Cultural perceptions and experiences on postpartum depression and associated traditions and help-seeking behaviors among Vietnamese, Chinese and Asian Indian mothers

Background. Postpartum depression (PPD) is the most frequent cause of maternal morbidity after childbirth. Due to the adverse effects of untreated PPD, it is important to understand the reasons why Asian American mothers underutilize mental health services.

Objective. To compare and contrast perceptions and experiences on PPD and associated help-seeking behaviors among Asian American mothers.

Methods. This mixed methods study comprised of semi-structured interviews and quantitative surveys.  This convenience sample comprised of 42 recent Asian mothers (15 Vietnamese; 15 Chinese; 12 Asian Indian). An Edinburgh Postnatal Depression Scale score of ≥10 suggested PPD. Interviews were conducted in English/Vietnamese/Chinese. Participants were asked to describe how PPD is viewed in their culture, their postpartum traditions and help-seeking attitudes and behaviors.  Quantitative analyses and content analysis were conducted.

Results. Overall, the mean age was 32.8 years old, 90.5% were foreign-born, all were married, 11.9% reported lifetime experience with depression, and 23.8% had a high risk of developing PPD (33.3% Vietnamese; 20% Chinese; 16.7% Asian Indian). Less than 7% of Vietnamese and 37.5% of Chinese mothers reported ever receiving mental health services. Mothers expressed the importance of postpartum traditions in promoting recovery and health, and maintaining their cultural values. Some Vietnamese and Asian Indian mothers reported feelings of isolation and desiring experiencing postpartum traditions more frequently. Many reported that PPD is not understood in their specific culture. Most mothers stated that they would seek professional help if needed, but only if their sadness/depression was severe and/or as a last resort. Many mothers preferred to use alternative methods for treatment. Cultural barriers to help-seeking (i.e. stigma/shame) were salient among all three groups.

Conclusion. Future PPD interventions should understand the importance of postpartum cultural traditions and address the cultural barriers to help-seeking as ways to prevent the adverse effects of untreated PPD among Asian American mothers.