Prevalence, Awareness, and Help-Seeking Behavior Regarding Antenatal Depression Among Pregnant Women in Quetta: A Cross-Sectional Study

Abstract

Background: Antenatal depression is a prevalent yet under-recognized mental health condition that can adversely impact both maternal and fetal outcomes. In low-resource settings such as Quetta, Pakistan, awareness of antenatal depression remains limited, and cultural stigma often prevents timely help-seeking, contributing to poor mental health care integration within routine antenatal services. Objective: This study aimed to determine the prevalence of antenatal depression among pregnant women in Quetta and to assess their awareness, perception of mental health stigma, and willingness to seek psychological support. Methods: A cross-sectional observational study was conducted among 78 pregnant women attending antenatal clinics in Quetta. Inclusion criteria included pregnant women aged ≥18 years at any gestational stage; those with prior psychiatric diagnoses or high-risk pregnancies were excluded. Data were collected using the Edinburgh Postnatal Depression Scale (EPDS) and a structured questionnaire assessing awareness, stigma perception, and help-seeking behavior. Ethical approval was obtained from the Institutional Review Board, and all procedures complied with the Declaration of Helsinki. Statistical analysis was performed using SPSS v27, employing descriptive statistics, chi-square tests, and logistic regression. Results: The prevalence of probable antenatal depression (EPDS ≥13) was 34.6%. Only 39.7% of participants were aware of antenatal depression, and 55.1% expressed reluctance to seek help. Logistic regression suggested higher depression likelihood among those in later trimesters and with poor social support, though results were not statistically significant (p > 0.05). Conclusion: Antenatal depression is common yet under-recognized in the study population, with low awareness and limited help-seeking highlighting critical service gaps. These findings support the integration of routine mental health screening and culturally appropriate education within antenatal care to improve maternal and fetal outcomes.