Currently little is known of postpartum depression (PPD) screening and referral for refugee and immigrant women in Northern New England where the foreign born population has been rapidly expanding in the past decade. Research on PPD has focused largely on the general population leaving a large gap in our understanding of PPD in this vulnerable group. A retrospective chart review was conducted from a tertiary medical center with 1,160 births per year. Total sample n = 126, 28 % scored at risk for PPD. 39 % of women at risk had follow up documented as a phone call alone, however 43 % of that at risk group did not speak English. Focuses on the suitability of tools that have not been psychometrically tested for this population and may be culturally inappropriate for non western women. Lack of appropriate follow up is challenged and who is best placed to perform screening is considered.

The aim of this work is to synthesize qualitative research on refugee and immigrant women's experiences of postpartum depression (PPD) to gain insight into the unique needs of this group of women. This population is more at risk of developing PPD due to a complexity of issues including pre- and postmigratory stressors; however, there is currently little research on this topic available to health care providers and policy makers. Thirteen articles met inclusion criteria, and five themes emerged from the meta-synthesis: (a) suffering in solitude, (b) the invisible illness, (c) cultural conceptualizations, (d) barriers to help seeking, and (e) facilitators of help seeking. Conclusions suggest immigrant women with PPD may lack understanding of their condition, are often isolated, are alone, fear stigmatization, and risk being considered an unfit mother. Raising awareness with health care providers of the meaning of PPD for immigrant women is key to the provision of effective care.