Cultural Expressions of Postpartum Depression

Overview: Culture shapes the perspectives on mental health challenges. This qualitative meta-synthesis investigated the cultural expressions of postpartum depression and other maternal mental health disorders.Proposal text:

Background: The experience of becoming a mother is complex, emotionally charged, and life altering across cultures (Mercer, 2004). While the experience of becoming a mother is a significant one across cultures, the transition is shaped by personal, familial and societal factors situated in cultural context. Cultural context shapes the expectations of what the transition should be and how the mother should experience it. Inextricably, personal, familial and societal factors add complexity to the cultural context of becoming a mother. Similarly, for mothers who develop postpartum depression (PPD), cultural context greatly impacts diagnosis and treatment and said impact varies depending upon the personal, familial and societal factors impacting the mother’s transition. Even though PPD affects mothers of all ethnicities and socioeconomic backgrounds, there are populations that are disproportionately affected. Cultural aspects of the postpartum experience may impact outcomes and there are many intersecting identities mothers can hold which shape their perinatal experience. The purpose of this study was to elucidate the cultural misperceptions used to invalidate the PPD experience through the theoretical lens of becoming a mother (BAM).

Method: This study used Qualitative Interpretive Meta-Synthesis (QIMS) to answer the question, what are the culturally specific experiences of maternal mental health challenges? QIMS is social work specific synthesis method which allows researchers to synthesize qualitative findings on a topic across the literature to reveal insights into participants’ experiences with a phenomenon (Aguirre & Bolton, 2014). This is accomplished by not only reviewing the original authors’ published themes, but also reviewing the participant quotations included within the manuscript. The themes and quotations are extracted and compiled into a new dataset to capture participants’ experiences of a shared phenomenon across the literature. QIMS follows a set analysis process that involves developing a research question, completing a systematic search of existing literature, and finally analyzing identified articles through theme extraction, theme synthesis, and triangulation (Aguirre & Bolton, 2014).

Results: Multiple databases were searched with keywords. The initial database search yielded 586 articles. After removing duplicates there were 339. After title and abstract review116 remained. Then, after a full text review, a total of 32 articles were the final QIMS sample. There were five main themes with various subthemes: 1. Interpretations of depression and mental health, 2. Lack of cultural support, 3. Cultural norms and traditions, 4. Lack of cultural awareness by providers, and 5. Language Barriers.
Implications: Implications include practitioner training on cultural humility when working with people during the perinatal period and increased knowledge and education among mental health providers of cultural expressions of maternal mental health challenges. Research implications include better understanding of cultural expressions of PPD as well as adapted measurements for maternal mental health challenges due to culturally specific expressions of PPD.