By Damilola Fagite
There are cries a maternity ward is trained to hear. The first cry of a newborn is celebrated. The cry of a woman in labour summons nurses, doctors and anxious relatives. There is, however, another cry that often begins after mother and child have gone home. It may make no sound. It may hide behind a tired smile, a whispered prayer, an unfinished meal or another sleepless night.
And when the newborn has a disability, that silence can become deafening.
The world sees a mother carrying her child. It rarely asks what else she is carrying.
For many women, childbirth opens the familiar season of broken sleep, feeding schedules, healing bodies and the bewildering demands of caring for someone entirely dependent on them. For a mother whose baby arrives with a disability, the ordinary upheaval of motherhood can suddenly collide with hospital appointments, frightening diagnoses, financial uncertainty, family pressure and the relentless question of what the future will hold.
Then postpartum depression may arrive.
Quietly.
Without announcement.
And, in too many homes, without recognition.
Globally, postpartum depression affects roughly one in eight mothers, with estimates placing prevalence at about 17.7 per cent during the first year after childbirth. Among Black women in the United States, the picture is even more disturbing. Recent figures associated with Black Maternal Mental Health Week suggest that maternal mental health conditions affect close to 40 per cent, almost twice the general rate, while as many as half of affected women may receive no treatment.
Nigeria tells its own troubling version of the story.
There is still no single nationally representative dataset capable of giving us the complete picture, but available facility-based studies already reveal enough to demand attention. A study among mothers in Eti-Osa Local Government Area of Lagos reported a prevalence of 35.6 per cent, with caesarean delivery, inadequate assistance with childcare and intimate partner violence emerging among significant predictors.
Across five hospitals in Enugu metropolis, researchers found a prevalence of 22.9 per cent. In Bayelsa State, more than 40 per cent of surveyed mothers reported varying degrees of postnatal depression. Research around Kano places documented prevalence across Nigerian sub-regions between 10.7 and 44.4 per cent. An older controlled study in western Nigeria found depressive disorder among 14.6 per cent of postpartum women compared with 6.3 per cent among women who were not postpartum.
In Yobe and Niger States, another dimension of the problem comes into view: income, education and the number of previous births can influence whether a depressed mother seeks help at all.
This raises a disturbing possibility. Nigeria may be counting mainly the women who somehow make themselves visible to the health system. Behind every statistic may stand many more mothers suffering beyond the reach of diagnosis, sympathy or treatment.
Now place childhood disability inside that already fragile world.
The burden does not simply become heavier. The entire emotional landscape changes.
Researchers are only beginning to understand fully what happens when motherhood, disability, race, geography and poverty converge after childbirth. What is emerging should trouble us. A nationally representative American study published in 2025 found that women with disabilities reported postpartum depressive symptoms at almost three times the rate recorded among women without disabilities: 33.1 per cent compared with 12.1 per cent. Black and Native American women who were themselves disabled faced especially elevated odds.
The Nigerian reality takes another form.
Studies involving parents of children with autism and other neurodevelopmental conditions repeatedly reveal how heavily caregiving responsibility falls upon mothers. Where knowledge about disability is poor, the mother may carry something crueler than responsibility, which is blame.
A child’s condition can become an accusation against the woman who gave birth to that child.
Was it something she did? Was it something she ate? Did she offend somebody? Did she fail spiritually? Is there a curse in her family?
Questions that should belong to medicine are dragged before the court of superstition.
UNICEF estimates that West and Central Africa carries the world’s highest rate of childhood disability. Yet across much of the region, particularly in communities where public understanding remains limited, mothers frequently stand at the intersection of caregiving, poverty, stigma and silence.
The child requires care. The household requires money. Relatives demand explanations. Neighbours whisper. Society stares.
And the mother is expected to remain strong.
That word, strong, has concealed an astonishing amount of suffering.
In many Nigerian communities, disability continues to be interpreted through spiritual explanations. A child’s developmental difference may be described as an affliction, punishment or supernatural visitation. Parents may therefore move first towards traditional or faith healers, sometimes before seeking medical support and sometimes instead of doing so altogether.
Research from Rivers State has documented families hiding children with disabilities from public view to escape ridicule.
Consider what that means for a new mother already slipping into depression.
The home, which should become her refuge, can become a hiding place. The community that should surround her can become a source of judgement. The family that should reassure her can become an interrogation panel.
Her child’s condition becomes public conversation while her own emotional collapse remains private.
Then come the economic realities. Therapy costs money. Specialist consultations cost money. Transportation costs money.
