Prevalence and Determinants of Postpartum Depression Among Mothers in Badung Regency, Bali: A Cross-Sectional Study
PDF

Keywords

Associated factors
Husband support
Postpartum depression
Prevalence
Stressor

How to Cite

Lindayani, I. K., Nurmala, I., Puspitasari, N., & Prasetyo, B. (2025). Prevalence and Determinants of Postpartum Depression Among Mothers in Badung Regency, Bali: A Cross-Sectional Study. Jurnal Kesehatan Manarang, 11(3), 351–362. https://doi.org/10.33490/jkm.v11i3.2136

Abstract

Postpartum depression (PPD) affects many aspects of a mother's life. Understanding the factors that contribute to this condition is crucial, as some factors may play a greater role than others. This study aimed to identify the prevalence of PPD, examine its associated factors, and determine the dominant factors related to the incidence of PPD in Badung Regency, Indonesia. This research employed a cross-sectional design conducted between May and July 2024. It involved 239 mothers who were 2 – 6 weeks postpartum. Participants were selected from seven public health centers in Badung Regency using two-stage cluster sampling. A questionnaire was used to assess several factors, including sociodemographic characteristics, obstetric history, baby characteristics, stressors during the postpartum period, husband’s support, and postpartum depression symptoms. These factors were analyzed using bivariate chi-square analysis and multivariate logistic regression. The prevalence of PPD in this study was 47.3%. Associated factors included maternal age, stressors related to personal needs and fatigue, infant nurturing, body changes and sexuality, and instrumental and emotional husband support. Among these, the most dominant factors were body changes and sexuality, personal needs, and fatigue, which increased the risk of PPD by approximately threefold. The prevalence of PPD in Badung Regency is higher than previously reported in other areas. This highlights the importance of PPD screening and educating husbands about the need to provide both instrumental and emotional support during the postpartum period. We recommend implementing early screening and husband involvement programs.

https://doi.org/10.33490/jkm.v11i3.2136
PDF

References

Aadillah, V. Y., & Nurbaeti, I. (2023). Postpartum Depression and Its Contributing Factors among Mothers during the COVID-19 Pandemic in North Jakarta, Indonesia. Nurse Media Journal of Nursing, 13(1), 85–94. https://doi.org/10.14710/nmjn.v13i1.49860

Antoniou, E., Tzanoulinou, M.-D., Stamoulou, P., & Orovou, E. (2022). The Important Role of Partner Support in Women’s Mental Disorders During the Perinatal Period. A Literature Review. Maedica - A Journal of Clinical Medicine, 17(1), 289–298. https://doi.org/10.26574/maedica.2022.17.1.194

Asadi, M., Noroozi, M., & Alavi, M. (2022). Identifying women’s needs to adjust to postpartum changes: a qualitative study in Iran. BMC Pregnancy and Childbirth, 22(1), 115. https://doi.org/10.1186/s12884-022-04459-8

Atuhaire, C., Rukundo, G. Z., Nambozi, G., Ngonzi, J., Atwine, D., Cumber, S. N., & Brennaman, L. (2021). Prevalence of postpartum depression and associated factors among women in Mbarara and Rwampara districts of south-western Uganda. BMC Pregnancy and Childbirth, 21(1), 503. https://doi.org/10.1186/s12884-021-03967-3

Biaggi, A., Conroy, S., Pawlby, S., & Pariante, C. M. (2016). Identifying the women at risk of antenatal anxiety and depression: A systematic review. Journal of Affective Disorders, 191, 62–77. https://doi.org/10.1016/j.jad.2015.11.014

Bradshaw, H., Riddle, J. N., Salimgaraev, R., Zhaunova, L., & Payne, J. L. (2022). Risk factors associated with postpartum depressive symptoms: A multinational study. Journal of Affective Disorders, 301(July 2021), 345–351. https://doi.org/10.1016/j.jad.2021.12.121

Corrigan, C. P., Kwasky, A. N., & Groh, C. J. (2015). Social Support, Postpartum Depression, and Professional Assistance: A Survey of Mothers in the Midwestern United States. The Journal of Perinatal Education, 24(1), 48–60. https://doi.org/10.1891/1058-1243.24.1.48

Dlamini, L. P., Mahanya, S., Dlamini, S. D., & Shongwe, M. C. (2019). Prevalence and factors associated with postpartum depression at a primary healthcare facility in Eswatini. South African Journal of Psychiatry, 25(0), 1404. https://doi.org/10.4102/sajpsychiatry.v25i0.1404

Galbally, M., Watson, S. J., Permezel, M., & Lewis, A. J. (2019). Depression across pregnancy and the postpartum, antidepressant use and the association with female sexual function. Psychological Medicine, 49(09), 1490–1499. https://doi.org/10.1017/S0033291718002040

