by Eleri Jones and Ernestina Coast
Epidemiological research has rejected previous assertions of the absence of postpartum depression in ‘non-western’ contexts. In South Asia, recent estimates suggest a much higher prevalence of postpartum depression than in ‘western’ contexts. Poor social relationships (and support in particular) are recognised as a key risk factor for the condition, as for many other physical and mental health outcomes. Yet, there are vast socio-cultural differences in the nature of relationships with kith and kin. It cannot be assumed that findings on the association in limited contexts can be generalised across all societies and cultures. In Jones and Coast (2012), we systematically review the evidence on the association between social relationships and postpartum depression in South Asia.
Our review finds that low perceived support, dissatisfaction and conflict in family relationships, and marital violence are associated with postpartum depression in South Asia. Whilst the emphasis in many other contexts is on the marital relationship, characteristics of family and household structures in this region increase the importance of relationships with in-laws in the aetiology of the condition. Social and cultural norms influence the association through their effect on what is preferred, expected and exchanged in interpersonal interactions. Identifying gaps in the current evidence base, we make recommendations for further research. Qualitative research is needed on the conceptualisation of support in South Asia and more studies should systematically examine the various dimensions of relationships and support. The likely complex interrelationships between social risk factors should also be further investigated.
For more information
Jones E, Coast E (2012) Social relationships and postpartum depression in South Asia: A systematic review, International Journal of Social Psychiatry. Published online 31 July 2012.