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Reports of non-Western prevalence of postpartum depression (PPD) are highly variable. This variation may indicate that the label of PPD may be unacceptable in some groups or not used, that manifestations may vary by culture, or that cross-cultural diagnostic standards do not match Western clinical criteria. These factors complicate efforts to explore the relationship of postpartum traditional practices to PPD between Western and non-Western cultures. Although Stern and Kruckman viewed PPD as a culture-bound phenomenon of Western culture, an expanding international literature has demonstrated that PPD occurs in a variety of countries. To address these issues, the authors examined the literature to describe cultural postpartum traditions, to explore possible relationships among practices and PPD prevalence, to critique the culture-bound theory, and to discuss clinical practice implications.

The study showed that a coaching strategy had a positive effect on maternal-infant interaction in this sample. Future research is needed to test coaching interventions in conjunction with other strategies targeted to promote maternal-infant responsiveness and to reduce PPDS.

The purpose of this study was to examine changes in maternal depression symptoms over time from the postpartum period to 2 years after delivery among a sample of women identified with elevated depression symptoms at 2 to 4 weeks postpartum, a longitudinal within-subjects design was used to examine changes in maternal depression symptoms. Two years after delivery, 62 women who had elevated depression scores at 2 to 4 weeks postpartum completed mailed questionnaires including a Demographic Information Sheet, the Beck Depression Inventory II, and the Parenting Stress Index. Among this sample of women, 30.6% scored in the depressed range 2 years after delivery. Although depression scores decreased over time, the significant change in mean scores occurred from 4 to 8 weeks to 10 to 14 weeks postpartum, and mean scores did not change significantly from 10 to 14 weeks, to 14 to 18 weeks, to 2 years after delivery. Depression history, lower overall social support, and higher parental distress were associated with higher depression scores among mothers at 2 years after delivery. Initial decrease in depression scores suggests that postpartum depression symptoms posed a time-limited problem for many women with peak occurrence from 4 to 8 weeks after delivery. However, for many women depression symptoms persisted at 2 years after delivery. Previous depression, limited current support, and parental distress increased depression symptom severity. Additional longitudinal research is needed to determine factors that increase and ameliorate risk for chronic maternal depression. Clinical assessment of maternal depression beyond the early postpartum weeks is warranted for at-risk women.