Ghaedrahmati, M., Kazemi, A., Kheirabadi, G., Ebrahimi, A., & Bahrami, M. (2017). Postpartum depression risk factors: A narrative review. Journal of Education and Health Promotion, 6(1). https://doi.org/10.4103/jehp.jehp_9_16

Halbreich, U., & Karkun, S. (2006). Cross-cultural and social diversity of prevalence of postpartum depression and depressive symptoms. Journal of Affective Disorders, 91(2–3), 97–111. https://doi.org/10.1016/j.jad.2005.12.051

Hopkins, J., & Campbell, S. B. (2008). Development and validation of a scale to assess social support in the postpartum period. Archives of Women’s Mental Health, 11(1), 57–65. https://doi.org/10.1007/s00737-008-0212-5

Khademi, K., Kaveh, M. H., Ghahremani, L., Nazari, M., & Karimi, M. (2023). The impact of family social support on postpartum quality of life among Iranian women: structural equation modelling. Journal of International Medical Research, 51(2). https://doi.org/10.1177/03000605221147198

Kristensen, I. H., Simonsen, M., Trillingsgaard, T., Pontoppidan, M., & Kronborg, H. (2018). First-time mothers’ confidence mood and stress in the first months postpartum. A cohort study. Sexual & Reproductive Healthcare, 17(June), 43–49. https://doi.org/10.1016/j.srhc.2018.06.003

Lee, M.-S., Lee, J. J., Park, S., Kim, S., & Lee, H. (2023). Is social support associated with postpartum depression, anxiety and perceived stress among Korean women within the first year postpartum? Journal of Psychosomatic Obstetrics & Gynecology, 44(1), 2231629. https://doi.org/10.1080/0167482X.2023.2231629

Leistikow, N., & Smith, M. H. (2024). The role of sleep protection in preventing and treating postpartum depression. Seminars in Perinatology, 48(6), 151947. https://doi.org/10.1016/j.semperi.2024.151947

Lindayani, I. K., & Marhaeni, G. A. (2020). Prevalensi dan Faktor Risiko Depresi Postpartum Di Kota Denpasar Tahun 2019. Jurnal Midwifery Update (MU), 2(2), 100–109. https://doi.org/10.32807/jmu.v2i2.94

Lowdermilk, D. L., Perry, S. E., & Cashion, K. (2013). Maternity Nursing-Revised Reprint-e-book (8th ed.). Elsevier health Sciences. https://books.google.co.id/books/about/Maternity_Nursing_E_Book.html?id=A9XsAwAAQBAJ&redir_esc=y

Luciano, M., Sampogna, G., Del Vecchio, V., Giallonardo, V., Perris, F., Carfagno, M., Raia, M. L., Di Vincenzo, M., La Verde, M., Torella, M., & Fiorillo, A. (2021). The Transition From Maternity Blues to Full-Blown Perinatal Depression: Results From a Longitudinal Study. Frontiers in Psychiatry, 12, 1–9. https://doi.org/10.3389/fpsyt.2021.703180

Martínez-Galiano, J. M., Hernández-Martínez, A., Rodríguez-Almagro, J., Delgado-Rodríguez, M., Rubio-Alvarez, A., & Gómez-Salgado, J. (2019). Women’s Quality of Life at 6 Weeks Postpartum: Influence of the Discomfort Present in the Puerperium. International Journal of Environmental Research and Public Health, 16(2), 253. https://doi.org/10.3390/ijerph16020253

Miller, E. R., Anderson, K. L., & Smith, J. A. (2022). Postpartum Body Image Dissatisfaction and Its Association with Depressive Symptoms. Journal of Women’s Health, 31(5), 545–554. https://doi.org/10.1089/jwh.2021.0545

Mitnick, D. M., Lorber, M. F., Smith Slep, A. M., Heyman, R. E., Xu, S., Bulling, L. J., Nichols, S. R., & Eddy, J. M. (2022). “Self-report measures of coercive process in couple and parent–child dyads”: Correction. Journal of Family Psychology, 36(4), 522–522. https://doi.org/10.1037/fam0000973

Modak, A., Ronghe, V., Gomase, K. P., Mahakalkar, M. G., & Taksande, V. (2023). A Comprehensive Review of Motherhood and Mental Health: Postpartum Mood Disorders in Focus. Cureus, 29(15). https://doi.org/10.7759/cureus.46209

Muraca, G. M., & Joseph, K. (2014). The Association Between Maternal Age and Depression. Journal of Obstetrics and Gynaecology Canada, 36(9), 803–810. https://doi.org/10.1016/S1701-2163(15)30482-5

Nakić Radoš, S., Brekalo, M., & Matijaš, M. (2023). Measuring stress after childbirth: development and validation of the Maternal Postpartum Stress Scale. Journal of Reproductive and Infant Psychology, 41(1), 65–77. https://doi.org/10.1080/02646838.2021.1940897

Nguyen, T. (2023). The Impact Of Social Media On Adolescents. In Senior Theses (Vol. 104). https://doi.org/10.33015/dominican.edu/2023.NURS.ST.19

