Migrant women’s experiences, meanings and ways of dealing with postnatal depression: A meta-ethnographic study

Abstract

AimTo conduct a meta-ethnographic study of the experiences, meanings and ways of ‘dealing with’ symptoms or a diagnosis of postnatal depression amongst migrant women living in high income countries.BackgroundPrevalence of postnatal depression is highest amongst women who are migrants. Yet many women do not seek help for their symptoms and health services do not always respond appropriately to migrant women’s needs. Studies have reported migrant women’s experiences of postnatal depression and it is timely to synthesise findings from these studies to understand how services can be improved.DesignA meta-ethnographic synthesis of 12 studies reported in 15 papersData sourcesFive databases were searched for papers published between January 1999 and February 2016Review methodsThe quality of included studies was assessed using the Critical Appraisal Skills Program tool. The synthesis process was guided by the seven steps of meta-ethnography outlined by Noblit and Hare.FindingsFour key metaphors were identified: “I am alone, worried and angry—this is not me!”; ‘Making sense of my feelings’ ‘Dealing with my feelings’ and ‘What I need to change the way I feel!’. Primarily women related their feelings to their position as a migrant and as women, often living in poor socio-economic circumstances and they were exhausted keeping up with expected commitments. Many women were resourceful, drawing on their personal strengths and family / community resources. All the studies reported that women experienced difficulties in accessing appropriate services.ConclusionThe meta-ethnographic study demonstrates the impact of migration on perinatal mental health, particularly for women lacking family support, who have no employment, a precarious migration status and/or relationship conflict. Migrant women are resourceful and this requires support through appropriate services. Further research is needed to evaluate effective support strategies for migrant women in the perinatal period.

Migrant women’s experiences of pregnancy, childbirth and maternity care in European countries: A systematic review

“…While the healthy migrant phenomenon may mean that some migrants are healthier than the native population [22]; a theme which emerged particularly strongly within this review is that to meet the unique needs of many migrant women there is a necessity for care which goes beyond traditional models. Other academic studies and reports have highlighted migrant women's unstable or inappropriate living conditions, their financial struggles [25,89,104,105] and the enormous burden of loneliness and the lack of a family network around them [25,85,100,[104][105][106]. As the wider determinants of health are well recognised [107], including intimate partner violence [108], low health literacy [109][110][111], limited social support [112]; Table 3.…”

The relationship between intimate partner violence reported at the first antenatal booking visit and obstetric and perinatal outcomes in an ethnically diverse group of Australian pregnant women: a population-based study over 10 years

“… 14 15 This is an even more complex issue where migrant women are concerned and cultural understandings, taboos and language barriers could all have a significant influence. 16 …”

Perception of Childbirth Experiences of Japanese Women in Bali, Indonesia: A Qualitative Study

“…Nevertheless, for some childbirthwas a stressful experience, with the increased potential for developing postpartum post-traumatic stress disorder symptoms [51].Literature reveals that the prevalence of postnatal depression is highest among migrant women [52]. Brief midwife-led counselling interventions for women who report distressing birth experiences have been found to be effective for reducing symptoms of trauma, depression, stress, and coping with feelings of self-blame [53].…”