Association between person-centered care during pregnancy and perinatal depression in Ghana

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BACKGROUND: Risk factors for perinatal depression (PND) have been well documented, yet the relationship between person-centered care during antenatal and childbirth care and PND remains understudied. OBJECTIVE: To examine the association between person-centered antenatal care (PCANC) and person-centered maternity care (PCMC) and PND. STUDY DESIGN: Data are from cross-sectional surveys with 293 postpartum women in Ghana. The 10-item Edinburgh Postnatal Depression Scale (EPDS), together with validated 36-item PCANC and 30-item PCMC scales were administered to participants. The PCANC and PCMC scale both have 3 subscales: dignity and respect, communication and autonomy, and supportive care. Bivariate and multivariable logistic regressions were used to examine the relationship between PCANC and PCMC and PND measured within six months postpartum. RESULTS: In bivariate analyses, higher PCANC scores were associated with lower odds of perinatal depression (OR: 0.97, 95% CI: 0.95-0.99). After controlling for confounders, this association strengthened (aOR: 0.96, 95% CI: 0.93-0.99). Dignity and respect (aOR: 0.96, 95% CI: 0.94-0.98) and responsive and supportive care subscales (aOR: 0.96, 95% CI: 0.93-0.99) were significantly associated with reduced odds of perinatal depression. While PCMC showed protective trends, only the dignity and respect subscale showed a significant association with lower odds of perinatal depression (aOR: 0.97, 95% CI: 0.95-0.99). CONCLUSION: PCANC, particularly its components of dignity and respect and responsive and supportive care, may serve as a protective factor against PND. These results suggest that implementing person-centered approaches could offer a feasible strategy for addressing PND in low-resource settings where routine mental health screening is unavailable.

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