The root causes: It is never just one reason

My years of counselling at CPAC show me abandonment is rarely an act of malice. It is the tragic endpoint of seven overwhelming distresses:

1. Severe maternal mental illness —The hidden emergency

a) Clinical Postpartum Depression (PPD): This is far beyond “baby blues.” It is a severe mood disorder that can appear weeks to months after birth. Due to a massive drop in hormones, extreme sleep deprivation, and emotional exhaustion, the mother feels deep sadness, worthlessness, and complete emotional numbness towards her baby. Picture: A new mother sits by her bed all day, staring blankly. Her baby cries for hours, but she cannot lift her hands to carry the baby. She whispers, “This baby would be better off without me.” She does not hate the baby; she feels she has completely failed as a mother.

b) Peripartum Psychosis (Postpartum Psychosis): This is a psychiatric emergency. Rare but extremely dangerous, appearing suddenly within the first 2-3 weeks after delivery. The mother completely loses touch with reality. She hears commanding voices telling her to abandon the baby, or believes the baby is possessed by an evil spirit or is a “spirit child” who will bring a curse. Picture: A mother genuinely believes she heard a voice saying, “Leave this child at the crossroads at midnight or your family will die.” She abandons the baby not out of hatred, but because her broken mind believes she is obeying a higher spiritual order to save her family.

c) Pre-existing untreated Schizophrenia: This is a chronic, severe mental disorder that existed before the pregnancy. The stress of pregnancy and labour shatters her fragile coping. She suffers from paranoid delusions — believing people want to poison her and the baby — flat affect (zero facial expression), and grossly disorganised thinking, making it impossible to plan how to feed or clean a baby. Picture: A young woman whose family called her illness “spiritual attack” instead of taking her for medication wanders away after delivery, completely forgetting she even gave birth, leaving the infant behind.

2. Extreme socio-economic deprivation: For many girls in some parts of Ghana such as Kasoa, Madina, or Bekwai, poverty is not a statistic; it is a daily panic. No money for antenatal care, no money for hospital delivery, no money for baby diapers or formula. When a mother cannot feed herself, the thought of feeding another mouth feels impossible. Some mothers say, “I left her where someone richer would find her, because I could not watch her starve to death in my hands.” It is a distorted act of survival.

3. Intense societal stigma and shame: In Ghana, pregnancy outside marriage, teenage pregnancy, or pregnancy from rape can bring extreme family rejection. The girl is called “spoilt,” beaten, banned from church, or sacked from school. The fear of bringing shame to the family name is heavier than the fear of police. So she hides the pregnancy for 9 months, delivers alone, and abandons in secret to protect her family’s “honour.”

4. Paternal abandonment — The Man Who Ran Away: Behind almost every abandoned baby is a man who vanished. He says, “It is not mine,” or “Abort it,” and switches off his phone. The mother is left utterly isolated — no emotional, financial, or social support. She is criminalised alone, but the abandonment started with him. Psychological research shows paternal denial is one of the strongest predictors of maternal panic and newborn abandonment. 

5. Substance abuse disorders: Alcohol, tramadol, and other drug addiction impair the brain’s executive functioning — the ability to plan, judge consequences, and process emotions. A mother struggling with addiction may give birth in a highly intoxicated or withdrawal state, unable to comprehend the needs of the newborn, leading to neglect and eventual abandonment.

6. The spirit child cultural phenomenon and superstition: In some remote pockets of Northern Ghana and even in few parts of Central and Ashanti regions, public health research shows babies born with congenital deformities, severe disabilities, or whose mothers die in childbirth are branded as “spirit children” or cursed. In extreme instances, families, under cultural pressure, mandate that such babies be exposed or abandoned at shrines or bushes. This is not mental illness, but a harmful cultural belief system that still kills.

The invisible wounds

On the baby: Risk of death from hypothermia, sepsis, and infection. Survivors suffer Anaclitic Depression and Failure to Thrive due to lack of touch. As adults, they battle Reactive Attachment Disorder, chronic mistrust, and identity crisis — “Why did my mother leave me in a dustbin?”

On the mother: Lifelong hidden grief, intense guilt, chronic PTSD, depression, and elevated suicide risk. A prison cell does not heal this.

On the nation: Overburdened orphanages like Osu Children’s Home, draining health budgets, and overworked Social Welfare officers.

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The driver stopped the vehicle at the gate of the big fenced property along the Nsawam Highway, and Kakraba stepped out to meet the several workers who had gathered to wait for him. He greeted them and went to straight to the point.                                                                                                                                      

 ‘Gentlemen, I am glad to see that you have almost completed the clearing of the land. I’m happy to report that we have concluded all arrangements with Nana Serebour, and construction of the palace will start in a few days.