Nurbaeti, I., Deoisres, W., & Hengudomsub, P. (2018). Postpartum depression in Indonesian mothers: Its changes and predicting factors. Pacific Rim International Journal of Nursing Research, 22(2), 93–105. https://he02.tci-thaijo.org/index.php/PRIJNR/article/view/84760

Nurbaeti, I., Deoisres, W., & Hengudomsub, P. (2019). Association between psychosocial factors and postpartum depression in South Jakarta, Indonesia. Sexual & Reproductive Healthcare, 20(January), 72–76. https://doi.org/10.1016/j.srhc.2019.02.004

Orchard, E. R., Rutherford, H. J. ., Holmes, A. J., & Jamadar, S. D. (2023). Matrescence: lifetime impact of motherhood on cognition and the brain. Trends in Cognitive Sciences, 27(3), 302–316. https://doi.org/10.1016/j.tics.2022.12.002

Putriarsih, R., Budihastuti, U. R., & Murti, B. (2017). Prevalence and Determinants of Postpartum Depression in Sukoharjo District , Central Java. Journal of Maternal and Child Health, 3(1), 11–24. https://thejmch.com/index.php/thejmch/article/view/76

Qobadi, M., Collier, C., & Zhang, L. (2016). The Effect of Stressful Life Events on Postpartum Depression: Findings from the 2009–2011 Mississippi Pregnancy Risk Assessment Monitoring System. Maternal and Child Health Journal, 20(S1), 164–172. https://doi.org/10.1007/s10995-016-2028-7

Shi, P., Ren, H., Li, H., & Dai, Q. (2018). Maternal depression and suicide at immediate prenatal and early postpartum periods and psychosocial risk factors. Psychiatry Research, 261, 298–306. https://doi.org/10.1016/j.psychres.2017.12.085

Shorey, S., Chee, C. Y. I., Ng, E. D., Chan, Y. H., Tam, W. W. S., & Chong, Y. S. (2018). Prevalence and incidence of postpartum depression among healthy mothers: A systematic review and meta-analysis. Journal of Psychiatric Research, 104, 235–248. https://doi.org/10.1016/j.jpsychires.2018.08.001

Silveira, M. L., Ertel, K. A., Dole, N., & Chasan-Taber, L. (2015). The role of body image in prenatal and postpartum depression: a critical review of the literature. Archives of Women’s Mental Health, 18(3), 409–421. https://doi.org/10.1007/s00737-015-0525-0

Smith, M. V, Shao, L., Howell, H., Lin, H., & Yonkers, K. A. (2011). Perinatal Depression and Birth Outcomes in a Healthy Start Project. Maternal and Child Health Journal, 15(3), 401–409. https://doi.org/10.1007/s10995-010-0595-6

Tola, Y., Ayele, G., Boti, N., Yihune, M., Gethahun, F., & Gebru, Z. (2021). Health-Related Quality-of-Life and Associated Factors Among Post-Partum Women in Arba Minch Town. International Journal of Women’s Health, Volume 13, 601–611. https://doi.org/10.2147/IJWH.S295325

Trier, A. M., Mack, M. R., & Kim, B. S. (2019). The Neuroimmune Axis in Skin Sensation, Inflammation, and Immunity. The Journal of Immunology, 202(10), 2829–2835. https://doi.org/10.4049/jimmunol.1801473

Wang, Z., Liu, J., Shuai, H., Cai, Z., Fu, X., Liu, Y., Xiao, X., Zhang, W., Krabbendam, E., Liu, S., Liu, Z., Li, Z., & Yang, B. X. (2021). Mapping global prevalence of depression among postpartum women. Translational Psychiatry, 11(1), 543. https://doi.org/10.1038/s41398-021-01663-6

WHO. (2008). Perinatal Period. In Encyclopedia of Public Health (pp. 1096–1096). Springer Netherlands. https://doi.org/10.1007/978-1-4020-5614-7_2589

WHO. (2023). Maternal Mental Health. https://www.afro.who.int/sites/default/files/2024-02/Policy brief - Strengthening Maternal Mental Health in Ghana.pdf

Winston, R., & Chicot, R. (2016). The importance of early bonding on the long-term mental health and resilience of children. London Journal of Primary Care, 8(1), 12–14. https://doi.org/10.1080/17571472.2015.1133012

Yoo, H., Ahn, S., Park, S., Kim, J., Oh, J., & Koh, M. (2021). Factors influencing prenatal and postpartum depression in Korea: a prospective cohort study. Korean Journal of Women Health Nursing, 27(4), 326–336. https://doi.org/10.4069/kjwhn.2021.11.17

Creative Commons License

This work is licensed under a Creative Commons Attribution-ShareAlike 4.0 International License.

Copyright (c) 2025 I Komang Lindayani, Ira Nurmala, Nunik Puspitasari, Budi Prasetyo