Postpartum depression (PPD) is a significant yet often overlooked mental health issue affecting millions of women worldwide. Characterised by persistent sadness, hopelessness, and fatigue following childbirth, the condition takes a severe toll on women in conflict-affected regions, where access to mental health services is scarce. Despite its devastating impact, discussions on the prevalence and treatment of PPD in these areas remain limited.
This analysis delves into the crisis of PPD among women in African conflict zones, explores the barriers to addressing the condition, and highlights strategies to improve maternal mental health in these high-risk environments.
PPD in conflict-affected regions: A silent epidemic
Globally, maternal mental health disorders affect 10 per cent of pregnant women and 13 per cent of postpartum mothers. In sub-Saharan Africa, studies indicate that Nigeria records PPD prevalence rates ranging from 10.7 per cent to 22.9 per cent. However, these figures are likely underreported, particularly in conflict zones where mental health remains a low-priority issue.
Women in these regions experience a unique set of challenges that heighten their risk of developing PPD. Symptoms such as severe mood swings, emotional numbness, sleep disturbances, and flashbacks of past trauma are exacerbated by their circumstances. HumAngle previously reported on the lack of maternal healthcare for women in these areas, notably in IDP camps. One woman in Maiduguri, northeast Nigeria, experienced a distressing situation when she went into labour with no experienced professional in sight. Her husband was forced to act as a midwife for her, despite having no experience. Years later, she still struggles with its mental effects.
“I am terrified of anything that may have to do with childbirth again,” Hadiza told HumAngle. “I do not want to go through it again.”
The persistent state of insecurity, forced displacement, and disruption of traditional support systems further compound the suffering of new mothers like Hadiza.
Conflict and maternal mental health: A worsening crisis
Nigeria has endured prolonged conflicts, including insurgencies, communal clashes, and political instability, all of which have had severe consequences for maternal mental health. The erosion of social structures has left many women without the traditional care networks that previously played a vital role in postpartum recovery.
Studies suggest that in conflict settings, postpartum depression is often intensified by a woman’s struggle to reconcile personal trauma with societal expectations. In patriarchal cultures, women are frequently expected to suppress signs of distress, further alienating them from the support they need.
Beyond Nigeria, the situation is similarly dire across Africa. In the Democratic Republic of Congo, for instance, years of war and mass displacement have led to a mental health crisis, with new mothers particularly affected. Overcrowded displacement camps, sexual violence, and lack of maternal care create an environment where postpartum depression thrives unchecked.
Barriers to addressing postpartum depression in conflict zones
The lack of recognition and intervention for PPD in conflict zones stems from several key obstacles:
- Stigma and cultural norms
Mental health struggles, including PPD, are highly stigmatised in many African societies. Women fear being labeled as weak or incapable of fulfilling their maternal duties, discouraging them from seeking help.
A lack of understanding about PPD—both among healthcare providers and the general population—often results in underdiagnoses. Many women do not recognise their symptoms as a medical condition, while healthcare workers may dismiss their concerns.
- Collapsing healthcare systems
Conflict severely disrupts healthcare services, making maternal mental health care inaccessible. In South Darfur, Sudan, for instance, the war has led to a surge in maternal deaths, further straining healthcare resources.
- Focus on survival over mental health
In conflict zones, immediate survival needs—food, shelter, and physical safety—take precedence. As a result, mental health issues such as PPD are frequently neglected.
Coping Mechanisms: How women in conflict zones manage PPD
Despite these immense challenges, women in conflict-affected areas develop various coping strategies shaped by their cultural context and personal resilience:
Studies in rural Ethiopia indicate that women with PPD often rely on family and community networks for emotional support. In many cultures, older women step in to provide care and reassurance to new mothers.
Some women take proactive steps to address stressors, such as seeking help from local midwives, religious leaders, or humanitarian organisations.
Women also manage their emotional distress by turning to prayer, meditation, or traditional healing practices.
Some mothers withdraw from social interactions or deny their struggles, a strategy that provides temporary relief but may worsen long-term mental health outcomes.
While no single coping mechanism is sufficient, strengthening social and healthcare support systems can help women recover from PPD more effectively.
Strategies to address postpartum depression in conflict zones
To improve maternal mental health outcomes, targeted interventions must be implemented:
- Strengthening traditional support systems
Cultural postpartum practices have long provided new mothers critical emotional and physical support. These practices include:
- Omugwo (Igbo, Nigeria): Mothers or mothers-in-law provide hands-on care and special diets.
- Itoju Omo (Yoruba, Nigeria): Older women offer postpartum guidance and spiritual support.
- Wankan Jego (Hausa/Fulani, Nigeria): Ritual bathing and religious counseling promote recovery.
- Ababelithisi (South Africa): Traditional birth attendants provide postpartum massage therapies and emotional support.
Integrating these traditional systems into modern mental health interventions—especially within internally displaced persons (IDP) camps—can enhance maternal well-being.
- Community-based support networks
Building peer-support groups allows women to connect with others facing similar challenges. Local organisations and NGOs should facilitate these groups, providing safe spaces for women to share their experiences.
- Training healthcare providers
Primary healthcare workers and traditional birth attendants must be trained to recognise and manage PPD. Given the shortage of mental health professionals in conflict zones, integrating mental health training into routine maternal care can help bridge this gap.
- Leveraging technology for mental healthcare
Emerging digital tools, such as virtual reality (VR), offer promising solutions for treating postpartum depression in areas with limited resources.
HumAngle has been piloting the use of VR for anxiety reduction in conflict-affected communities. With further investment, VR therapy could be expanded to provide immersive relaxation experiences and cognitive behavioral therapy (CBT) for women with PPD.
Governments and humanitarian organisations must prioritise maternal mental health in national policies. This includes:
- Integrating mental health screenings into routine maternal care
- Training healthcare professionals in trauma-informed care
- Expanding mobile mental health services for displaced women
By embedding maternal mental health into broader conflict recovery strategies, policymakers can break the stigma and improve support systems.
A call to action
Postpartum depression in conflict-affected African regions remains a critical yet under-discussed issue. Ignoring maternal mental health not only endangers individual women but also disrupts families and entire communities.
By fostering open dialogue, strengthening healthcare support, and implementing culturally sensitive interventions, stakeholders can improve the well-being of mothers and, by extension, the next generation. Addressing PPD in conflict zones is not just a health priority—it is a fundamental step toward rebuilding societies in the aftermath of war.
Postpartum depression (PPD) is a significant mental health issue often overlooked, particularly within conflict-affected regions in Africa, where access to mental health services is minimal. In these areas, such as Nigeria, social upheaval and inadequate healthcare exacerbate the condition, with affected women experiencing heightened risks due to persistent insecurity, displacement, and broken support systems.
Despite the prevalence of PPD due to long-standing conflict in countries like the Democratic Republic of Congo and regions like South Darfur in Sudan, there remain substantial barriers to addressing the condition, including stigma, limited awareness, collapsing healthcare systems, and a focus on survival over mental health.
Women in these environments often adopt various coping mechanisms, from relying on traditional support networks to seeking help from local leaders and organizations, though these are insufficient without stronger healthcare and community networks.
Strategies proposed to tackle PPD in conflict zones include enhancing traditional societal support, developing community peer groups, training healthcare providers, leveraging digital tools like virtual reality for therapy, and advocating for policy changes.
These efforts aim to integrate maternal mental health into larger conflict recovery initiatives, emphasizing the critical need for open dialogue and innovative solutions to support affected mothers and improve community resilience. Addressing PPD is essential for rebuilding at-risk societies, offering not just immediate relief to mothers but also ensuring healthier futures for their families and communities.