Social Support and Postpartum Depression Revisited: The Traditional Female Role as Moderator among Mexican Women

A qualitative analysis of adolescent motherhood within the broader family context in Peru

Objective

The purpose of this study was to characterize the impact of adolescent pregnancy on families and describe the needs of adolescent mothers and their infants in order to assess the need for intervention and identify potential intervention targets.

Background

Adolescent mothers and their offspring face an increased risk of mental health problems. Adolescent mothers and their families also face significant resource constraints; 95% live in low- and middle-income countries (LMICs). Cost-effective interventions are needed to improve outcomes for this vulnerable group.

Method

This qualitative study conducted in Lima, Peru, consisted of four clinician focus groups and 18 in-depth interviews with adolescent mothers and their family members. Data were coded thematically, and direct content analysis was employed.

Results

The study identified the following issues facing adolescent parents: the transition to parenthood, the need for family support, difficulty accessing support, the difficulty for family members of providing support, and ideas about responsibility and adolescent autonomy.

Conclusion

Overall, these findings demonstrate the need for interventions that engage families and address barriers to accessing support, including relationship conflict and differing beliefs about responsibility and autonomy.

Implications

Interventions are needed for adolescent mothers in LMICs that mobilize family support. Clinicians who care for these patients need to be aware of the family context and the resources available where they practice.

Impact of Facebook on Social Support and Emotional Wellbeing in Perinatal Women during Three Waves of the COVID-19 Pandemic in Mexico: A Descriptive Qualitative Study

The COVID-19 pandemic affected the mental health of pregnant and postpartum women in unique, unprecedented ways. Given the impossibility of delivering face-to-face care, digital platforms emerged as a first-line solution to provide emotional support. This qualitative study sought to examine the role that a closed Facebook group (CFG) played in providing social support for Mexican perinatal women and to explore the concerns they shared during the COVID-19 pandemic. A thematic analysis of all the posts in the CFG yielded nine main categories: (1) COVID-19 infections in participants and their families; (2) fear of infection; (3) infection prevention; (4) health services; (5) vaccines; (6) concerns about non-COVID-19-related health care; (7) effects of social isolation; (8) probable mental health cases; and (9) work outside the home. Participants faced stressful situations and demands that caused intense fear and worry. In addition to household tasks and perinatal care, they were responsible for adopting COVID-19 preventive measures and caring for infected family members. The main coping mechanism was their religious faith. The CFG was found to be a useful forum for supporting perinatal women, where they could share concerns, resolve doubts, and obtain information in a warm, compassionate, and empathetic atmosphere. Health providers would be advised to seek new social media to improve the quality of their services.

Pregnancy Anxiety and Beliefs Surrounding Motherhood in Latinas: A Qualitative Study

Objectives

Prior research indicates that Latinas are at risk for experiencing high levels of anxiety during pregnancy. Pregnancy anxiety is a specific affective experience involving fears and worries about one's current pregnancy and it has been linked to heightened risk for preterm birth and developmental effects. Despite this concerning pattern, research has rarely examined Latina beliefs about the transition to motherhood and little is known about specific sources of pregnancy anxiety in Latinas, including whether fears are rooted in cultural concerns. The present study investigates the experiences of pregnancy anxiety among Latinas and explores their broader cultural beliefs surrounding pregnancy.

Methods

Fourteen pregnant Latinas articulated their experience of pregnancy anxiety, how they coped with their anxiety, and the beliefs they held surrounding pregnancy in 11 individual interviews and one focus group of three participants, all conducted in Spanish.

Results

Thematic analysis revealed that overall, Latinas felt that anxiety during pregnancy was normal, and that they worried about labor and delivery, losing their baby, their baby being born with a birth defect, and felt affected by the broader sociopolitical climate. Latinas felt lucky to be pregnant, believed that pregnancy was a blessing from God, and stressed the importance of maintaining a healthy pregnancy. Themes about family involvement and culturally-driven privileged status also emerged.

