Postnatal depression is common but largely undetected; the issue is whether mothers are heard before it becomes a crisis.
What kind of mom would you be if you didn't suffer? It is common to honor a mother's sacrifice. It also embodies an ingrained assumption that a good mother should suffer from exhaustion, sleeplessness, emotional stress, and vast responsibilities for an entire family without complaining.
Motherhood is celebrated. Suffering of the mother is normalised. That distinction matters.
Maternal mental health has been in the spotlight again following the ongoing trial of labour-and-delivery nurse Lindsay Clancy, who is accused of murdering her three young children in Massachusetts in 2023.
The defence has maintained she was in such a serious state of psychiatric illness, such as postpartum psychosis. Prosecutors have rebutted that argument, saying she was still guilty. After two days of deliberation, the jury had not reached a verdict. The situation is tragic. However, a question remains: What happens when a mother is struggling? Still, do those around her see it as just being a mother?
The issue of maternal mental health is already a significant public-health problem in our country.
A systematic review and meta-analysis study of Bangladeshi mothers published in 2025 found that the prevalence of postnatal depression was 27.75 per cent.
Studies in the 2010s found it to be higher, at 36 per cent.
The review also found the risk factors for postnatal depression, such as unintended pregnancy, intimate-partner violence, preference for male children and poor relationships with in-laws and husbands.
The prevalence of maternal mental disorders across studies varied from 9 per cent to 51.7 per cent in a separate narrative review of maternal mental disorders conducted in 2024 in Bangladesh.
The authors also identified significant knowledge gaps, such as the lack of a national study with confirmatory diagnostic tools.
This wide range across studies reflects differences in populations, methodologies, and screening instruments.
It should not, however, be confused with the bigger story, which is that maternal mental distress is not insignificant in the country, and that there is still not a full understanding of its prevalence. However, the issue is not restricted to depression.
The 2024 review identified evidence of a greater burden of mental disorders in pregnancy and the postpartum period. It highlights the need to include maternal mental health in the consideration of physical health.
However, a large part of maternal health care remains focused on the physical aspects of pregnancy and childbirth - safe delivery, anaemia, blood pressure, nutrition, breastfeeding and baby growth.
All these are required. But the mother is more than a body recovering from childbirth.
Someone also has to ask whether she is sleeping, feeling overwhelmed, feeling like herself, or feeling sad, anxious, or having other concerning symptoms that persist.
Where cultural expectations can get in the way, a tired new mom could be told, "It's just part of being a mom. A sleepy new mom may be told, "It's just part of being a mom. When a woman feels overwhelmed, she may be reminded that previous generations had several children without complaining. Asking for more help may prompt a mother to feel that caring for children is her job.
Friction arises when the same attitudes that cause a woman to struggle with the transition to motherhood can lead her to mistake it for a mental disorder that needs professional help.
Not all mothers who are tired are depressed and suffering from distress necessarily have postpartum psychosis.
Depression, anxiety and postpartum psychosis are distinct disorders which should be assessed and treated accordingly. However, any serious symptoms should not be ignored just because a woman is a new mother. Another misconception which needs to be noted is the belief that being professionally competent is a safeguard for women against psychological crisis. It does not.
A woman with a high level of education can become depressed. A health care worker can get upset. A severe psychiatric illness may occur in a woman who has a strong love for her children.
The stereotype of a strong woman can make it harder for people to spot distress. An apparently well-functioning mother who is still working is assumed to cope. Of course, one should not retroactively classify all cases of maternal distress as being of the nature of postpartum psychosis. What is far more important is that maternal mental illness must be identified before it turns into an unsolvable crisis.
Bangladesh's evidence on maternal mental health is scattered, and the diagnosis and surveillance across the country are still lagging, as commented by psychiatrist S. M. Yasir Arafat and co-author Ravi Philip Rajkumar in their review in 2024. Their results suggest that maternal mental health should not be considered a 'nice to have' but should be a part of healthcare.
Screenings for mental health should be integrated meaningfully into antenatal and postnatal care; trained health care workers should be able to recognise symptoms of concern and organise referrals for appropriate support.
Families should also be reminded that practical assistance is different to advice. When a mother is exhausted and nights are long, having someone else share the burden of childcare and housework is more valuable than merely saying, "Take your time." (need quote)
Partners have a specific role. But a working-at-home husband is not necessarily a good indicator of childcare support. Not being physically present does not mean less sharing of feeding responsibilities, night care, household management, and emotional labour.
Women should be encouraged to recognise warning signs, speak up, and protect their health. The mother shouldn't have to constantly demonstrate distress before she gets attention. Nor should she have to hit a breaking point before the healthcare system catches up with her.
It is impossible to say if earlier or other interventions would have altered the Clancy results. It would be irresponsible to make such a statement before a final judgment is reached and the case is resolved. However, a similar tragedy need not happen in our society to make maternal mental health a priority.
Growing research also recognised gaps in detecting, diagnosing, and caring for people. Now we need a stronger link between recognising and acting.
"Kosto na korle kiser ma?" may have been intended to honour maternal sacrifice. It should never be used as an excuse to disregard the distress of the mother. No criterion of good motherhood should be judged by the amount of pain a woman can sustain. The yardstick for a healthy society is how fast it listens when a mother tells it that she needs help.
