Postnatal depression, maternal–infant bonding and social support: a cross-cultural comparison of Nigerian and British mothers

Afolabi, Oladayo; Bunce, Louise; Lusher, Joanne; Banbury, Samantha

doi:10.1080/09638237.2017.1340595

Cited by 31 publications

(24 citation statements)

References 53 publications

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“…Our non-autistic sample only included mothers with at least one autistic child and included a higher than usual proportion of women who had experienced postpartum depression. Whilst average rates in population samples are 10-15% [37,38], 45% of non-autistic mothers in our sample reported experiencing postnatal depression following the birth of at least one of their children. Additionally, mothers in our samples were also from predominantly Western countries, suggesting that the themes reported here may not be applicable to women from non-Western countries.…”

Section: Limitationsmentioning

confidence: 58%

A comparative study of autistic and non-autistic women’s experience of motherhood

et al. 2020

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Background: Autism is a lifelong neurodevelopmental difference and disability, yet there is limited research examining parenting in autistic mothers. Objective: To explore autistic mothers' experience of the perinatal period and parenthood. This includes pregnancy, childbirth, the postpartum period, self-perception of parenting strengths and weaknesses, communication with professionals in relation to one's child, mental health difficulties and the social experience of motherhood. It also includes disclosing one's diagnosis of autism in parenting contexts. Methods: We used a community-based participatory research model, and recruited an advisory panel, with whom we co-developed an anonymous, online survey for autistic mothers. The online survey was completed by autistic and nonautistic mothers, and we compared their responses using Chi-squared analysis. Sample: Autistic mothers (n = 355), and non-autistic mothers (n = 132), each of whom had at least one autistic child, were included in our final analysis. Results: There were differences in education, gender identity and age of mother at birth of first child. Autistic mothers were more likely to have experienced additional psychiatric conditions, including pre-or post-partum depression, and reported greater difficulties in areas such as multi-tasking, coping with domestic responsibilities and creating social opportunities for their child. They were also more likely to report feeling misunderstood by professionals, and reported greater anxiety, higher rates of selective mutism, and not knowing which details were appropriate to share with professionals. They were also more likely to find motherhood an isolating experience, to worry about others judging their parenting, or feel unable to turn to others for support in parenting. However, despite these challenges, autistic mothers were able to act in the best interest of their child, putting their child's needs first. Conclusions: Autistic mothers face unique challenges and the stigma associated with autism may further exacerbate communication difficulties. Greater understanding and acceptance amongst individuals who interact with autistic mothers is needed, and autistic mothers would benefit from additional and better-tailored support.

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Section: Limitationsmentioning

confidence: 58%

A comparative study of autistic and non-autistic women’s experience of motherhood

et al. 2020

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“…37 Our findings in light of other work in this region highlight the importance of interventions and associated research to assess and address the type of social support most salient in the culture and context. 38 Scholars have pointed to the 'stress buffering hypothesis' to explain the benefits of social support for mental health. 13,39 Indeed, an increase in support can relieve the increased demands associated with child rearing.…”

Section: Discussionmentioning

confidence: 99%

Longitudinal effects of perinatal social support on maternal depression: a marginal structural modelling approach

Hagaman

LeMasters

Zivich

et al. 2021

J Epidemiol Community Health

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BackgroundDepression in the perinatal period, during pregnancy or within 1 year of childbirth, imposes a high burden on women with rippling effects through her and her child’s life course. Social support may be an important protective factor, but the complex bidirectional relationship with depression, alongside a paucity of longitudinal explorations, leaves much unknown about critical windows of social support exposure across the perinatal period and causal impacts on future depressive episodes.MethodsThis study leverages marginal structural models to evaluate associations between longitudinal patterns of perinatal social support and subsequent maternal depression at 6 and 12 months postpartum. In a cohort of women in rural Pakistan (n=780), recruited in the third trimester of pregnancy and followed up at 3, 6 and 12 months postpartum, we assessed social support using two well-validated measures: the Multidimensional Scale of Perceived Social Support (MSPSS) and the Maternal Social Support Index (MSSI). Major depressive disorder was assessed with the Structured Clinical Interview for Diagnostic and Statistical Manual of Mental Disorders (DSM IV).ResultsHigh and sustained scores on the MSPSS through the perinatal period were associated with a decreased risk of depression at 12 months postpartum (0.35, 95% CI: 0.19 to 0.63). Evidence suggests the recency of support also matters, but estimates are imprecise. We did not find evidence of a protective effect for support based on the MSSI.ConclusionsThis study highlights the protective effect of sustained social support, particularly emotional support, on perinatal depression. Interventions targeting, leveraging and maintaining this type of support may be particularly important for reducing postpartum depression.

