The role of family support in maternal mental health during the postpartum period in Malaka District

Yosefa Sarlince Atok; Roslin E. M. Sormin; Isna Yuswela Babis

doi:10.21927/jnki.2025.13(4).623-632

The role of family support in maternal mental health during the postpartum period in Malaka District

Yosefa Sarlince Atok, Roslin E. M. Sormin, Isna Yuswela Babis

Abstract

Background: Postpartum depression is a major maternal mental health concern that remains insufficiently addressed in rural areas such as Malaka District, East Nusa Tenggara, where structural and social vulnerabilities may heighten psychological risks. Limited evidence from these settings underscores the need to understand the contextual determinants influencing maternal mental health.

Objectives: The objective of this study was to examine the relationship between family support, sociodemographic characteristics, and the risk of postpartum depression among mothers in Malaka District.

Methods: This cross-sectional analytic study involved 100 postpartum mothers selected through purposive sampling. Data were collected using a structured questionnaire that included demographic characteristics, a family support scale, and the Edinburgh Postnatal Depression Scale (EPDS). Statistical analyses comprised descriptive tests, chi-square tests, and multivariate logistic regression.

Results: The results indicated that 40% of participants were at risk of postpartum depression (EPDS ≥13), and more than half (55%) experienced inadequate family support. Bivariate analysis revealed a significant association between family support and postpartum depression (p=0.001). Multivariate logistic regression demonstrated that inadequate family support was the strongest predictor of postpartum depression, with affected mothers having 3.8 times higher odds of developing depression (AOR 3.8; 95% CI: 1.7–8.3). Low maternal education was also a significant predictor (AOR 2.5; 95% CI: 1.1–5.8), whereas maternal age and employment status were not associated with depression risk.

Conclusions: These findings emphasize the critical role of family involvement and maternal education in mitigating postpartum mental health problems. Strengthening the active participation of husbands and family members, improving maternal mental health literacy, and integrating family-centered approaches into antenatal and postnatal care are essential steps for reducing the burden of postpartum depression in Malaka District.

Keywords

family support; maternal education; mental postpartum depression; health; postpartum mothers

Full Text:

PDF

References

Shorey S, Chee CYI, Ng ED, Chan YH, Tam WWS, Chong YS. Prevalence and incidence of postpartum depression among healthy mothers: A systematic review and meta-analysis. Journal of Affective Disorders. 2023;328:1–13. https://doi.org/10.1016/j.jad.2023.01.001

Hahn-Holbrook J, Cornwell-Hinrichs T, Anaya I. Economic and health predictors of national postpartum depression prevalence: A systematic review. Frontiers in Psychology. 2022;13:920114. https://doi.org/10.3389/fpsyg.2022.920114

Stewart DE, Vigod SN. Postpartum depression: Pathophysiology, treatment, and emerging therapeutics. Lancet. 2021;398(10302):1864–76. https://doi.org/10.1016/S0140-6736(21)01635-5

Islam MJ, Broidy L, Baird K, Mazerolle P. Relationship between postpartum depression and intimate partner violence: A meta-analysis. Archives of Women's Mental Health. 2021;24:585–95. https://doi.org/10.1007/s00737-020-01096-7

Zhou Y, Zhang R, Liu Z, Zhang Q. Mental health status of postpartum women in rural China: A cross-sectional community-based study. BMC Pregnancy Childbirth. 2021;21:512. https://doi.org/10.1186/s12884-021-03939-1

Atif N, Lovell K, Husain N. Maternal mental health: Global challenges and opportunities in low-resource settings. World Psychiatry. 2021;20(3):315–6. https://doi.org/10.1002/wps.20983

Gelaye B, Rondon MB, Araya R, Williams MA. Epidemiology of maternal depression, risk factors, and child outcomes in low- and middle-income countries. Current Psychiatry Reports. 2022;24:15–25. https://doi.org/10.1007/s11920-022-01333-z

