overall how would you rate your mental health? | |||
| Excellent | 100 | 25.00 | |
| Good | 148 | 37.00 | |
| Not sure | 42 | 10.50 | |
| Poor | 110 | 27.50 | |
| Have you ever felt particularly low or down for more than 2 weeks in a row? | |||
| Not at all | 28 | 7.00 | |
| Not so often | 101 | 25.25 | |
| Somewhat often | 145 | 36.25 | |
| Very often | 126 | 31.50 | |
| Are you able to enjoy some of the activities you used to enjoy before becoming a mother? | |||
| No – I take part, but don’t feel as if I’m really enjoying anything | 205 | 51.25 | |
| No, I just don’t have the time | 108 | 27.00 | |
| Yes, I am still able to enjoy things | 87 | 21.75 | |
| Do you have frightening thoughts- for example about hurting yourself or your child? | |||
| No | 89 | 22.25 | |
| Sometimes | 154 | 38.50 | |
| Yes | 157 | 39.25 | |
| During the past two weeks, how often has your mental health affected your relationships? | |||
| Not at all | 11 | 2.75 | |
| Not so often | 56 | 14.00 | |
| Somewhat often | 192 | 48.00 | |
| Very often | 141 | 35.25 | |
| Have you noticed any change in your diet habits? | |||
| No change | 47 | 11.75 | |
| Not much | 143 | 35.75 | |
| Yes, I don’t feel hungry | 120 | 30.00 | |
| Yes, I eat too much | 90 | 22.50 | |
| Onset of physical symptoms? | |||
| After 1 month | 125 | 31.25 | |
| After 2 to 3 weeks | 199 | 49.75 | |
| Before the birth | 76 | 19.00 | |
| Duration of symptoms? | |||
| 1 month | 148 | 37.00 | |
| Less than 1 month | 211 | 52.75 | |
| More than 1 month | 41 | 10.25 | |
| When did you last get your mental health examination done? | |||
| 6 months ago | 96 | 24.00 | |
| A year ago | 230 | 57.50 | |
| Less than 6 months ago | 74 | 18.50 | |
Table 4 presents the risk factors of the participants involved in the study, according to which 44% of women had no history of mental illness, 39.50% reported a family history of mental problems, whereas 16.50% were unclear of their family history. The sleep duration of 44% of the participants was 4 to 6 h, 26.50% slept for 7 to 9 h, and 22% reported getting less than 4 h of sleep every day. 12% of participants expressed dissatisfaction with their relationships and families, more than half of the females (59.50%) had unwanted/unplanned pregnancies 43.75% of the individuals reported no difficulties during pregnancy or childbirth while 56.25% had complications during pregnancy or childbirth.54% of the participants were coping with financial issues however 46% did not disclose any financial concerns.69.50% of women did not use any medication for PPD while 30.50% were presently taking medication for PPD.76.50% of the subjects had no prior anxiety symptoms while 23.50% has experienced anxious symptoms previously.
Table 4.
Risk factors
| Questions | Frequency | Percentage (%) |
|---|---|---|
| Is there a history of mental disorder in your family? | ||
| No | 176 | 44.00 |
| Not sure | 66 | 16.50 |
| Yes | 158 | 39.50 |
| How many hours do you sleep per day? | ||
| 4 to 6 | 176 | 44.00 |
| 7 to 9 | 106 | 26.50 |
| Less than 4 | 88 | 22.00 |
| More than 9 | 30 | 7.50 |
| Are you satisfied with your relationships and family? | ||
| No | 48 | 12.00 |
| Sometimes | 160 | 40.00 |
| Yes | 192 | 48.00 |
| Was the pregnancy unwanted or unplanned? | ||
| No | 162 | 40.50 |
| Yes | 238 | 59.50 |
| Did you face any complications during pregnancy or birth? | ||
| No | 175 | 43.75 |
| Yes | 225 | 56.25 |
| Do you have any financial issues? | ||
| No | 184 | 46.00 |
| Yes | 216 | 54.00 |
| Are you currently taking any medication for PPD? | ||
| No | 278 | 69.50 |
| Yes | 122 | 30.50 |
| Do you have any previous anxiety symptoms? | ||
| No | 306 | 76.50 |
| Yes | 94 | 23.50 |
EPDS is a self-rating questionnaire consisting of ten items. The cut-off score is 12, according to which an EPDS score of less than 12 indicates no depressive symptoms, whereas greater than and equal to 12 indicates symptomatic depression. In this study, 12.5% of participants had PPD, as shown in Fig. 1.
Fig. 1 .
Frequency and percentage distribution of postpartum depression (PPD) based on EPDS
Table 5 represents a relationship between socio-demographic factors and the patients with risk of PPD based on EPDS scoring. The table clearly shows that women that fall between the age group 25–32, were married, had intermediate education levels, and were housewives had a maximum positive response for PPD.
Table 5.
