Motherhood and mental pain: Kenya's overlooked crisis

From anxiety during pregnancy to postpartum depression after delivery, many women carry emotional wounds that remain unseen, untreated and deeply misunderstood.

For many mothers, mental health challenges begin long before childbirth and continue long after delivery. Yet conversations around motherhood in many communities still revolve around resilience, sacrifice and endurance, leaving little room for women to openly discuss emotional distress.

Speaking during a maternal mental health forum at the African Population and Health Research Center, experts warned that the crisis is being worsened by stigma, weak support systems, obstetric violence and lack of consistent data, leaving many mothers to suffer silently.

Esther Muchiri has witnessed firsthand how untreated maternal mental illness can spiral into dangerous situations for mothers and their babies.

She recalls one painful case involving a woman who developed severe depression during her third pregnancy.

“At first, she could not even understand what delivery meant or what was happening around her,” says Muchiri. “But there was hope because the family was supportive in the beginning.” 

Muchiri says, the woman had experienced similar symptoms during her first pregnancy, but the condition had never been properly addressed. Over time, her mental state deteriorated, forcing relatives and community health workers to intervene constantly.

“Sometimes we would spend nights at her home because she could not be left alone,” she says.

The situation took a frightening turn shortly after the woman delivered her baby.

“One night I received a call from the chief after members of the community reported seeing her standing inside a river with the baby,” says Muchiri. “She said she wanted to baptise the child.”

Community members rescued the mother and baby before emergency responders arrived. The child, who was malnourished, was admitted for treatment while the mother underwent psychiatric care for nearly four months.

But even after discharge, the struggle continued.

Muchiri reveals that family relationships had already broken down due to repeated conflicts linked to the woman’s condition. The father was absent, the children frequently missed school and relatives had become overwhelmed trying to cope.

“It became a battle between the community, local administration and the family,” she says. “At some point everyone was exhausted.”

Working alongside local leaders, teachers and neighbours, Muchiri helped organise food support, childcare and temporary guardianship for the children while following up on the mother’s recovery

She says such cases are more common than many people realise.

“Maternal mental health problems are real and they can become very severe if mothers are not supported early,” she says.

For Faith Ong’iro, the emotional trauma surrounding childbirth began inside the delivery room.

The founder of The Amot Network, a maternal wellness initiative, recalls carrying her first pregnancy without complications. But when it came time to give birth to her daughter Zuri, now eight years old, everything changed.

“I carried the pregnancy well for nine months,” she says. “Then during delivery I was told I had cephalopelvic disproportion. I did not even know what it meant.”

The condition, where a baby cannot safely pass through the mother’s pelvis during delivery, left her frightened and confused at a moment when she expected support and reassurance

“I kept wondering, how I carried a baby for nine months and suddenly I am being told I cannot push the baby out,” she says.

Instead of receiving empathy, Ong’iro says she felt blamed and judged by some healthcare workers.

“People were telling me what to do, others asking how I could be so careless,” she recalls. “As a first-time mother, how was I expected to know these things?”

By the time she finally held her baby, Ong’iro reveals that she was emotionally overwhelmed.

“I was postpartum haemorrhaging, everything had shut down and I was trying to understand this condition I had just been told about,” she says.

Her experience reflects what experts say many Kenyan mothers silently endure during and after childbirth — fear, confusion, shame and emotional distress that often go unnoticed or dismissed entirely.

For Sammy Lewalchingei, maternal mental health conversations cannot ignore the role of fathers and the cultural barriers that often keep men distant from pregnancy, grief and emotional support.

Coming from a marginalised community where childbirth and maternal matters are traditionally considered women’s issues, Lewalchingei says many men grow up believing they should not be involved in antenatal care or emotional conversations.

“When it comes to issues involving women, especially pregnancy and childbirth, many communities see men participating as an abomination,” he says.

But his perspective changed after he and his wife lost their first baby, Arianna.

“When we lost our baby at around 3.30am, it completely opened my eyes to maternal mental health,” he says.

He recalls how most people who came to comfort the family focused entirely on the mother while ignoring fathers who were also grieving.

“Everyone would ask my wife how she was doing, but nobody asked me how I was feeling as the father,” he says. “Yet we are human beings too. Men cry. Men grieve.”