Rathod S, Pinninti N, Irfan M, Gorczynski P. Stigma and mental health support among postpartum women in India: A mixed-method study. International Journal of Mental Health Systems. 2023;17:7. https://doi.org/10.1186/s13033-023-00566-9

Yunitasari E, Rahayu EP, Priscilla V. Family support as a protective factor for postpartum depression in Indonesian mothers. BMC Nursing. 2024;23:45. https://doi.org/10.1186/s12912-024-01574-9

Chen H, Selix N, Nosek M. Social support and maternal mental health outcomes among Asian postpartum women: A systematic review. Asian Nursing Research. 2020;14(2):73–81. https://doi.org/10.1016/j.anr.2020.04.001

Rahman A, Surkan PJ, Cayetano CE, Rwagatare P, Dickson KE. Grand challenges: Integrating maternal mental health into maternal and child health programs. PLoS Medicine. 2021;18(3):e1003562. https://doi.org/10.1371/journal.pmed.1003562

Owais S, Faltyn M, Alavi N. Digital mental health interventions for postpartum women: A scoping review. Journal of Medical Internet Research. 2022;24(6):e37245. https://doi.org/10.2196/37245

Skoczek-Rubińska A, Król K, et al. Predictors of postpartum depressive symptoms among low-education mothers. Journal of Clinical Medicine. 2023;12:1157. https://doi.org/10.3390/jcm12031157

Ting EY, Kim Y, Ho IK. Educational disparities and mental health outcomes in postpartum women. Women Health. 2021;61(7):636–50. https://doi.org/10.1080/03630242.2021.1930870

Wong JN, Fong DYT, et al. Effectiveness of family-based interventions for postpartum mental health: A meta-analysis. Psychology & Health Journal. 2024;39(2):133–52. https://doi.org/10.1080/08870446.2023.2205607

Jha S, Bano S, Singh AK. Prevalence and determinants of postpartum depression in rural communities in India. International Journal of Environmental Research and Public Health. 2022;19:1105. https://doi.org/10.3390/ijerph19031105

Silva M, Ferreira CF, Cruz S. Socioeconomic barriers to maternal mental health care: A rural health perspective. Rural and Remote Health. 2023;23:8129. https://doi.org/10.22605/RRH8129

Yuliana L, Oktaviani W. Postpartum depression and the role of midwives in early detection: A qualitative study. Midwifery. 2021;98:102996. https://doi.org/10.1016/j.midw.2021.102996

Banerjee D, Varma S. Maternal mental health challenges in underserved populations: Lessons from Asia. Asian Journal of Psychiatry. 2025;80:103469. https://doi.org/10.1016/j.ajp.2024.103469

Wang Y, Wang Y, Huang W, et al. Association of maternal postpartum depression, anxiety, and stress symptoms: a network analysis. BMC Psychiatry. 2024;24:940. https://doi.org/10.1186/s12888-024-06412-9

A longitudinal study of a mHealth app and regional policies on the uptake of postpartum depression referral after positive screening in Shenzhen. BMC Pregnancy Childbirth. 2024;24:536. https://doi.org/10.1186/s12884-024-06733-3

Lewkowitz AK, Guillen M, Ursino K, et al. Optimizing a novel smartphone app to prevent postpartum depression adapted from an evidence-based cognitive behavioral therapy program: qualitative study. JMIR Human Factors. 2024;11:e63143. https://doi.org/10.2196/63143

Effect of technology-supported mindfulness-based interventions for maternal depression: a systematic review and meta-analysis with implementation perspectives for resource-limited settings. BMC Pregnancy Childbirth. 2025;25:155. https://doi.org/10.1186/s12884-025-07286-9

Wijayanti P, Bainuan L, Yuliana N. Relationship between pregnancy anemia and depression in postpartum mothers: systematic review. The Journal of Maternal and Child Health (The JMCH). 2024;09(05):10. https://doi.org/10.26911/thejmch.2024.09.05.10

DOI: http://dx.doi.org/10.21927/jnki.2025.13(4).623-632