Prevalence and determinants of postpartum depression among rural and urban women in South India: a comparative cross-sectional study

Background: Postpartum depression (PPD) is a significant public health concern affecting maternal wellbeing, infant development and family health, particularly in low- and middle-income countries. Evidence comparing the burden of PPD between rural and urban populations in India remains limited. This study aimed to assess and compare the prevalence of postpartum depression and its associated socio-demographic and obstetric factors among rural and urban women in Bengaluru. Methods: A community-based comparative cross-sectional study was conducted over two months among 150 postpartum women (75 rural and 75 urban) in Bengaluru. Women between 4 weeks and 1 year postpartum were selected using a multistage sampling technique. Data were collected using a structured questionnaire including socio-demographic and obstetric details and the Edinburgh postnatal depression scale (EPDS). Descriptive statistics and chi-square tests were used for analysis. Results: The prevalence of PPD was 76% among rural women and 69% among urban women. Mild depression was more common in urban participants, whereas moderate and severe depression were more prevalent among rural women. Significant associations were observed between PPD and housing status, husband’s employment and place of delivery (p<0.05). Conclusions: The study revealed a high burden of postpartum depression in both rural and urban settings, with greater severity among rural women. Routine screening for postpartum depression at primary healthcare facilities and strengthening maternal mental health services under national programs are urgently required.