This paper is a literature review of the topic ‘prevalence and risk factors of postnatal depression among immigrant and refugee mothers.’ The postnatal period is the period a mother faces usually six to eight weeks after childbirth. Within this period, most new mothers experience several changes. These various changes differ from emotional, social and even routine changes brought about by childbirth. These changes are also known as baby blues to the layman. For most mothers, these changes eventually become less evident and die out. However, for some new mothers, the changes become worse and lead to a condition known as postnatal depression. Postnatal depression is a type of major depression and it varies in both severity and longevity depends on the mother’s condition. With proper medication and assistance, postnatal depression can be efficiently cured.
With the understanding of how postnatal depression occurs and its symptoms, it is possible to diagnose and cure the condition. Therefore, consistent examination and research on this topic allow clinical practitioners to come up with solutions for this condition. This paper is relevant to those in clinical practice who deal with mental health issues. Likewise, it affects medical specialists who focus on the care and treatment of newly born mothers. These aforementioned groups are the main beneficiaries of this research and play a big part in furthering research on the current topic.
In selecting the material to be examined and reviewed several criteria were observed. First, the scope of research articles was limited to books and scholarly articles published within the last fifteen years. It means that only books published from 2005 onwards were considered for inclusion in the paper. The selection was limited in such a way to ensure only the most relevant and timely material was considered for discussion. Additionally, the works to be reviewed were regulated to include only those written in the English language. This factor was included to ensure ease of access and readability of the works in question. Author name and publisher were not a priority while selecting the works and other more relevant factors were considered. Keywords included while selecting the scholarly works from the database were ‘postnatal depression’ and ‘immigrant and refugee mothers.’ After about thirty-two books were identified as appropriate, those that did not contain the keywords in their titles or abstracts were eliminated. Finally, eight books qualified to be used in this literature review and they are discussed below.
Statistically, under normal conditions, postnatal depression affects about nine to twenty-one percent of new mothers. However, postnatal depression is more prevalent among refugee and immigrant women. According to Bandyopadhyay (2010), immigrant mothers in Australia are more vulnerable to suffering emotional health issues when compared to Australian-born mothers. Mental health issues are often brought about by problems that are often specific to immigrants. Such issues include loneliness and isolation. Immigrant mothers are often left alone to tend to their children and this leads to loneliness (Bandyopadhyay, 2010). Therefore, they end up requiring both physical and emotional support and lack of this can lead to depression. The sample size was rather limited as the response was based on a postal survey. This method resulted in the under-representation of immigrant women. However, the numbers were still large enough to qualify the research as valid. The research found out that immigrant mothers who were not proficient in English were more likely to face depression. They would also require more physical and emotional support than local-born mothers (Bandyopadhyay, 2010). Also, the solution suggested is improving awareness of these challenges and responsiveness by the medical departments.
The next piece discussed in the book ‘Refugee, asylum seeker, immigrant women and postnatal depression: rates and risk factors.’ The findings of the research are that immigrant women are more likely to experience postnatal depression, with a rate of forty-two percent. It is a much higher rate than that of locally born women which is between ten to fifteen percent (Collins, 2010). The findings are agreeable as the research was based off more than ten published articles discussing the risk factors faced by immigrant women and the relationship with postnatal depression. Among the common risk factors identified are evidence of stress in previous relationships or life in general, inadequate social care and other social issues (Collins, 2010). These factors are similar to those stated in other books and hence I can agree on their relevance and importance. Also, Collins suggests that the best solution is increasing awareness about the condition to improve response time. This solution is similar to what the other articles suggest. Additionally, Collins suggests that immigrant and refugee mothers should be considered as people with a high risk of suffering postnatal depression (Collins, 2010).
The book ‘Prevalence of postpartum depression among immigrant women: A systematic review and meta-analysis’ is the next in the review. The authors, after research, identified that immigrant women were 1.5 to twofold more susceptible to postpartum depression compared to local-born women (Falah-Hassani, 2015). Likewise, the research finds that the condition’s symptoms are similar among all immigrant mothers during the first year after the child is born (Falah-Hassani, 2015). This finding is unique to this article and appears agreeable as the scope of their research is rather broad. However, the authors argue that little is known about the risk factors involved in postpartum depression (Falah-Hassani). I disagree with this point as the other articles have already proved and listed the major risk factors involved. This article utilized twenty-two studies done similar topics, with their scope being from 1950 to 2014. The authors agree that immigrant mothers are more vulnerable to suffering from postpartum depression and require special attention.
The article ‘Postpartum depression among immigrant women’ by Fung, Kenneth, Dennis and Cindy-Lee are the next in focus. It focuses on the relationship between postpartum depression and immigrant mothers, more so those in the North America demographic (Fung, 2010). This article focuses on a unique viewpoint which seeks to explain the challenges immigrant women are likely to face. These challenges affect their mental health and tend to infringe on their rights to receive the required support and attention. When these challenges are compounded with childbirth, the mothers are likely to fall into postpartum depression (Fung, 2010). The authors also focus on the significance culture has on immigrant mothers. These unique investigations bring about a different way to look ay these issues and are very important. The authors encourage the improvement of medical response and changing of cultural views to grant equal opportunity to immigrants (Fung, 2010). I agree with the research in this article which gives ample solutions on how immigrant women can be offered equal opportunities. It will assist in reducing the prevalence of postpartum depression in this demographic.
