Adolescent mothers worldwide face a heightened risk of postpartum depression. In Kenya, 15 percent of girls give birth before turning 18. Social support can help reduce the risk of postpartum depression but there is limited understanding of which types of support are most beneficial.

Working with the African Population and Health Research Center and Ali Groves, PhD, MHS, associate professor at DSPH, Gebrekristos gathered and quantified the experiences of 193 adolescent mothers (aged 14–19) living in an informal settlement in Nairobi within one year after giving birth. They looked at different types of social support, including help from the child’s father, parental support, support for education, social club membership, and having supportive female bonds. Using statistical analysis, they examined how these types of support were linked to depression while considering other relevant factors.

The research found that having supportive parents who value a girl’s education and having a close female friend may lower the risk of postpartum depression. Since adolescent mothers in Kenya face unique challenges and high birth rates, more support from parents and friends could help. Programs that strengthen these support systems during pregnancy and after childbirth may improve their mental health. Encouraging family and peer involvement could make a positive difference in their well-being.

To learn more about this research, Gebrekristos answered some questions below.

What specific aspects of support seem to contribute to lower postpartum depressive symptoms among adolescent mothers in Nairobi?

Gebrekristos: The strongest protective factor against postpartum depressive symptoms was having parental support for girls' education. Having a parent who valued girls’ education protected all girls from postpartum depression even those who were out of school. Further, adolescent mothers who had a female friend to confide in experienced lower risk of postpartum depressive symptoms.

Were there any cultural or social barriers that influenced how adolescent mothers accessed or perceived social support?

Gebrekristos: Adolescent mothers in Nairobi may experience discrimination in settings like hospitals and schools, and these experiences may negatively affect their access to social support. For example, In another paper, we found that adolescent mothers in Nairobi often face stigma, particularly in healthcare settings, where one-third reported experiencing abuse, stigma or discrimination during childbirth.

Experiencing mistreatment from healthcare providers can be a barrier to receiving postpartum care and support, leading to negative implications for their mental and physical health. Further, less than 10 percent of adolescent mothers in our study were currently in school, which could limit their access to peer support and lead to social isolation. Addressing these barriers may provide adolescent mothers with additional sources of support.

What recommendations do you have for implementing community-based interventions or policies to foster parental and peer support for adolescent mothers?

Gebrekristos: Recommendations include the following:

1. Programs that offer structured peer support groups. Such groups may facilitate meaningful friendships for adolescent mothers, which in turn, may reduce their postpartum depression risk.
2. Train healthcare providers in providing adolescent-friendly, stigma-free maternal health services. Such trainings may reduce stigma and discrimination, which in turn, may enhance access to postpartum care.
3. Strengthen/enforce existing policies that support postpartum return to school.
4. Explore the feasibility and efficacy of mobile-based interventions to provide support.

What can the U.S. learn from these findings?

Gebrekristos: Adolescent pregnancy can be challenging and isolating in many contexts.

Research to reduce postpartum depression for young mothers in the U.S. might explore whether/how friends, families and schools might best support young women to maximize their mental health postpartum.

Read the full study in Reproductive Health