Postpartum depression

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By Shannon Chavez

sad-womanResearch shows that the number of Latinas suffering from postpartum depression is on the rise. There are several factors that may affect why the number is growing. Factors, such as socio-economic status, education, acculturation and cultural beliefs, can impact how a Latina woman seeks help and addresses a problem. Latinas are challenged by limited access to health care, cultural norms that prevent mental health care, and beliefs that seeking help will be frowned upon by family, religion and spouse. Feelings of fear and shame can contribute to why Latinas are not reporting postpartum depression and why we should be concerned about making changes to prevent mental health issues later in life.  

The number of women with postpartum depression is reported to be as high as 10 to 15 percent of the population. This statistic is informed by self-report questionnaires gathered by the Centers for Disease Control and Prevention. The last major survey data were compiled in 2008, but didn’t take into account demographic and cultural differences, whether there was a live birth or not, and language barriers. Women can still experience postpartum depression if the baby is stillborn or they have a miscarriage. More women are reporting symptoms of depression during pregnancy. Providing the survey in one language does not account for the general population. These are all factors that must be considered when diagnosing and recognizing the problem and providing proper treatment. 

Postpartum depression is often misdiagnosed and overlooked. Most women experience what is known as postpartum blues or “baby blues.” Over 85 percent will experience blues and not depression. Important factors in the diagnosis are the duration of the depressive symptoms, severity, effect on daily functioning and risk factors. Postpartum depression symptoms include change in appetite, weight gain, sleep disturbances, fatigue, difficulty concentrating, isolation, intensity of emotions of fear, anger or sadness, difficulty taking care of self and child, and feeling overwhelmed or hopeless. If the symptoms persist for over two weeks, it is recognized as postpartum depression and requires treatment. Women often get counseling to gain coping skills and tools for dealing with their emotions. The support of the spouse is crucial and can sometimes involve couples therapy. Group therapy has been shown to provide hope and motivation, support from other women going through the same experience, and skill-building for coping with the changes both physically and mentally. In some cases, antidepressants may be indicated if all other options are not successful and the medication is suitable while breastfeeding. 

Despite all of these facts, Latinas seem to be even more impacted by postpartum depression because of cultural indicators that are deeply rooted in the social roles and belief systems of the Latina mother. 

How a health care professional defines “depression” may differ from that of a Latina mother. If symptoms, such as anxiety, sadness or feeling overwhelmed, are present, there is a cultural belief that is it attributed to mal de nervios, an ailment of the nerves, and not a mental illness like depression. The Latina mother perceives these symptoms as temporary and expected. Family members might reinforce the idea that these symptoms are expected and that they will eventually subside. 

The roles and expectations of the Latina mother can vary based on the level of acculturation. Overall, the expectation is that, to be a good mother, the baby becomes the focal point of life. The baby’s health and well-being are most important and take priority even over the mother’s health. When a new Latina mother starts to feel down and self-critical postpartum, to admit difficulty with  coping may be shameful. The expectations, both internal and external, are guilt-inducing, and can cause even more reason to mask depressive feelings. The Latina mother is a matriarch. When something is lacking in the house, it is the responsibility of the mother. When something happens with the children, it is the responsibility of the mother. The father may represent strength, but the mother is the power: Padre puede ser qualquiera, pero madre hay una sola (Father could be anyone, but mother – only one).

For many Latinas, even those that work, there is a cultural prescription of solo mothering in the home as an ideal. This ideal comes from tradition and cultural practices that allow for women to work while tending to their children, but also emphasizes the importance of the mother and child bonding after birth. Some Latino cultures believe that no one but the mother should take care of the baby after birth. This belief and many others put an incredible amount of pressure on the Latina mother to live up to the expectations and ideals of being a good mother.

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