 I will need you to go and level the ground, and come back to start this project. Some workers from a construction company will come and join us to start the project. My plan is to build twenty houses in four months, then we will do twenty more until we reach two hundred.

 I am relying on you to help me deliver good quality work to satisfy our clients, and as I have already indicated to you, I will reward you for your work’. After an hour’s discussion, he closed the meeting and moved to drive away. Wofa Yaw drew closer.                     

 ‘Director, can you please spare me five minutes? I would like to discuss a small issue’.                ‘Why Wofa Yaw, your wife has threatened to leave you?’                                                               ‘No, Director’. My wife will never leave me. This concerns a young niece of mine’.                      

‘I hope it’s something I can help with. Please sit in the car and let me hear you’.                           ‘Boss, my niece Beesiwa is a polytechnic graduate, very beautiful and with very good character.

Unfortunately, her parents virtually forced her into a relationship with an idiot based in the US, which impacted her badly. She has now recovered from that experience, and boss, I am respectfully asking if you would find a job for her.

I promise you that you will never regret it’. ‘Well, Wofa Yaw, let me meet her and speak with her. I may be able to help, maybe not in the way you will expect, but let me meet her. I will not be back here till after a week, but I will be at the office the whole of next week. You can come with her’.

‘On Monday morning, Wofa Yaw and Beesiwa were seated at the office by nine. Three young ladies welcomed them warmly, offered them soft drinks, and assured them that Kakraba would be there shortly, and got seated behind computers with large screens showing various building designs. Kakraba walked in and greeted them warmly, and after chatting with the three ladies, he ushered Wofa Yaw to his office’.                                                                                                     ‘Director, this is my niece, Beesiwa. I mentioned her to you when you came to Nsawam’.            ‘Yes indeed. Madam Beesiwa, you are very beautiful, as your uncle said. Wofa Yaw is my colleague.

We have just started a building project that will take about three to four years. He mentioned that you have a very small problem, so I said I would like to meet you, and see how I can help. So Beesiwa, please tell me a little about yourself’.

Beesiwa described her childhood, her school experience, her brief work at the bank, and the nasty episode with Sammy Abrokwa which shattered her peaceful life, and how she had been recovering’.                                                                                                         

‘I am really sorry to hear this. Now, here is what we are going to do. We are a small but very busy company. The three ladies over there spend most of the day on site, and come back to report on their work in the morning.

I have three main projects. The big one is an estate project in Nsawam, where your uncle is one of my main colleagues. I need a personal assistant who can take care of my activities, especially when I am not in town.

Now, we will have to start with trust. Based on what I know about Wofa Yaw, and based on what you yourself have told me, I think we can start on a sound basis. So, Wofa Yaw will take you to my home. You can move into one of the four guest rooms. I will give you a good phone and a laptop. I will arrange computer lessons for you’.                                                                                                                           ‘Sir, I have taken some computer lessons, and I have even done graphics and web design’.          ‘Fantastic! Now, Wofa Yaw, take her home. My sister Kuukuwa will meet you and show you round, and you can return to Koforidua. When would you like to start work?’                                               ‘Sir, I would like to start today, but I would need to go and bring my things’.                                ‘No problem. Take a taxi to my house, meet my sister, and let me know what you decide’.

Kakraba and the three ladies met with some bank officials to conclude on the sale of the three buildings at Adabraka.

They closed at five-thirty, and after rewarding the ladies for their hard work, he got home just after dark. He was surprised to find Kuukuwa and Beesiwa sitting at table enjoying supper.                                                                                                                                                                ‘What’s happening here?’ her said. ‘Beesiwa, I thought you would return to Koforidua?’                ‘She changed her mind’, Kuukuwa said. ‘We went to the Mall and bought a few things for her, and we came back to cook. She has made some nice changes to your bedroom. And she cooked a couple of interesting things. Sit down, we will serve you’.  

‘Well, I certainly can’t refuse that. It’s been a busy day. So what’s the plan now? Will Beesiwa go to Koforidua tomorrow, gather her stuff together and come down?                                          ‘No, I will stay here for a while. Kuukuwa bought me things that I need, so I may go back next week. I’m ready to start work. What would you like me to start with?’

‘Well, you can come to the office tomorrow morning, meet the three girls and get a feel of what we do. Since you are living here, at least for now, we can discuss the plans for the next few weeks. Sometimes there are gaps when I travel up north. You can take care of things from now. I think the girls would like having someone like you around’.