Socio-demographic factors screened with the Edinburgh postpartum depression scale
| Characteristics | Normal n (%) | Positive for PPD n (%) |
|---|---|---|
| Total (400) | 350 (87.5) | 50 (12.5) |
| Age (years) | ||
| 15–24 | 130 (37.5) | 17 (34) |
| 25–32 | 163 (46.57) | 22 (44) |
| 33–40 | 57 (16.29) | 11 (22) |
| Marital Status | ||
| Divorced | 17 (4.86) | 6 (12) |
| Married | 237 (67.71) | 31 (62) |
| Separated | 96 (27.43) | 13 (26) |
| Education | ||
| Graduate | 31 (8.86) | 10 (20) |
| Intermediate | 85 (24.29) | 17 (34) |
| Matric | 69 (19.71) | 14 (28) |
| Under-matric | 165 (47.14) | 9 (18) |
| Employment Status | ||
| Employed | 108 (30.86) | 17 (34) |
| Housewife | 167 (47.71) | 19 (38) |
| Student | 75 (21.43) | 14 (28) |
Table 6 summarizes the findings of binary logistic regression analysis to find the association between socio-demographic characteristics, pregnancy and postpartum experience, risk factors, and PPD. According to analysis, among the socio-demographic factors, i.e., age of respondent, marital status, education, and employment, only the education of the respondent OR 1.542 (95% CI 1.168–2.035, and p = 0.002) had a statistically significant association with risk of PPD. Of the factors found in pregnancy and postpartum experience, i.e., number of children, gestational age, and mode of delivery, only number of children OR 0.598 (95% CI 0.375–0.954, and p = 0.031) remained associated with an increased risk of developing PPD. Of the factors found in pregnancy and postpartum experience, i.e., number of children, gestational age, and mode of delivery, only number of children OR 0.598 (95% CI 0.375–0.954, and p = 0.031) remained associated with an increased risk of developing PPD.
Table 6.
Binary logistic regression analysis showing socio-demographic characteristics, pregnancy and postpartum experience, risk factors associated with the PPD of the women (n = 400)
| Characteristics | B | S.E | Wald | df | p-value | OR (95% CI) |
|---|---|---|---|---|---|---|
| Age | 0.176 | 0.212 | 0.687 | 1 | 0.407 | 1.192 (0.787–1.806) |
| Marital Status | 0.335 | 0.235 | 2.027 | 1 | 0.115 | 1.398 (0.881–2.217) |
| Education | 0.433 | 0.142 | 9.336 | 1 | 0.002 | 1.542 (1.168–2.035) |
| Employment Status | -0.297 | 0.219 | 1.845 | 1 | 0.174 | 0.743 (0.484–1.141) |
| Number of children | -0.514 | 0.238 | 4.657 | 1 | 0.031 | 0.598 (0.375–0.954) |
| Gestational age | 0.153 | 0.203 | 0.567 | 1 | 0.452 | 1.165 (1.783–1.733) |
| Mode of delivery | -0.095 | 0.307 | 0.095 | 1 | 0.758 | 0.910 (0.499–1.659) |
| History of mental disorder in family | 0.638 | 0.211 | 9.122 | 1 | 0.003 | 1.892 (1.251–2.863) |
| How many hours do you sleep per day? | 0.248 | 0.172 | 2.067 | 1 | 0.150 | 1.281 (0.914–1.797) |
| Are you satisfied with family and your relationship? | 0.506 | 0.211 | 5.733 | 1 | 0.017 | 1.658 (1.096–2.509) |
| Was the pregnancy unwanted /unplanned? | 0.626 | 0.304 | 4.229 | 1 | 0.040 | 1.870 (1.030–3.394) |
| Complications during pregnancy or birth? | 0.752 | 0.308 | 5.942 | 1 | 0.015 | 2.121 (1.159–3.881) |
| Do you have any financial issues? | 0.367 | 0.303 | 1.461 | 1 | 0.227 | 1.443 (0.796–2.616) |
| Have you had professional help or treatment for these symptoms? | -0.420 | 0.342 | 1.515 | 1 | 0.218 | 0.657 (0.336–1.283) |
| Are you currently taking any medication for PPD? | -0.524 | 0.343 | 2.338 | 1 | 0.126 | 0.592 (0.302–1.159) |
| Do you have any previous anxiety symptoms? | -0.773 | 0.376 | 4.218 | 1 | 0.040 | 0.462 (0.22–0.965) |
B (estimated coefficient), S.E. (standard error), Wald (wald chi square test), df (degrees of freedom), OR (odds ratio), CI (confidence interval). Bold values indicate statistical significance
Discussion
Our research included 400 participants. The mean age (median) is 26.55 (28.50) years, with a range of 15 to 40 years. The current study aimed to identify patients with depression throughout pregnancy and the postpartum period. A score of 12 on the EPDS was used as a cut-off point to define a line of therapy for women at higher risk of PPD [28]. According to the EPDS score, the postpartum depression prevalence in our research is 12.5%. However, this prevalence of postpartum depression is relatively lower than the 19% prevalence rate for PPD derived from studies of relatively low- and middle-income countries [29]. These variations were caused by different methodologies, study designs, gathering procedures, cross-cultural variety, economic situations, social assistance, and other national and local trends.
