NEW DELHI: India has more than 25 million births per year, but most women with mental health problems during pregnancy and one year after birth go undetected and untreated, especially in rural areas, experts said here Monday.
Experts, including specialists from AIIMS and NIMHANS, also said that deep-rooted male child preference and rigid social norms continue to deny women autonomy over their bodies and decisions around pregnancy.
The mental health impact of repeated pregnancies, domestic violence, and stigma faced by women - especially when giving birth to a girl or a child with a disability is huge, they pointed out.
According to Prof. Pallab Maulik, Director of Research, The George Institute for Global Health India, “Perinatal mental health is a major concern in India with large number of women with undiagnosed and untreated perinatal depression and psychosis which not only affect the mother but also the health of the baby and wellbeing of the family.”
He was speaking at a national consultation on the Perinatal Mental Health (PRAMH) Project, led by the Institute in partnership with the University of Oxford, and supported by the UK Medical Research Council.
At the meet, experts highlighted the importance of engaging with perinatal women on their mental health and emphasized the need for scalable, culturally sensitive interventions integrated within health systems.
A recent systematic review among perinatal women in India found that the prevalence rates for perinatal depression ranged from 14 - 24% in community-based studies, while some meta-analyses reported a pooled estimate of around 22% for postpartum depression.
Although maternal mortality in India has reduced by over 50% since the early 2000s to 97 deaths per 100,000, maternal suicide constitutes an increasing proportion of maternal deaths.
At the event, the findings of the project were discussed. The aim of the PRAMH study is to integrate perinatal mental health into routine maternal care by addressing barriers such as poverty, gender inequity, domestic violence, and stigma.
After identifying critical gaps in states like Telangana and Haryana, the Phase 2 of the PRAMH study tested practical, scalable models to ensure mothers in rural India receive timely and culturally sensitive support.
Speaking about the key role of social determinants, Dr. Nicole Votruba, University of Oxford, UK, who is the Principal Investigator, said, “The findings from the PRAMH project underscore the profound impact that social determinants - such as child sex preference, domestic violence, and poverty - have on maternal mental health.”
“It is imperative that we only prioritise the mental health of women but also address these underlying social challenges within the communities. Supporting women in both areas is essential for fostering healthier mothers, children and families, and stronger societies.”
The experts highlighted that there is an urgent need to create a roadmap for action and to improve perinatal mental health whilst addressing its key social determinants, particularly for women in rural India.
A recent report in Kerala estimated that maternal suicide accounted for nearly one in five maternal deaths in 2020.
“The disparity is made worse by stigma, lack of access to mental health services, and growing socio-economic inequalities,” they pointed out.
Dr. Y.K. Sandhya, Program Lead, Mental Health, The George Institute for Global Health India, said, “It is critical to ensure that perinatal mental health is not seen as a standalone as this might increase the stigma and discrimination that women with perinatal mental health problems face; rather it should be included within the routine antenatal and postnatal care that pregnant and lactating women receive, thus making it sustainable.”
What is needed is to break harmful traditions, and educating sarpanches, in-laws, especially men, employers across all job sectors, ASHAs, and frontline health workers, and closing critical gaps through capacity building, orientation, and practical training was the need of the hour.
Emphasis was given to engaging with community leaders, politicians, and religious figures, while also establishing clear tools, protocols, and a robust referral system to extend counseling support not only to women but also to their families.
The need for strong institutional backing was also taken up.
This, they said, will ensure better outcomes in perinatal mental health, along with affordable and accessible childcare facilities, such as crèches, to support mothers and families more effectively.
There is an urgent need to integrate perinatal maternal mental health into national programs. They noted that while women’s mental health is mentioned in policies, there is no dedicated program or screening mechanism in place.