The transition to motherhood is a significant life event that requires emotional, psychological, and social adjustments, particularly for young, first-time mothers who often have limited parenting experience and support [1, 2]. The postpartum period (the first 6 weeks after childbirth) is critical for recovery, yet it is frequently overlooked [3]. Globally, a large proportion of maternal and neonatal deaths occur during this time, with sub-Saharan Africa shouldering the heaviest burden [4]. In Tanzania, despite progress in reproductive, maternal, newborn, child, and adolescent health (RMNCAH) policies, postpartum care—especially psychosocial support—remains insufficient.

Young mothers (<20 years old) and first-time mothers are especially vulnerable due to inadequate preparation, fragmented information from family/peers, and limited healthcare guidance [4]. Studies from Uganda, Kenya, and elsewhere in sub-Saharan Africa highlight common challenges, including breastfeeding difficulties, anxiety, stigma, and insufficient emotional/practical support [5]. In Tanzania, harmful practices and low utilization of postnatal services further elevate the risks for younger mothers [5]. In Uganda, teenage first-time mothers reported significant healthcare needs in the immediate and early postpartum period, including information on self-care, newborn care, and emotional support; many of them felt unprepared, experienced anxiety related to breastfeeding and infant crying, faced stigma, or had limited family support [6]. Another phenomenological study of adolescent mothers at Mbale Regional Referral Hospital, Uganda, highlighted hardships such as fear of the unknown during the intrapartum and immediate postpartum periods, negative treatment by family and community members, extreme parenting challenges, and social isolation—although the joy of seeing their babies often alleviated some of the stress [7].

Qualitative findings from Kenya further illustrate these issues. First-time mothers in Nairobi reported breastfeeding difficulties in the early postpartum period, influenced by inadequate information, pain, and a lack of practical support from healthcare workers or family [8]. Broader reviews of postnatal care experiences in sub-Saharan Africa consistently reveal inadequate information provision, poor communication with healthcare workers, limited resources, and insufficient emotional support, which exacerbate feelings of isolation and anxiety among young and first-time mothers [9].

Globally, adolescent pregnancy remains a public health concern. The World Health Organization (WHO) estimates that approximately 21 million girls aged 15–19 years in developing countries become pregnant each year, with approximately 12 million of them giving birth [10]. This group is at increased risk of pregnancy-related complications, adverse birth outcomes, and poor utilization of maternal health services [11–13].

In Tanzania, substantial efforts have been made to improve reproductive, maternal, newborn, child, and adolescent health (RMNCAH) through national policies and initiatives, including the Sharpened One Plan and the Health Sector Strategic Plan IV [14]. Despite these efforts, postpartum care—particularly psychosocial support—remains insufficient. Evidence suggests that first-time mothers require emotional, instrumental, and informational support to effectively navigate the postpartum period [15]. However, such support is often inadequate in low-resource settings [15–17].

The Mwanza Region in northwestern Tanzania has a high rate of institutional maternal deaths. According to the national Maternal and Perinatal Death Surveillance and Response (MPDSR) Report for 2018–2023, Mwanza Region recorded 962 institutional maternal deaths (the second highest total nationally after Dar es Salaam), with Mwanza City Council ranking second among city councils with 511 deaths (5.3% of the national total) [18]. This is linked to suboptimal coverage of antenatal care (≥4 visits), skilled birth attendance, and postnatal care, alongside prevalent conditions such as maternal anemia, malaria during pregnancy, and HIV [18].

This study aimed to explore the postpartum needs and lived experiences of young and first-time mothers in Mwanza City to inform context-specific interventions that would enhance maternal and infant health in high-mortality urban settings.

This study highlights the complex postpartum experiences of young and first-time mothers in northwestern Tanzania. Cultural, social, economic, gender-related, and community factors shape these postpartum experiences, while gaps in knowledge about postnatal care and breastfeeding remain evident. Consistent with previous literature, limited psychological support, information, and practical assistance further exacerbate postpartum challenges [1, 6, 8, 9]. The positive aspects of pride, bonding, and confidence align with findings that joy can buffer stress and strengthen parent-infant attachment [21]. However, negative experiences (e.g., sleep issues, breastfeeding difficulties, anxiety) underscore vulnerabilities, particularly among those who have had a cesarean section and with limited family support. These echo findings from Tanzanian and sub-Saharan African studies highlighting isolation and unmet needs [9, 22].

Young and first-time mothers in northwestern Tanzania have significant postpartum necessities, some of which remain inadequately addressed. Key needs include information, psychological and material support, shared experiences, and mentorship to help them adjust to motherhood. Similar gaps in postpartum information have been reported among young and first-time mothers in England [23]. It is important to understand that the respondents are new to the role and may not have enough experience and knowledge of many postpartum issues, as far as postnatal care is concerned. In the words of one of the respondents, “I would have liked it if someone had talked to me before”.

