Background: Postnatal depression is a major public health concern, which may produce adverse outcomes for the mother, the infant and the family.
Aim: To systematically review the qualitative evidence that comprehensively explores the perceived causes of postnatal depression.
Methods: Following the PRISMA (2009) guidelines, a systematic review was conducted from February 2016 through to May 2016 using a range of databases. Search terms included postnatal depression, postpartum depression, interview, focus group, experience, view, belief and qualitative. Studies were eligible if a) women were interviewed within the first year after childbirth b) mothers were detected or diagnosed with a validated tool c) studies aimed to explore women’s perceived causes of postnatal depression d) studies were of English transcript e) studies were published between 2000 and 2016 f) study design was qualitative. Studies were critically appraised by two independent reviewers using the Critical Appraisal Skills Programme and Evaluative Tool for Qualitative Studies. Adopting Noblit and Hare’s guidelines (1988), key findings from primary studies were extracted, described and synthesised.
Results: Seventeen qualitative studies from 9 countries were included. Perceived causes for postnatal depression were organised into six categories including psychological (e.g. expectations of motherhood), socio-demographic (e.g. financial worries), cultural/religion (e.g. gender of the infant), biological/physical (e.g. breastfeeding), obstetric/paediatric (e.g. childbirth complications) and social support (e.g. lack of support).
Conclusion: This review provides current knowledge of the perceived causes of postnatal depression. This systematic review included studies from Eastern and Western countries, demonstrating that the phenomenon of postnatal depression is universally recognised, however explanations may vary across cultures. A holistic understanding of causal beliefs of postnatal mental illness in diverse communities is a vital component of delivering equitable, accessible and culturally competent Perinatal Mental Health services.
By Harpreet Kaur Sihre, Public Health PhD Student
