Singapore's Postnatal Depression Programme Works. Not Every Mother Can Reach It
If you develop postnatal depression in Singapore, there is somewhere to go. KK Women's and Children's Hospital has run a dedicated Postnatal Depression Intervention Programme, PNDIP, since 2008, and it's now part of standard care. More than 18,000 women have been screened through it over the years, and for mothers who complete the programme, it works. Symptoms drop by more than three quarters on average, and mothers report real improvements in how they're coping day to day.
That's genuinely good news, and worth knowing if you're pregnant or newly postpartum right now. But having spent years looking at how maternal health support actually plays out in practice, I think the more useful question isn't whether the programme works. It's who it's working for, and who it's quietly missing.
How it works, in plain terms
At your postnatal check-up, you'll be asked to fill in a short questionnaire about how you've been feeling over the past week, the Edinburgh Postnatal Depression Scale. If your answers suggest you might be struggling, you're offered a proper assessment, counselling, and a case manager who stays with you through the process rather than passing you between departments. Medication is an option too, with your baby's feeding in mind if you're breastfeeding.
It's a sensible design. It gives mothers both the tools to cope and, just as importantly, a way to see their own distress as something ordinary and treatable rather than something to hide.
The part that doesn't make it into the good news
Here's the number that stood out to me most. In the programme's own data, roughly two in three mothers who screen as needing help end up declining it. That's not a small gap. It means the encouraging outcomes we hear about describe the mothers who stayed, not the ones who were identified as struggling and never came back.
Some of that is about access rather than willingness. If you're running on broken sleep, with no one to watch the baby during an appointment and pressure to be back at work, an in-person clinical visit can be genuinely hard to get to, whatever you actually want for yourself.
Who tends to fall through unnoticed
A few groups seem to slip past the current screening entirely, and I think mothers should know about this, if only so they can advocate for themselves or a friend.
The screening tool was built around how distress is usually described, feeling sad, feeling low. But in many Asian families, including here in Singapore, emotional strain often shows up as tiredness, headaches, or physical tension instead, a pattern researchers call somatisation. A mother who describes herself as simply exhausted, rather than sad, can score below the cutoff and be told she's fine.
Cultural expectations around maternal strength add another layer. If admitting you're struggling feels like admitting you've failed at something you're supposed to handle quietly, you're less likely to be fully honest on a form, especially one filled out quickly without much privacy.
Two groups in particular aren't currently flagged as higher risk, even though the evidence suggests they should be. Mothers who conceived through IVF carry a well documented, elevated risk of anxiety and low mood, yet after a hard-won pregnancy, admitting to postnatal distress can feel almost ungrateful. And in Singapore specifically, mothers over 35, and mothers who aren't breastfeeding, have been shown to be significantly more likely to be dealing with probable postnatal depression, but age and feeding history aren't part of how risk gets assessed right now.
The direction of travel is encouraging
Singapore isn't standing still on this. Since 2023, KKH has extended depression screening to all pregnant women, not just those who've already given birth. And since mid-2024, Health and Mind Clinics have been running across all seven National University Polyclinics, with nurses checking in on mothers during routine visits for their baby. These are meaningful steps. What's still missing is consistency, a mother's chances of being asked how she's really doing shouldn't depend on which hospital she delivered at or which clinic she happens to visit afterward.
What would actually help close the gap
A few changes would go a long way. Screening that looks beyond a single questionnaire score, so IVF mothers and older mothers aren't invisible to the system by default. More flexible ways to get support, a phone consultation or a check-in that doesn't require arranging childcare and taking time off work. And louder, more honest conversation about postnatal struggles among partners and families, not just in clinics, so a mother isn't the only one watching for the signs.
If you've been feeling low, anxious, or just not like yourself since having a baby, that isn't a personal failure, and it isn't something you have to sort out on your own. If it would help to talk through what extra support could look like for you, you're welcome to get in touch.
About the author
Pamela Vanessa Lim is a Health Psychologist in research and Integrative Nutrition & Movement Therapist, focused on maternal and child health in Singapore. Read more about her work here.
Sources
Hong, L. F., Chua, T.-E., Ch'ng, Y. C., Chui, K., & Chen, H. Y. (2023). The Postnatal Depression Intervention Program 'PNDIP': A 10-year review. Asian Journal of Psychiatry, 88, 103635. Screening and outcome data across 2010-2020.
Chen, H., Wang, J., Ch'ng, Y. C., Mingoo, R., Lee, T., & Ong, J. (2011). Identifying mothers with postpartum depression early: Integrating perinatal mental health care into the obstetric setting. ISRN Obstetrics and Gynecology, 2011, 309189. First-year programme data, including the 66% decline rate among high scorers.
Quah, P. L., Poo, Z. X., Chen, H. Y., Chua, T.-E., Tan, L. K., & Tan, K. H. (2025). Perinatal mental health in Singapore: Prevalence, knowledge, attitudes, and practices. Frontiers in Medicine, 12, 1623596. Findings on somatisation and on older, non-breastfeeding mothers being more likely to screen positive.
Monti, F., Agostini, F., Fagandini, P., La Sala, G. B., & Blickstein, I. (2008). Depressive symptoms during late pregnancy and early parenthood following assisted reproductive technology. Fertility and Sterility, 89(1), 143-149. Elevated psychological distress among IVF mothers.
KK Women's and Children's Hospital. (2023). KKH introduces universal antenatal depression screening to reduce postnatal risks in mothers and children.
National University Health System. (2024). Health and Mind Clinics set up at all seven western polyclinics under National University Polyclinics.