Conclusions

The present study highlights specific themes that may be important to consider in the context of Latina perinatal health. Such findings set the stage for future investigations examining the experience of anxiety specific to pregnancy in Latinas.

Social connectedness as a determinant of mental health: A scoping review

Public health and epidemiologic research have established that social connectedness promotes overall health. Yet there have been no recent reviews of findings from research examining social connectedness as a determinant of mental health. The goal of this review was to evaluate recent longitudinal research probing the effects of social connectedness on depression and anxiety symptoms and diagnoses in the general population. A scoping review was performed of PubMed and PsychInfo databases from January 2015 to December 2021 following PRISMA-ScR guidelines using a defined search strategy. The search yielded 66 unique studies. In research with other than pregnant women, 83% (19 of 23) studies reported that social support benefited symptoms of depression with the remaining 17% (5 of 23) reporting minimal or no evidence that lower levels of social support predict depression at follow-up. In research with pregnant women, 83% (24 of 29 studies) found that low social support increased postpartum depressive symptoms. Among 8 of 9 studies that focused on loneliness, feeling lonely at baseline was related to adverse outcomes at follow-up including higher risks of major depressive disorder, depressive symptom severity, generalized anxiety disorder, and lower levels of physical activity. In 5 of 8 reports, smaller social network size predicted depressive symptoms or disorder at follow-up. In summary, most recent relevant longitudinal studies have demonstrated that social connectedness protects adults in the general population from depressive symptoms and disorders. The results, which were largely consistent across settings, exposure measures, and populations, support efforts to improve clinical detection of high-risk patients, including adults with low social support and elevated loneliness.

Traditional feminine gender roles, alcohol use, and protective behavioral strategies among Latina college students

OBJECTIVE

Studies conducted with Latina/o populations suggest there are gendered norms surrounding drinking behavior, but research examining alcohol use among Latina college students in the context of traditional feminine gender role (TFGR) norms, is scarce.Participants and Methods: 405 Latina undergraduates completed a web-based study of sociocultural factors and alcohol use. Path analyses assessed the relation between TFGR , alcohol use, and alcohol-related protective behavioral strategies (PBS).

RESULTS

A dimension of TFGR characterized by purity was related to (a) reduced alcohol use in general, and (b) PBS designed to modify the manner of drinking among drinkers. In turn, this dimension of PBS related to a lower likelihood of experiencing drunkenness.

CONCLUSIONS

These findings support the notion that enacting some dimensions of TFGR among Latina college students may limit general alcohol use (directly) and high-risk drinking (indirectly through use of PBS), while enacting other dimensions may place Latinas at risk of alcohol misuse.

Abortion laws and women's health

We examine the impact of progressive and regressive abortion legislation on women's health in Mexico. Following a 2007 reform in the Federal District of Mexico which decriminalised and subsidised early-term elective abortion, multiple other Mexican states increased sanctions on illegal abortion. We observe that the original legalisation resulted in a sharp decline in maternal morbidity, particularly morbidity due to haemorrhage early in pregnancy. We observe small or null impacts on women's health from increasing sanctions on illegal abortion. These results quantify the considerable improvements in non-mortal health outcomes flowing from legal access to abortion.

Perinatal Anxiety Symptoms: Rates and Risk Factors in Mexican Women

Anxiety during pregnancy and after childbirth can have negative consequences for a woman and her baby. Despite growing interest in the perinatal mental health of Mexican women living in the U.S., perinatal anxiety symptom (PAS) rates and risk factors have yet to be established for women in Mexico. We sought to determine PAS rates and identify risk factors, including the traditional female role (TFR) in a sample of Mexican women. This secondary data analysis is based on 234 Mexican women who participated in a longitudinal study on perinatal depression in Mexico. Anxiety symptoms were assessed in pregnancy and at six weeks postpartum. Rates were determined through frequencies, and multiple logistics regressions were conducted to identify risk factors in the sample. The PAS rate was 21% in pregnancy and 18% postpartum. Stressful life events and depressive symptoms were associated with a higher probability of PAS. Adherence to TFR increased the probability of prenatal anxiety; lower educational attainment and low social support during pregnancy increased the probability of postpartum anxiety. The PAS rates were within the range reported in the literature. The TFR was only associated with anxiety in gestation, highlighting the role of this culturally relevant risk factor. Culturally responsive early interventions are therefore required.

