Refugee, asylum seeking, non-refugee, and immigrant new mothers with depressive symptoms, were interviewed in a qualitative study to better understand their (a) experiences and attributions of depressive symptoms, (b) their experiences with health care providers and support services, (c) factors that facilitated or hindered help seeking, (d) factors that aided recovery or (e) were associated with women continuing to experience symptoms of depression. Ten immigrant new mothers who scored 10 or over on the Edinburgh Postpartum Depression Scale shortly after giving birth, participated 12 to 18 months later in postpartum semi-structured interviews which were taped, transcribed and analyzed using a constant comparative approach. Many women attributed their depressive symptoms to social isolation, physical changes, feeling overwhelmed and financial worries. They had poor knowledge of community services. Barriers to care included stigma, embarrassment, language, fear of being labeled an unfit mother, or the attitude of some staff. Facilitators to recovery included social support from friends, partners and family, community support groups, "getting out of the house", or personal psychological adjustment. Personal and systematic barriers exist in new immigrant mothers obtaining care for symptoms of depression. Suggestions for improvements are offered.

The results suggest that not only are there important barriers to accessing postpartum care for recent immigrant women, but it can also be challenging for healthcare workers to deliver such needed care. Understanding some of these barriers and challenges from the perspective of healthcare providers is an important step to remedying gaps and obstacles in the service system.

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