Group postpartum care improves mental health among postpartum women: a randomized controlled trial in Ghana

Despite the significant contribution of poor perinatal mental health to maternal morbidity and mortality, mental health care is often overlooked and not prioritized during postpartum care in many developing countries. In a parallel randomized controlled trial in Ghana, we tested an innovative postpartum care model—entitled Focused-Postpartum Care (Focused-PPC), with aims to improve mental health outcomes among women in Ghana. The Focused-PPC model involved comprehensive clinical assessments, evidence-based education, and peer support delivered throughout the first year after birth. A total of 192 postpartum women, 18 years of age or older, who experienced a live birth, were enrolled into the trial from four health centers in Tamale, Ghana. Participants were assigned in a 1:1 allocation without blinding to either the control arm or the intervention arm. The control arm received standard postnatal care while the intervention arm received the Focused-PPC model of care. Participants in the intervention arm had significantly lower perceived stress scores at three- and six-months post-birth. At baseline, the same number of participants (n = 71) in both the control and intervention arms screened positive for Postpartum Depression (PPD) via the Edinburgh Postnatal Depression Scale (EPDS). Significantly less participants in the intervention arm (0) screened positive for PPD by three-months post-birth compared to the control arm (5). Focused-PPC has potential to reduce postpartum stress and postpartum depression among women after birth.