Social Support and Perinatal Depression: The Perspectives of Mexican-American Adolescent Mothers

Perinatal depression is estimated to affect one in seven pregnant women. As such, social support has been shown to impact the mental health of women during the perinatal period. The purpose of this qualitative descriptive study was to examine the types of social support received by pregnant and parenting Mexican-American adolescent mothers and their perceptions of how it can influence perinatal mental health. Deductive content analysis was used to analyze the data using emotional, instrumental, and informational support as primary categories. Positive and negative aspects of the adolescent's social network were also included to understand how individuals impact their mental health. A convenience sample of 20 perinatal Mexican-American adolescents were interviewed. Emotional support, such as encouragement and affirmation, as well as instrumental support, via financial assistance and help with infant care, were primarily sought from significant others, which consisted of family members and their partner. Having strained relationships with their significant others primarily contributed to emotional distress. Health care providers were often sought out for informational support concerning perinatal depression. However, some adolescents were unable to establish rapport with their health care provider, making it difficult to inquire about pertinent mental health information. Study findings suggest that identifying support needs and expectations is an important component of facilitating positive mental health outcomes for Mexican-American adolescent mothers. Future efforts to promote mental health and prevent perinatal depression among Mexican-American adolescent mothers should consider integrating a strong focus on social support.

Correlation between postpartum depression and spousal support and factors affecting postpartum depression

This study was conducted to investigate the relationship between postpartum depression (PPD) and women's perceived spousal support during the early postpartum period and the prevalence of PPD and affecting factors. Data were collected using a Personal Information Form, the Edinburgh Postpartum Depression Scale (EPDS) and the Perceived Spousal Support among Women in Early Postpartum Period Scale (PSSAWEPP). The study was completed with 181 women. The prevalence of PPD was found as 28.2%. A significant negative correlation was found between the total EPDS score and total PSSAWEPP score and subscale scores of emotional support, social support and physical support (p < 0.01). It was also found that as spousal support perceived by women increased, PPD risk decreased. In our study, it was observed that spousal violence (aOR = 5.69, 95% CI: 1.65-19.55) and having an unintended pregnancy (aOR = 0.24, CI: 0.11-0.54) were two factors that significantly affected PPD.

A systematic review of cultural orientation and perinatal depression in Latina women: are acculturation, Marianismo, and religiosity risks or protective factors?

Latinas in the USA and Spanish-speaking countries experience elevated rates of perinatal depression (PND) because of high psychosocial stressors. Latinas are heterogeneous and have varying cultural practices. It is unclear whether specific cultural orientations have differential risks for PND. This systematic review aimed to determine whether degree of acculturation, Marianismo, and religiosity are risks or protective factors for PND in Latina women living in the USA, Latin America, and other countries. The review included PubMed, CINAHL, PsycINFO, PsycARTICLES, Academic Search Ultimate (EBSCO), and Social Services Abstracts, and used Boolean combined keywords. English and Spanish language articles were considered. The review was conducted between July 2017 and February 2018, with no boundaries on publication dates. Ten studies were selected for inclusion. Of those, two studies were conducted in Mexico and most studies conducted in the USA included women of Mexican descent. Degree of acculturation (adoption of mainstream values) was inconsistently directly associated with PND; evidence suggest indirect associations. Marianismo, the traditional female role of virtue, passivity, and priority of others over oneself, was inconsistently correlated with risk for depression in pregnancy, but significantly and indirectly associated with postpartum depression. Two of three studies found religiosity to be protective postpartum. Further research on protective and risk factors of specific cultural orientations, particularly degree of acculturation and Marianismo, for PND in Latinas in the USA and abroad is needed. Attention to specific perinatal periods is necessary given the inconsistent findings.