One of the most painful moments for him was hearing how some healthcare workers spoke to grieving mothers after stillbirths and pregnancy loss.

“You cannot tell a grieving mother that she is still young and can have another baby,” he says. “At that moment she needs compassion, comfort and dignity.”

Lewalchingei believes maternal mental health support must extend beyond urban hospitals and policy discussions to rural communities where women often suffer in silence with little access to counselling or psychosocial support.

“We talk about maternal mental health mostly in towns and cities,” he says. “But what about the mother sitting in a remote village with no road, no hospital and no support system?”

The experiences shared by mothers, families and advocates mirror a growing global mental health crisis surrounding childbirth.

According to 2025 data from the Postpartum Depression Organisation, an estimated 10 to 20 per cent of women worldwide experience postpartum depression after childbirth. The burden is even higher in low- and middle-income countries, where prevalence rates often approach 20 per cent.

Despite postpartum depression being treatable, nearly half of affected mothers are never diagnosed by a health professional.

Recent research by the Kenya Medical Research Institute and its partners shows postpartum and postnatal depression are becoming a major public health concern in Kenya.

Studies conducted between 2023 and 2026 indicate that postnatal depression affects between 13 per cent and 72.5 per cent of mothers depending on location and vulnerability factors such as poverty, nutrition and maternal age.

While the general prevalence of postnatal depression in Nairobi is estimated at around 18 per cent, studies show rates rise sharply among vulnerable groups, including adolescent mothers, mothers caring for malnourished children and women with preterm infants.

According to Caroline Wainaina, one of the biggest challenges facing maternal mental healthcare in Kenya is the lack of consistent national data on perinatal depression.

“We really do not have consistent national data on perinatal depression in Kenya,” she says. “Most of the available research consists of cross-sectional studies conducted in different populations, making it difficult to track trends over time.”

Wainaina says maternal healthcare in Kenya still focuses heavily on physical wellbeing while overlooking emotional and mental health needs.

“Health is not only physical,” she says. “It also includes mental, emotional and social wellbeing, but that aspect is often missing during maternal health assessments.”

She warns that untreated maternal depression can trigger a chain of health complications for both mother and child. Women experiencing depression are less likely to attend all recommended antenatal visits, increasing the risk of complications during pregnancy and childbirth.

After delivery, she says, healthcare systems often shift attention almost entirely to the baby while neglecting the mother’s emotional wellbeing.

“We only have a few postnatal check-ups, and most of the time the focus is entirely on the child,” she says. “Nobody really asks the mother, ‘How are you coping?’”

Dr Linet Ongeri says Kenya already has policies recognising maternal mental health, but implementation remains weak.

“The policy is clear that women should be screened for mental health conditions during pregnancy and after childbirth,” she says. “But are we implementing it consistently, and do we actually have data showing how many women are being screened?”

According to Dr Ongeri, healthcare systems must identify psychosocial risk factors early enough before they escalate into severe depression, anxiety or postpartum psychosis.

“There is an element of timeliness when it comes to maternal mental health,” she says. “If we fail to identify psychosocial risk factors early, then we miss the opportunity for intervention.”

She says integrating mental healthcare into antenatal, delivery and postnatal services could help bridge the gap between policy and practice.

Meanwhile, Anita Otieno says stigma surrounding maternal mental health is worsened by weak legal protections for mothers experiencing depression, trauma and obstetric violence.

“There is no formal legal statute that fully recognises the stigma mothers face during depression and maternal mental health challenges,” she says.

Otieno argues that obstetric violence — including mistreatment, humiliation, neglect or abusive care during childbirth — can leave lasting psychological scars.

“Obstetric violence does not only happen during birth itself,” she says. “It can also continue during postnatal care and in the way mothers are treated within the healthcare system.”

At the same time, Dr Mercy Karanja says healthcare workers already receive basic mental health training during medical education, including mental health assessment during internship rotations.

“All doctors undergo mental health assessment training during their internship rotations,” she says. “The challenge is not necessarily a knowledge gap.”

Instead, she says, mental illness remains deeply stigmatised in society, preventing many mothers from seeking help early.