Postpartum depression: perception, management, and help-seeking barriers in a Palestinian context: a qualitative study.

Abstract

Background: Postpartum depression (PPD) is a global concern that adversely affects the well-being of mothers, their children, and their families. It is particularly prevalent in low- and middle-income countries, where limited research has been conducted. This study aimed to examine the perspectives of mothers regarding PPD and identify their health-seeking behaviors and barriers in a Palestinian context.

Methods: This study utilized a qualitative approach involving three focus group discussions (FGDs), with a total of 17 mothers in three different regions of the Bethlehem governorate, Palestine. A phenomenological orientation was used to explore the participants' experiences.  RESULTS: Regarding mothers' perceptions of PPD, not all mothers perceived PPD as a mental disorder; some considered it a result of envy. Risk factors for PPD include a lack of practical and emotional support from the extended family and husband, an unpleasant childbirth experience, or a lack of preparation for motherhood. Seeking help from family members was the first option for all participants; sometimes, it was the only method they considered. The extended family may have control over the decision-making process for help-seeking behavior. Mothers may not seek professional help to avoid acknowledgment of their condition or due to shyness, fear of negative reactions from others, lack of personal free time, family misperceptions of PPD, and the underestimation of psychological therapy. However, when mothers seek help, they prefer venting sessions that include receiving advice, and they refuse to take psychotropic medication.

Conclusion: In Palestine, PPD is often misunderstood and poses a significant barrier to seeking professional treatment. Addressing this challenge demands a holistic approach extending beyond mere medical interventions, given the complex social and cultural circumstances confronting Palestinian mothers. Vital steps include implementing regular PPD screenings, establishing a culturally suitable referral system, and actively combating the societal stigma surrounding mental health disorders.