Introduction

Postpartum depression (PPD) is an important mental health disorder that occurs in women after giving birth with its symptoms that include constant sadness, anxiety, exhaustion, irritability, and impaired daily functioning. In contrast to the temporary postpartum "baby blues," which usually passes quickly, PPD is much more severe and persistent and can have negative consequences for both the mother and the child if untreated. Worldwide, PPD affects about 10-20 % of women after childbirth, with incidence rates influenced by a complex combination of genetic, hormonal, psychological and socio-environmental factors [1, 2].

PPD typically develops during the first year after giving birth, most often occurring in the first three months after childbirth. It has been said metaphorically to be "the thief that steals motherhood," for it robs mothers of the expected joy that comes with nurturing a newborn during an important time of transition with profound emotional, physical, and social transformations. The exact cause of PPD is unclear; however, many risk factors have been consistently identified in the literature, such as hormonal and physiological changes, genetic predisposition, psychological vulnerability, and poor obstetric outcomes. Other salient factors include unexpected pregnancy, infant illness or bereavement, previous mental illness, chronic stress, marital discord, domestic violence and a lack of social or emotional support [4].

Contemporary evidence emphasizes the importance of women's awareness of PPD to early identification, help-seeking and participation in appropriate therapy. Understanding of PPD includes the ability to identify symptoms, risk factors and mechanisms leading to them, and different treatment modalities. A deficit of this understanding may hinder the ability of women to identify the symptoms of depression and seek professional help, which may lead to maladaptive responses to the symptoms in turn causing prolonged psychological suffering [5]. As a result, assessment of women's understanding of PPD is critical in understanding how mothers perceive, identify and respond to symptoms of depression during the postpartum period.

Despite the growing global attention on maternal mental health, the research in various cultural and geographic settings continues to show the lack of understanding of PPD among women. Cross-sectional studies of perinatal women in China have shown poor mental health literacy for PPD, especially in relation to identification of symptoms and appropriate help-seeking behaviors [2, 6]. Investigations in Saudi Arabia revealed that despite over fifty % of women assessed having a moderate understanding of PPD; there were still misconceptions and unfavorable attitudes surrounding mental health disorders [7]. Similar results have been found in the Middle Eastern context with the lack of understanding of PPD being a barrier to early identification and treatment [8].

In addition to geographic disparities, research tend to show these awareness deficiencies in sub-Saharan Africa. A Nigerian study suggested that although many women were aware of PPD, their understanding of symptoms, severity and implication was not sufficient [9]. Moreover, in online surveys that assessed women's knowledge on postpartum mood disorders and evidence-based interventions such as cognitive-behavioral therapy, overall awareness of PPD and treatment for PPD was low in different populations [10].

Women's views of PPD are deeply connected to the current beliefs and stigma about mental health in society. Negative perceptions (such as the perception of PPD as a normative aspect of parenthood; or a perception that women should innately be able to handle childcare without psychological distress) are often found. These beliefs could affect the recognition of symptoms and negatively influence women's inclination to seek professional help, which can make symptoms of depression more severe and prolonged [11].

Accordingly, early screening is important for the early detection and management of PPD. Several professional organizations recommend regular screening for postpartum depression. The United States Preventive Services Task Force recommends screening all persons including postpartum women irrespective of risk factors. The Edinburgh Postnatal Depression Scale (EPDS) is most commonly used as a screening tool, and has been recognised for its strong validity, reliability and easy administration. Additional validated instruments include the Patient Health Questionnaire-patient health questionnaire (PHQ-9) and the Postpartum Depression Screening Scale (PDSS) [12].

Maternity nurses and midwives play an important role in the early detection and prevention of PPD, with which they maintain regular communication with women during the prenatal and postpartum periods. Through well-designed assessments, planned follow-ups and targeted education, nurses are able to identify women who may be at increased risk, support increased awareness of PPD symptoms and support early referral and intervention. Providing accurate information with useful resources to mothers so that they can recognize the signs for early warnings may significantly enhance early detection and treatment outcomes [13].

Given the significant prevalence and serious consequences of PPD, the extent to which women understand PPD is important for developing effective educational and preventive interventions. Identifying existing knowledge gaps can be used to identify targeted strategies aimed at improving maternal mental health literacy, as well as stimulating the early identification of and treatment for postpartum depression.

Findings of the Study

Figure 1. Table (1): Descriptive Statistics for the Socio-demographic Characteristics

Figure 2. Table (2): Descriptive Statistics for the Reproductive information

Figure 3. Table (3): Descriptive Statistics for the Marital and family relationship factors

Figure 4. Table (4.1 ): Assessment Women's Knowledge about Postpartum Depression

Figure 5. Table (4.2 ): Assessment Women's Knowledge about Postpartum Depression

Figure 6. Table (5 ): Knowledge of Study Sample

Discussion

Age :

The current study used to determine that most of the participants aged between 30 and 40 years (62 %) were in the age group, hence indicating that they belonged to the mature stage of reproductive age. This finding agrees with the most recent academic syntheses, in particular, the systematic review and meta-analysis by Zarroug et al. (2025). The total number of articles included 32 studies with a cumulative number of 10,975 women, and the mean age of the study population was 30.38 8.622 years.

Residence:

The present research also indicated that 54  % of the respondents were city dwellers as earlier results indicated. Putri et al. (2023) reported a prevalence rate of PPD in the six months of 4.0 % with a advanced frequency in urban parts (5.7 %) compared to rural parts (2.9 %).

Educational Level

The investigations found out that 24 % of the respondents were illiterate, which is contrary to Alsulami et al. (2024). On the other hand, 53.1 % had received university degrees.

Occupation

Pre-eminent demographic features revealed 77 % of the study sample consisted of housewives. As Huang et al. (2023) affirm, this subgroup showed that it is significantly connected with a high level of postpartum depression literacy (F = 11.808, p = 0.001). Also, female workers evidenced higher literacy rates compared to the jobless ones (F ⁙ = 2.187, p= 0.05).

Monthly Income

The research found that 48 0f respondents had a sufficient monthly income, which is in contrast to Karki et al. (2024), where 72 0f respondents had a monthly income ranging between 20,000 and 40,000, which only 9 0f had higher incomes over 60,000.

Knowledge of the Study Sample

Among women, the level of size of postpartum depression knowledge was generally notable, as compared to the findings of Mohamed et al. (2024). In fact, 51% of the sample of the new mothers studied had little knowledge, and 78.3% had negative attitudes towards the condition.

Conclusions: the present study concluded

A major proportion of the respondents (62 %) was of the ages between 30 and 40, and half of them lived in cities. Interestingly, 24% of them had no literacy, and 77% were housewives. Further, 48% of them said that they have sufficient monthly income. The high levels of knowledge were reported in postpartum depression.

Recommendations: the study recommends

1. It is considered to be necessary to implement supportive programs that can contribute to the improvement of women in terms of psychological, emotional, and social competency, and hope to prevent the worsening of the situation.
2. Scholars emphasize the necessity of managing the postpartum depression because it is harmful both to the child and the mother.
3. Postpartum disorder educational workshops must be launched specifying the possible difficulties and providing an overall picture of the period of transition that will take place.
4. The researchers recommend that this study should be replicated in all localities of Al -Muthanna Governorate.