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“…Afolabi et al [ 16 ] used 13 or more on the EPDS for each of the three groups of mothers in their study: British mothers in the UK, immigrant Nigerian mothers in the UK, and Nigerian mothers in Nigeria. While they did however discuss how Nigerians can be less inclined to express distress through psychological, as opposed to physical or somatic symptoms, they did not discuss an earlier validation study on Nigerian women and the EPDS which had found a lower score was optimal [ 7 ].…”

Section: Resultsmentioning

confidence: 99%

“…Afolabi et al [ 16 ] (2017) state: “… more recent studies have tended towards a general consensus for EPD cut-offs at 13 or more …” (p. 429). Redinger et al [ 37 ] state: “The internationally recognized threshold score for probable depression of ≥ 13 was used” (p. 31); Levis et al [ 38 ] state “… (scores on the on the EPDS) of 10 or higher and 13 or higher (are) typically used to identify women who might be depressed” (p. 1), and Eberhard-Gran et al [ 39 ] state that a score of 10 or more “is frequently used in recent publications” (p. 114).…”

Section: Resultsmentioning

confidence: 99%

“…Some of the reasons investigators give as to why different optimal cut-off scores were obtained in their sample, compared to other cultural or gender groups, include that such groups may differ in their expression of depression or the actual symptoms experienced [ 4 , 9 , 10 , 12 , 16 ], as well as differences in the comprehension of the screening scale’s items [ 4 , 6 ]. These reasons, as opposed to more procedural or psychometric reasons (e.g., different caseness criteria, or different gold-standard interviews, used across studies), would support the need to conduct validation studies in different populations to ensure any such emotional expressiveness, comprehension, or symptom experience differences are taken into account when screening women, and men, for possible emotional health difficulties.…”

Section: Introductionmentioning

confidence: 99%

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Is Validating the Cutoff Score on Perinatal Mental Health Mood Screening Instruments, for Women and Men from Different Cultures or Languages, Really Necessary?

Matthey

2022

IJERPH

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Background: The most commonly used mood screening instrument in perinatal health is the Edinburgh Depression Scale. The screen-positive cut-off score on this scale, as for others, has been determined, via validation techniques, for over 20 languages/cultures, and for both women and men. While such validation appears to be considered essential, there are studies that could be interpreted to suggest that this is not an important consideration. Methods: Selective studies have been chosen to indicate these opposing points of view. Results: Examples of studies that support the notion of validating cut-off scores are described, as are examples of studies that appear not to support this point of view. Conclusions: (i) Clinical services and researchers need to be mindful of these opposing points of view, and openly discuss them when using screening cut-off scores for their respective populations. (ii) Researchers and Journals need to be more rigorous in ensuring this issue is correctly reported in studies, and/or openly discussed when relevant.

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Postnatal depression, maternal–infant bonding and social support: a cross-cultural comparison of Nigerian and British mothers

Abstract: Our findings highlight the importance that cultural factors play in the development of PND and the establishment of MIB in the context of culturally attuned healthcare services.

Cited by 31 publications

References 53 publications

A comparative study of autistic and non-autistic women’s experience of motherhood

A comparative study of autistic and non-autistic women’s experience of motherhood

Longitudinal effects of perinatal social support on maternal depression: a marginal structural modelling approach

Is Validating the Cutoff Score on Perinatal Mental Health Mood Screening Instruments, for Women and Men from Different Cultures or Languages, Really Necessary?

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