Postpartum depression in Pakistan 

When a child is born in Pakistan, the room is often filled with celebration. Relatives arrive with gifts, the air smells of mithai, and the new mother is expected to glow with joy. Yet behind her tired smile, many mothers are silently battling a darkness they never expected. Postpartum depression, a deeply misunderstood and rarely spoken of condition, is affecting thousands of Pakistani women, but our society offers little space for their pain.

Postpartum depression is not simply “baby blues” or mood swings that go away on their own. It is a medical condition that can manifest as persistent sadness, hopelessness, guilt, emotional numbness, or even detachment from the newborn. Some women experience panic attacks, difficulty bonding with their baby, or terrifying intrusive thoughts they are too ashamed to share. This is not because they are bad mothers. It is because their brains and bodies are undergoing one of the most intense transformations a human can face, and yet they are expected to carry on, unaided, as though nothing has changed.

Globally, about 10 to 15 percent of new mothers experience postpartum depression. In Pakistan, the numbers are significantly higher. Studies estimate that nearly 37 percent of women suffer from it within the first year after childbirth. The figure is likely underreported due to stigma and lack of awareness. Our healthcare system largely focuses on the physical health of the mother and baby during and after delivery. Emotional health is barely acknowledged. The checkups after birth are about stitches healing and weight gain. No one asks the mother if she feels like crying all day or if she’s afraid to be alone with her baby.

The cultural expectations placed on new mothers in Pakistan are overwhelming. She is expected to embrace motherhood instantly, care for her baby flawlessly, host visitors, maintain relationships, and bounce back to her previous routine, all while healing from the physical trauma of childbirth. In many households, there is an immediate expectation that she will resume housework and serve guests, regardless of her pain or exhaustion. In-laws and extended family may see this as a test of her strength, a measure of whether she is fulfilling her “duty.” The husband, often detached from the caregiving process, may see his role as limited to financial provision, while the emotional and physical labour of raising the child falls entirely on the mother. Nights without sleep, days without help, and no one to turn to; these are the invisible shackles that trap many women in a cycle of guilt and despair.

A mother who brings life into the world deserves more than our admiration. She deserves our attention, our care, and our understanding. Not every woman will talk about what she’s feeling, but if we create a culture where her pain is seen rather than silenced, we can begin to save lives, not just of mothers, but of the children they raise. Healing begins with listening. And it’s time we listened to the mothers who cannot find the words to speak.

The burden grows heavier for those who give birth to a girl. In a society that still silently values sons over daughters, a woman may be blamed, insulted, or humiliated for bringing a girl into the world, as if it were a failure of her body. There are women who are not given proper meals, who are mocked in subtle ways, whose own mothers-in-law whisper bitter comments that wear down what little self-worth they have left. Postpartum depression in these cases is not just a medical condition, it becomes a lived consequence of misogyny, of constant beratement, and of being reduced to a womb that must produce a boy to be of worth.

The measures that need to be taken are not limited to hospitals and clinics. Yes, it is essential to integrate mental health screening into all postpartum care. Each mother should be gently assessed by trained counselors for signs of depression, not just once but multiple times in the first six months. Health professionals must be trained to take emotional symptoms as seriously as physical ones. But beyond that, the real reform must begin at home. Husbands must be taught by society, by families, by role models, that childcare is not a woman’s job alone. Changing diapers, waking up at night, and sitting beside a wife who is healing is not generosity, it is responsibility. In-laws must be made aware that rest, love, and patience are not luxuries but necessities for a new mother. Communities need to be taught that birthing a girl is not a failure, and that emotional breakdowns are not weakness, but a cry for help that must be met with care, not condemnation.

We must normalize counseling and therapy for new mothers and provide spaces, whether in hospitals, community centres, or even mobile apps, where women can speak without fear of being judged. Government health initiatives should include mother wellness programmes that provide both education and emotional support. In rural areas, where access to mental health professionals is scarce, even training midwives and lady health workers to recognize symptoms and provide first-line emotional care can make a life-changing difference.

A mother who brings life into the world deserves more than our admiration. She deserves our attention, our care, and our understanding. Not every woman will talk about what she’s feeling, but if we create a culture where her pain is seen rather than silenced, we can begin to save lives, not just of mothers, but of the children they raise. Healing begins with listening. And it’s time we listened to the mothers who cannot find the words to speak.