Association of Postpartum Depression with Mode of Delivery: A Cross Sectional Study at A Psychiatry Institute of Rawalpindi

Abstract

Objective: To determine the association between postpartum depression and mode of delivery among women presenting to a psychiatry institute in Rawalpindi.

Study Design: Cross-sectional analytical study
Place and Duration of Study: This study was conducted at the Armed Forces Institute of Mental Health Rawalpindi December 16 till March 15, 2026.

Methods: This study was conducted including 210 postpartum women within 6 weeks of delivery. Postpartum depression was assessed using the Edinburgh Postnatal Depression Scale, with a score ≥13 indicating depression.

Results: The mean age of participants was 29.8 ± 5.7 years, and the overall frequency of postpartum depression was 40.0%. Depression was significantly more common in women undergoing cesarean section compared to vaginal delivery (57.1% vs 42.9%, p = 0.002), with emergency cesarean showing a stronger association. Women with postpartum depression had higher mean EPDS scores (16.8 ± 3.2 vs 8.2 ± 2.6; p <0.001). Additional factors significantly associated with depression included age >30 years, low socioeconomic status, unplanned pregnancy, primiparity, poor neonatal health, and inadequate social support (p <0.05).

Conclusion: Postpartum depression is significantly associated with cesarean delivery, particularly emergency procedures, along with multiple demographic and psychosocial factors. Early screening and targeted interventions are essential to improve maternal mental health outcomes.