The next work discussed is ‘Social stress and depression during pregnancy and in the postnatal period in British Pakistani mothers: a cohort study.’ As stated in the title, the article focuses on Pakistani women who came to Britain as immigrants. The research states that ethnic minority groups in Britain are more at risk of postnatal depression (Husain, 2012). The study was carried out to identify the rates and factors leading to perinatal depression in Pakistani mothers living in Britain. This article differs from the other works mainly because it focuses on both the period before and after birth. Therefore, it gives a new perspective as it attempts to discover if factors before childbirth affect rates of postnatal depression. The sample size was more random than the other articles and the results were re-evaluated after six months (Husain, 2012). Similarly, to the other articles, the research found out that lack of social support was a significant risk factor to those who suffered the condition. However, the research’s main limitation was that the cause of depression could not be directly established (Husain, 2012).
The book ‘Birth outcomes, postpartum health and primary care contacts of immigrant mothers in an Australian nulliparous pregnancy cohort study’ is the next in the discussion. It focuses its discussion on first-time immigrant mothers in Australia (Lansakara, 2009). This book’s sample size is the largest among the articles discussed in this paper. A sample of more than one thousand five hundred women was used and was followed up from twenty-four weeks into pregnancy to three months after childbirth (Lansakara, 2009). The results of the study showed that immigrant women were more likely to claim they were depressed for at least two weeks three months after birth (Lansakara, 2009). This paper is commendable for its focus on timeline and large sample size. Its method of study is unique and the results are agreeable. The findings of the study were that immigrant mothers were more likely to state they are lacking emotional support than Australian born mothers (Lansakara, 2009). Additionally, despite immigrant women having equal time spent with medical practitioners, they were less likely to be asked about their emotional wellbeing. It shows a trend where immigrant women are not treated equally to locally born women.
The next article in the discussion is ‘Postpartum depression among Somali women in Norway.’ As the title suggests, it focuses on the experience of Somali women and specifically new mothers in Norway. The article states that postpartum depression affects ten to fifteen percent of new mothers in Norway (Løvlie, 2016). The Somali people were chosen in this investigation as they are one of the largest immigrant groups in Norway who are not of western descent (Løvlie, 2016). This study was unique as no search study had been done that focuses on Somali women in Norway. The sample size was identified from maternity wards with questions administered via questionnaires and interviews (Løvlie, 2016). The downside of this method of survey is incorrect information given due to bias or fear of judgement. On the other hand, the article can be lauded for its investigation of the mothers’ history of mental illness. Additionally, it checks other previously uncovered factors like assistance received during childbirth, economic status and self-rated health (Løvlie, 2016). However, the research concluded that the is no concrete proof of how much the factors affect the prevalence of postpartum depression (Løvlie, 2016). The authors encourage extensive research is carried out to put more emphasis on the findings of this research.
The last book in discussion in this paper is ‘Recognition of risk factors for postpartum depression in refugee and immigrant women: are current screening practices adequate?’ It is a book that focuses on the identification of the risk factors and checking the adequacy of current screening practices (Tobin, 2014). This article also focuses its studies in Northern New England. This region was selected due to the evidence of an increasingly expanding population of immigrants in the area. However, a major flaw in the research is that the research was carried out on the general population of the region (Tobin, 2014). It means that the research does not outrightly identify the percentage of the population studied that are immigrants. Also, while conducting the survey, phone calls were used to reach the at-risk population. This method of using phone calls was not effective as up to forty-three percent of those answering the phone could not speak English (Tobin, 2014). Additionally, due to the selected methods in research, several immigrant mothers were unable to give useful information. It is because the non-western population of the immigrant mothers were not acquainted with the culture in the area (Tobin, 2014).
Among the main deficiencies noted in a majority of the works reviewed is the limited sample size. Most of them did not attain a large enough sample in which they could survey and derive substantial findings. Also, the immigrants in certain areas were not conversant with English and the language barrier brought about difficulty and confusion. Thirdly, some immigrants were not comfortable with giving their experiences due to fear of being judged. This last issue is a major reason why the majority of the works reviewed recommend increasing awareness as a major way to reduce the rates of postnatal depression.
Thus, in conclusion, there is substantial evidence that proves postnatal depression is more prevalent in immigrant and refugee mothers. Various research was carried out and the result was that the risk factors are relatively similar to all immigrant mothers regardless of their location. The most common risk factor that was highlighted by nearly all authors was a lack of emotional and physical support. These immigrant mothers are often left in isolation to tend for their children and this leads to loneliness and a sense of isolation. Additionally, the solution suggested in most of the books are similar. They all advocate for increased awareness and claim a lack of awareness is the biggest issue faced. They all believe that with an increased level of awareness, immigrant and refugee mothers can express themselves better. Also, clinical professionals are expected to spread awareness to their patients about the existence and severity of postnatal depression. The clinical professions are also encouraged to keep in mind that immigrant and refugee mothers are the most in risk demographic to postnatal depression. Therefore, they are expected to pay extra attention to immigrant and refugee mothers.