Rehabilitation and developmental interventions demand resources. Time away from work carries its own price. For families already struggling to meet ordinary household needs, disability can transform the family budget into an endless arithmetic of sacrifice.
Nigeria’s mental health services remain thinly distributed, while psychiatric expertise is concentrated largely around major hospitals and urban centres. Mental health screening is still far from routine within many maternal and child healthcare settings.
The mother therefore enters the clinic carrying two patients.
Only one may be examined.
Everyone asks about the baby.
How is the baby feeding? Has the baby gained weight? Has the baby received immunisation? What did the specialist say? When is the next appointment?
All necessary questions.
Yet the woman holding that baby may be disintegrating before everyone’s eyes.
Few people ask: How are you?
And fewer still remain long enough to hear the answer.
This is part of what makes postpartum depression so dangerous. Exhaustion is dismissed as motherhood. Persistent sadness becomes ingratitude. Withdrawal is interpreted as moodiness. Anxiety is called overthinking. Emotional numbness becomes wickedness. A woman struggling to bond with her baby may be judged as an uncaring mother when she may actually be experiencing a recognised and treatable medical condition.
For Black women, existing research already points towards lower rates of screening, diagnosis and access to treatment despite substantial levels of need. Nigeria compounds that inequality with scarcity.
Primary healthcare centres are often the first and sometimes the only formal point of contact available to mothers after childbirth. Yet routine screening for postpartum depression is hardly embedded across the system.
When a child has a disability, professional attention understandably gravitates towards the child. The baby’s diagnosis, developmental milestones and treatment needs dominate clinical conversations.
The mother gradually disappears from the medical picture.
Her body delivered the child. Her arms carry the child. Her time revolves around the child. Her money is spent on the child. Her nights belong to the child.
But who is looking after her?
Untreated postpartum depression does not remain neatly locked inside one person’s mind. It can affect mother-infant bonding, interfere with caregiving, delay the pursuit of developmental assistance and weaken the emotional stability of an entire household. In severe circumstances, the consequences can become dangerous for both mother and baby. For a family already negotiating disability, allowing maternal depression to flourish untreated imposes yet another burden upon a household already carrying more than most people can see.
Awareness is necessary, but awareness without institutional change soon becomes another slogan.
Mental healthcare for mothers of children with disabilities should be integrated into the ordinary machinery of maternal and child health. Screening should not disappear after the conventional six-week postnatal visit. Every immunisation appointment, developmental assessment and early-intervention visit offers another opportunity to ask about the woman behind the child.
Primary healthcare workers should be trained to recognise warning signs and know where to refer mothers requiring further care. Religious and traditional leaders also have an important role. In communities where they command enormous trust, they can either prolong harmful interpretations of disability or become powerful partners in replacing stigma with understanding. Faith should never become a reason for delaying medical care.
Peer support deserves far more attention. Sometimes the first person capable of reaching a mother drowning in isolation is another mother who has travelled the same road. Networks connecting women raising children with disabilities can offer something hospitals cannot always provide: recognition without explanation, companionship without judgement and reassurance born not from theory but experience.
Nigeria’s Disability Rights Act of 2018 should also live beyond the pages of legislation. Protecting children with disabilities requires recognising the people performing most of the daily labour of care. Mothers cannot remain invisible within policies supposedly designed to improve the lives of their children.
Communities must also change their language.
A child with a disability is not evidence of a mother’s failure. Depression is not evidence of spiritual weakness. Seeking psychiatric or psychological help is not madness. A woman does not become a bad mother because motherhood has overwhelmed her.
No mother should be forced to choose between caring for her child and surviving motherhood herself.
Postpartum depression is a medical condition for which effective interventions exist. Yet treatment begins with recognition, and recognition begins when somebody notices that behind the child receiving all the attention stands another human being in need of care.
For Black mothers raising children with disabilities, whether in Lagos or Los Angeles, survival should demand more than extraordinary personal endurance
They deserve to be screened. They deserve to be heard. They deserve to be believed. They deserve communities that do not turn disability into shame and hospitals that do not treat the mother as the disposable vehicle through which the patient arrived.
Perhaps the revolution required here begins with one deceptively simple change.
At the next clinic appointment, when the immunisation is complete, the developmental chart has been checked and every question about the baby has been answered, someone should turn towards the woman holding the child.
Look at her.
Really look at her.
And ask:
“How are you?”
Then resist the temptation to rush away.
Because somewhere behind the automatic “I am fine” may be a woman desperately waiting for somebody to ask the question twice.
And mean it.
Damilola Fagite is a PhD student in the African History Programme at the University at Buffalo, New York, United States of America.