Perceived social support and its association with postpartum depressive symptoms among mothers: a community-based cross-sectional study from Kerala, India

Postpartum depression (PPD) is a serious mental health issue among postpartum women. In India, maternal well-being is significantly influenced by extended family and community support. Disruptions in these networks may heighten the risk of PPD. However, Community-based studies are scarce on social support and its association with PPD in India. This study aims to evaluate the pattern of perceived social support (PSS) among postpartum women in Malappuram district, Kerala, and to examine the association with PPD symptoms. The cross-sectional, community-based study recruited 560 eligible postpartum mothers using multi-stage cluster sampling. The Edinburgh postnatal depression scale and Multidimensional Scale of Perceived Social Support were used to screen for PPD and assess PSS. Spearman’s rank correlation and multivariable logistic regression examined the relationship between PSS and PPD symptoms. To determine if PSS indirectly associated with PPD and independent variables, Karlson–Holm–Breen mediation analysis was performed. About 80% of postpartum women had strong PSS. Mothers residing in a joint family (aOR = 2.5, P = < 0.001), prefer sex of infant (aOR = 2.6, P = < 0.001), unpaid care support (aOR = 6.09, P = < 0.001) and mothers who did not work or pursue education after giving birth (aOR = 2.3, P = < 0.001) reported lower PSS. The result suggests that PSS is indirectly associated with PPD and factors such as uncertainty about work after delivery. This study revealed the importance of PSS in the prevention of PPD.Higher PSS is associated with fewer PPD symptoms, suggesting a potential protective relationship that warrants further investigation through longitudinal research. The findings underscore that the implementation of community awareness and intervention programs via task-sharing techniques provides a sustainable solution.