Social Support, Coping Strategies and Healthcare Experiences among Women with Postpartum Mental Health Challenges in Southeast Nigeria: A Qualitative Study

Postpartum mental health disorders are among the leading contributors to maternal morbidity worldwide and represent a growing public health concern in low- and middle-income countries. Despite increasing recognition of postpartum depression and related mental health challenges, access to appropriate care remains limited in many parts of sub-Saharan Africa. In Nigeria, sociocultural stigma, inadequate integration of mental health into maternal healthcare, and weak referral systems continue to hinder timely identification and management of affected women. This study explored the social support systems, coping strategies, and healthcare experiences of postpartum mothers in Southeast Nigeria, with particular emphasis on health system gaps and utilization of maternal mental health services. A qualitative descriptive study was conducted in 2024 among 36 postpartum mothers attending Life International Hospital, Awka, Anambra State, Nigeria. Participants were purposively recruited from women within six months postpartum. Data were collected through four focus group discussions using a semi-structured interview guide. Discussions were audio-recorded with participants' consent, transcribed verbatim, and analyzed thematically following Braun and Clarke's approach. The study was reported in accordance with the Consolidated Criteria for Reporting Qualitative Research (COREQ). Three interconnected themes emerged from the analysis. First, participants relied primarily on informal social support from spouses, mothers, relatives, and close friends, although unsupportive family interactions frequently intensified emotional distress. Second, mothers adopted various coping strategies, including prayer, emotional suppression, social withdrawal, music, and peer support, reflecting both personal resilience and prevailing cultural expectations regarding motherhood. Third, participants described important shortcomings within the healthcare system, including limited routine screening for maternal mental health conditions, inadequate counselling services, insufficient provider engagement, and weak referral pathways. Most mothers reported that healthcare providers rarely enquired about their emotional wellbeing during postnatal visits, while stigma further discouraged disclosure of psychological distress. Women who received empathetic counselling and professional reassurance reported greater emotional relief and acceptance of their experiences. Postpartum mental health challenges among women in Southeast Nigeria are strongly influenced by the availability of social support, culturally shaped coping mechanisms, and deficiencies within maternal healthcare services. Integrating routine mental health screening into postnatal care, strengthening provider capacity to deliver culturally responsive psychosocial support, improving referral pathways, and promoting family-centred interventions may enhance service utilization and improve maternal mental health outcomes. These findings provide context-specific evidence to inform maternal mental health policy, service planning, and healthcare delivery in Nigeria.