BackgroundKnowledge about postnatal depression (PND) and associated risk factors which influence the development of PND is vital for early detection, intervention and prevention.SettingThe study was conducted in primary health care clinics (PHC) in the Witzenberg subdistrict, a rural community in South Africa.ObjectivesObjectives of this study were to determine the prevalence of PND and to identify the contributing risk factors associated with PND.MethodsA descriptive cross sectional research design with a quantitative approach was applied. The target population was mothers, 18 years and older. A convenience sampling method was used to select a sample of 159 (10%) from a population of 1605 live births. The Edinburgh Postnatal Depression Scale (EPDS) and Beck Depression Inventory (BDI), two validated self-rating questionnaires, including a questionnaire based on demographical, psychosocial and obstetrical data, were applied. The data was analysed using various statistical tests to determine statistical associations between variables using a 95% confidence interval.ResultsPND was a serious health problem with 50.3% of the mothers who suffered from PND. A BDI analysis showed that of the participants who had PND, 28.8% was severe, 48.8% moderate and 22.5% mild. Factors influencing the development of PND included most participants (63.5%) were unmarried, 61.3% were unemployed and the majority (53.8%) had a history of a psychiatric illness. Significant associations between PND and unplanned and unwelcome babies (p < 0.01); partner relationship (p < 0.01); were identified.ConclusionPrevention, early detection, appropriate referral and treatment of PND are critical in managing maternal, child and family well-being.