Abstract

Background & Aims: The prevalence of depression during pregnancy and after childbirth is on the rise, especially in developing countries like India. Postpartum depression is a common and serious psychiatric illness, which affects approximately 19% of women after delivery in India. It causes significant morbidity in mothers, estranges marital relationships, lowers rates of breast feeding rates and also causes poor emotional and cognitive development of the infant. Postpartum depression is generally attributed to complex interaction of genetic, hormonal and biological factors and there are very few studies which examined socio cultural factors. This study aims at identifying the prevalence of post-partum psychiatric disorders especially depression and associated socio cultural variables in a hospital based sample.

Methodology: This study is done in Sri Ramachandra medical college & Research Institute, which is a tertiary care hospital in Chennai, Tamilnadu, India. This study employed Observational cross sectional descriptive methodology in a sample of women who were referred to psychiatrists for emotional problems in the first 6 weeks of their child’s delivery. These participants were assessed using the English/Tamil translation of the Edinburgh Postnatal Depression Scale (EDPS) and also semi structured clinical interview to establish the psychiatric diagnosis using ICD-10.

Results: Out of 23 women referred to Department of Psychiatry in a period of three months for psychological problems, 8 women qualify for severe, 6 for moderate and 5 for a mild depressive episode. Two women were diagnosed to have postpartum psychosis. Majority of women referred from obstetricians had psychiatric illness. Many women reported relationship problems with in laws and dowry demand in their families. Most women said that their family had strong preference to male child.

Conclusions: Post-partum psychological problems, especially depression should be understood in the background of socio-cultural context especially in low and middle-income countries where gender inequality and poverty are prevailing. The symptoms of depression are determined by the societal expectations and cultural beliefs along with biological determinants. Understanding the personal significance of socio-cultural beliefs and addressing the core schema underlying those beliefs should be considered as a part of the management. A good knowledge in obstetricians about post-partum psychiatric disorders enables regular screening and appropriate referral to psychiatrists helps in timely intervention and subsequent well-being of mother and child.

Keywords: Post-partum, Girl child, Culture, Depression, Consultation.