A good rapport between healthcare providers and young and first-time mothers can improve their postpartum experience. In urban Tanzania, supportive midwives who communicated openly and provided emotional support contributed to better outcomes for mothers and newborns [17]. In other settings, however, mothers have been reported to require support from their spouses and extended family regarding the knowledge and skills needed for postpartum and baby care, rather than from healthcare workers [24]. For instance, in Shenzhen, it was reported that if the mothers and grandmothers agreed on child care practices, this would facilitate the transition into motherhood and ease the stress felt by postpartum women [24]. Such differences are attributed to cultural differences among communities.

Findings from this study show that young and first-time mothers may experience stress and depression because of limited experience and confidence in caring for their babies. Similar psychosocial challenges have been reported in Germany, while other studies have linked maternal distress to having a sick newborn, an emergency cesarean delivery, and severe labor pain [25]. The differences may reflect the timing of the interviews, as the majority of mothers in our study were at least 6 weeks postpartum and had begun to experience the joys of motherhood, whereas mothers in other studies were interviewed shortly after delivery while still in hospital.

Partner relationships, socioeconomic conditions, and limited social support may contribute to anxiety and depression among young and first-time mothers. Evidence from Mwanza City, showed that poor partner relationships and lower socioeconomic status were associated with higher odds of antenatal depression, with a prevalence of 33.8%, particularly among primigravidae [26].

Given the high maternal mortality burden and the limited attention given to psychosocial health during antenatal care, integrating psychosocial screening and support into antenatal and postnatal services, together with family and community involvement, may help to identify and address these challenges early [26–28].

Alongside the needs addressed at the hospital, young and first-time mothers also require adequate assistance at home to care for themselves and their babies. Our study found that mothers needed essential physical resources and emotional support, both of which were not adequately available to all participants. While healthcare workers play an important role in educating and guiding mothers during antenatal and postnatal care, partners and family members are equally important in providing practical, emotional, and financial help, particularly as the needs of mothers and their households increase during pregnancy and after childbirth. In Tanzania’s patriarchal society, where gender roles often shape the expectations placed on men and women, poverty further limits the ability of families to meet these needs. This includes the ability of fathers to provide financial and practical support, despite their willingness to help mothers and their infants [26, 29, 30].

Findings obtained from our study identified that the majority of mothers feel proud and happy after becoming mothers. This is especially true for those who have been childless for a long time. A woman who has a child is respected in the community, and motherhood signifies great responsibility. A similar study explained that the joy and positive emotions experienced during motherhood serve as a buffer against stress and are an important component of the connection between parents and children that enhances psychological health and wellbeing [21]. Hence, positive experiences during the postpartum period should be encouraged. It is important to note that the presence of social networks, such as family and friends, is important in providing resources for the wellbeing of the mother both during pregnancy and following childbirth [30].

The fact that first-time and young mothers have sleepless nights calls for immediate attention. A study by Hijazi et al. showed that good sleeping habits have a great impact on infant growth; therefore, mothers with infants who sleep well are less anxious compared to those who sleep poorly. Moreover, this study identified that sleep quantity may be affected by several factors in the sleeping environment, such as exposure to light and noise, mattress comfort, and room temperature [31]. Results from our study identified that mothers with infants who had poor sleeping patterns were restless and experienced uncomfortable sleep. However, other participants in our study said that they had plenty of time to rest because their spouses and family provided significant support with infant care during the postpartum period. Therefore, great support from family members and spouses is needed to help young and first-time mothers feel comfortable during the postpartum period.

The present study identified that mothers who delivered their infants with a cesarean section had difficulty breastfeeding their newborns in the first few days after delivery. This is consistent with previous studies, which reported that cesarean section causes depression in mothers and results in lower milk production [32]. Additional research is needed to determine the relationship between cesarean section, stress, and milk production.

The majority of young and first-time mothers in our study gained weight during the postpartum period; this may be due to changes in sleeping patterns, physical activity levels, and changes in dietary intake. A study in urban Malaysia also reported that being less active and a high-energy diet could explain variation in weight retention 6 months postpartum [33]. A study by Tahir et al. found that women who breastfed for 6 months or longer retain approximately 0.45 kg less weight 6 months after childbirth than those who breastfed for 3 months only [34]. Therefore, breastfeeding should be encouraged because it helps control weight and strengthens the health of the infant. Based on the findings of this study, there is a need to enhance user-friendly antenatal and postnatal services for first-time and young mothers to minimize detrimental effects. For instance, there is a need to improve the relationship between mothers and midwives, which has emerged as poor. The overall relationship will improve care and safety assurance for the mother and the baby throughout the entire postpartum period. It is vital to establish strategies to ensure that mothers' needs are met and that they are helped through their negative experiences more quickly by their partners and family members, who need to be educated in their respective communities. One cannot overemphasize the need to continue educating women, encouraging them to practice exclusive breastfeeding during the entire period of 6 months, as studies have shown this to be an effective way to control weight and ensure the good health of the baby. Well-trained and equipped healthcare workers play a crucial role in ensuring that the journey of a mother during postpartum is safe. There is a need, therefore, to continue putting more effort into continuous on-the-job training and increasing the number of healthy healthcare workers.