We analyzed to investigate the association between socio-demographic characteristics, pregnancy and postpartum experience and risk factors with PPD. The findings indicate that the mother's age is an indicator of PPD [30]. Our study also manifests it to be 44% in the 25 to 32-year age group. In the present research, we found a substantial connection between women's educational status and PPD, as indicated by a p-value < 0.05. PPD was more common in women with a low education level than in individuals with a higher education level. Similarly, other studies also found that a lower education level was associated with a higher prevalence of PPD [31]. Low education is associated with economic hardship and early marriages, which resulted in PPD among young women in terms of work status; the majority of women were not employed (19.38%). The data indicate that women who were previously diagnosed with depression and unemployed women are predisposed to PPD [32].
The current study also discovered a substantial link between postpartum depression and several children, indicating that women with 4 to 6 children are more likely to suffer from PPD. Many women have had pregnancy-related difficulties, as seen by the most common caesarean birth, which is the leading source of stress during the postpartum period. Our findings are consistent with the recently published study by Al Nasr and Altharwi [33]. It is because women who deliver via C-section are more likely to have postpartum problems because of limited physical activity, infection, and haemorrhage, which raises their chance of developing PPD.
Psychosocial risk factors are significantly associated with the start of depression in participants, whether owing to pregnancy discontent or a bad connection with their spouse, even if their delivery experience was favourable. A history of clinical depression is related to a fourfold higher chance of developing PPD than others. According to our findings, women with a family record of mental issues, as well as those who have previously had anxiety symptoms, are more likely to develop PPD. In keeping with our findings, another study found that females with a history of depression had a 20-fold greater incidence of PPD (CI 95% 5, 19.72–22.42) than those who had not had depression [34]. Furthermore, moms who have unexpected or undesired pregnancies are particularly susceptible to postpartum depression, which is also supported by previous findings [35].
Limitations
Our study has limitations. First, many women lacked academic education and were therefore incapable of reading or comprehending the questionnaire. In such circumstances, the writers narrated the surveys to the participants, who responded accordingly. Second, it was a cross-sectional study and didn't track patient outcomes. Further research using longitudinal research methods may help us better understand the association between these psychological, social, and demographic variables and postpartum depression in women.
Conclusion
In conclusion, the present research revealed that the prevalence of PPD was 12.5%. History of depression, poorer educational status, unemployment, and C-section delivery were all possible determinants of PPD development. The use of approved scales can help to provide fresh data on the correlation between risk factors and preventive measures during pregnancy. The Edinburgh Postnatal Depression Scale is universally relevant. However, the data should be compared to a professional diagnosis of PPD. Evidence is required to assist health practitioners in the proactive deployment of an appropriate method to deal with the problem. Improved quality of treatment, social support, greater literacy rates, and better socioeconomic position all help to reduce postpartum depression. Furthermore, expanding access to professional assistance and incorporating behavioural healthcare services into maternity care programs are crucial steps towards enhancing postpartum women's well-being in Pakistan.
Future recommendations
There is an urgent need for innovative evaluation techniques that can evaluate individuals based on culturally distinct symptom presentation. Future research should focus on the development of reliable and precise indigenous screening techniques in national and native languages. Furthermore, research should be conducted to build educational and training programs for prospective parents to educate them about the indications and challenges of motherhood. Additionally, parental intervention strategies should be designed to help patients who are suffering in silence.
Supplementary Information
Below is the link to the electronic supplementary material.
Acknowledgements
The authors gratefully acknowledge the Ibadat International University, Islamabad.
Author contributions
Jannat Yousaf and Fizza Yousaf prepared and reviewed the questionnaire. Isra Khalid and Najam us Sahar collected the data. Hafsah Arshad and Ayesha Sana analyzed the data and wrote the manuscript with the help of Dr. Kashif Iqbal and Najam us Sahar. All authors participated in reading and critically revising the manuscript and approving the final version. All authors agreed to be accountable regarding all aspects of the study.
Funding
No funding.
Data availability
The datasets generated and/or analyzed during the current study are not publicly available due to the privacy of the participants but are available from the corresponding author at reasonable request.
Declarations
Ethics approval and consent to participate
The datasets generated and/or analyzed during the current study are not publicly available due to the privacy of the participants. Still, they are available from the corresponding author at reasonable request. Ethical approval for this study was obtained from the Ibadat International University Islamabad ethics committee based on established guidelines and principles (Ref. No: IRB-IIUI-FAHS/PHM/1050-2235). Before data collection, informed consent was obtained from every participant, and confidentiality was ensured. The study was completely voluntary, and participants received no incentive. Parents/guardians' consent was obtained for the participants under 18 years old, ensuring full understanding and agreement with this study's purposes and confidentiality practices.
Consent for publication
Not applicable.
Competing interests
The authors declare no competing interests.
Footnotes
Publisher's Note
Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.
Jannat Yousaf and Fiza Yousaf have equal contributions.
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Associated Data
This section collects any data citations, data availability statements, or supplementary materials included in this article.
Supplementary Materials
Data Availability Statement
The datasets generated and/or analyzed during the current study are not publicly available due to the privacy of the participants but are available from the corresponding author at reasonable request.