A study highlighted the importance of engaging with perinatal women on their mental health and emphasised the need for scalable, culturally sensitive interventions integrated within health systems.
Published Sep 25, 2025 | 7:00 AM ⚊ Updated Sep 25, 2025 | 7:00 AM
Representative Image.
Synopsis: A recent research found that untreated mental health conditions torment lakhs of Indian women during pregnancy and the critical year following childbirth. The findings were shared by the researchers who conducted the Pregnancy and Mental Health (PRAMH) study from Siddipet in Telangana and Haryana.
In the corridors of Government General Hospital in Telangana’s Siddipet, two worlds exist within the same building, yet remain tragically disconnected.
The maternity ward buzzes with activity as nearly half of all deliveries end in Caesarean sections, higher than in any other state across the country. In another part of the building, a 30-bed psychiatric ward treats various mental health conditions. However, the connection between these wards might as well be broken.
The cruel irony is mathematical: Every surgical birth triples a woman’s risk of postpartum depression, yet not a single dedicated perinatal mental health service exists in the entire district. It’s a healthcare paradox that would be comical if it weren’t so devastating, like having fire trucks but no water, or surgeons but no anaesthesia.
This disconnect isn’t unique to Siddipet. Across rural India, an invisible epidemic rages alongside the celebrated decline in maternal deaths. While India has successfully halved maternal mortality over two decades, a new threat emerges from the shadows, untreated mental health conditions that torment lakhs of women during pregnancy and the critical year following childbirth, turning what should be life’s most celebrated moments into silent battles against despair.
Recent research reveals that up to one in five women globally face mental health challenges during this critical perinatal period, with rates in South India ranging between 16 percent and 36 percent.
In India, with over 25 million births annually, these aren’t just statistics; they represent millions of women suffering in silence, their mental anguish dismissed as temporary baby blues or, worse, as ingratitude for the blessing of motherhood.
The George Institute for Global Health India hosted a National Expert Consultation on Perinatal Mental Health and Social Determinants in New Delhi on Tuesday, 22 September. The consultation was based on the findings shared from the Pregnancy and Mental Health (PRAMH) study from Siddipet and Haryana.
It highlighted the importance of engaging with perinatal women on their mental health and emphasised the need for scalable, culturally sensitive interventions integrated within health systems.
In Siddipet district, the contradictions are particularly jarring. The area boasts impressive medical infrastructure, a 30-bed psychiatric ward at the Government General Hospital, trained primary health centre doctors, and direct access to Hyderabad’s prestigious Institute of Mental Health. Community health workers receive training to spot mental distress among pregnant women.
Despite this medical ecosystem, not a single dedicated service exists for perinatal mental health.
The irony deepens when considering Siddipet’s delivery statistics. Nearly 50 percent of births occur via Caesarean section, a rate that would alarm medical professionals in most countries. Research consistently links C-sections to increased postpartum depression risk, yet the district’s impressive medical infrastructure stops short of addressing this predictable consequence.
The study also found that the financial burden adds another cruel twist. Families in Siddipet already pay more out-of-pocket for deliveries than their counterparts in Haryana, creating economic stress that research shows can trigger or worsen postpartum depression. With 86 percent of the district’s population living in villages, the expensive private hospitals where counselling might be available remain as distant as the moon.
It’s a vicious cycle: surgical deliveries cost more, increase depression risk, but the mental health consequences go untreated because families have already exhausted their resources on the physical delivery.
The stigma runs so deep that visiting a psychiatrist becomes tantamount to admitting madness, while taking psychiatric medication marks a woman as fundamentally flawed.
The 22 September 2025 national consultation in New Delhi unearthed disturbing patterns that extend far beyond medical neglect.
“In Telangana, and indeed throughout India, it is common practice that women go back to their family home around the seventh month of their pregnancy and stay until around 40 days after birth, particularly for the birth of the first child. Here, they are well supported, and the practice of isolating the mother during this time seems to be rare,” said researchers.
“However, when women move back to their husband’s family, they often receive less support and are expected to do the housework in addition to looking after the baby. Little is known about how this move may affect the risk of mental health conditions, and this could be explored further in focus groups,” they added.
In families, some level of mental distress is frequently seen to be normal; family members often seem to reject the idea that PMHCs require treatment, help from outside is not accepted, and medical interventions can be seen as “unnecessary”.
“Consulting psychiatrists and psychotherapists, therapy and medication are widely considered taboo. Counselling seems to be better accepted but is usually only available through the private system,” said the researchers.
Consider the relentless pressure to have male children. Women face repeated pregnancies, each failed attempt to produce a son, adding layers of shame, anxiety, and depression.
Gender-based violence adds another devastating dimension. Domestic violence during pregnancy doesn’t just cause physical harm. “Importantly, intimate partner violence has been identified as one of the strongest predictors for PMHCs,” the research said.
Women who move to unfamiliar areas during pregnancy find themselves cut off from traditional support networks, struggling with language barriers while trying to access healthcare in foreign environments.
The human cost of this systematic neglect reveals itself in stark numbers. While India celebrates reducing overall maternal deaths by over 50 percent since the early 2000s, maternal suicide now accounts for an increasing share of these deaths. Recent reports from Kerala found that maternal suicide constituted nearly one in five maternal deaths in 2020, a statistic that should trigger national emergency protocols.
Prof. Pallab Maulik, Director of Research at The George Institute for Global Health India, emphasised the scale of the challenge: “Perinatal mental health is a major concern in India with a large number of women with undiagnosed and untreated perinatal depression and psychosis, which not only affects the mother but also the health of the baby and well-being of the family.”
As Dr Nicole Votruba from the University of Oxford, who serves as Principal Investigator for the PRAMH project, explained: “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 not 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.”
D YK Sandhya, Program Lead for Mental Health at The George Institute for Global Health India, emphasised the importance of integration: “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.”
The consultation concluded with a commitment to build a unified roadmap involving government agencies, civil society organisations, academic institutions, and frontline health workers. The goal is ambitious yet essential: ensuring that every mother in India can access the mental health care she needs.
(Edited by Muhammed Fazil.)
