Postnatal depression and its social-cultural influences among adolescent mothers: A cross sectional study

Chimwemwe Tembo; Linda Portsmouth; Sharyn Burns

doi:10.1371/journal.pgph.0002025

Postnatal depression and its social-cultural influences among adolescent mothers: A cross sectional study

PLOS Glob Public Health. 2023 Jun 23;3(6):e0002025. doi: 10.1371/journal.pgph.0002025. eCollection 2023.

Authors

Chimwemwe Tembo¹, Linda Portsmouth², Sharyn Burns²

Affiliations

¹ Saint John of God Hospitaller Services Malawi, Mzuzu, Malawi.
² School of Population Health, Faculty of Health Sciences, Curtin University, Perth, Australia.

Abstract

In rural Malawi, adolescent mothers represent 31% of pregnancies. While some adolescent mothers experience motherhood as an exciting, positive, and affirming experience, for others, it may increase their risk of postnatal depression (PND). Social norms and culture contribute to adolescent mothers' experiences and may influence their mental health. However, there is limited research around the prevalence of PND and its cultural influences among adolescent mothers. A cross-sectional survey was administered from 7th September 2021 to 31st March 2022. Three hundred and ninety-five adolescent postnatal mothers aged ≤19 were conveniently recruited at Mitundu hospital in Lilongwe, Malawi. The Edinburgh Postnatal Depression Scale was used to assess depression. A cutoff point of ≥ 10 was employed to categorize probable PND. Binary logistic regression was used to determine the predictors of depression. The mean age of participants was 17 (SD 1.157). and 43.6% (n = 172) presented with PND (EPDS scores ≥10). When all factors were considered in a binary logistic model, adolescents who had ever experienced intimate partner violence (IPV) were 13.6 times more likely to report PND after controlling for age and other predictors compared to those without an experience of IPV (aOR 13.6, p = 0.01, 95% CI 2.10-88.9). Participants whose families did not decide for them (regarding their care) were 2.3 times more likely to present with PND than those whose families decided for them (aOR 2.3 p = 0.03, 95% CI 1.04-5.2). Adolescent mothers who had interacted with their health worker were less likely to report PND than those who had no interaction with the health worker (aOR 0.4 P0.02, CI 0.17-0.67). Social and cultural factors can impact mental health of adolescent mothers. It is recommended that targeted and integrated interventions are developed, implemented. and evaluated. There is a need to improve policy and practice to better support adolescent mothers postnatally.

Copyright: © 2023 Tembo et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

Grants and funding

The research is part of a doctoral scholarship awarded by Curtin University to the corresponding author. Therefore, funding was provided to CT by Curtin University and the Malawi National Commission for Science and Technology to assist with data collection. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.