References

Agrati D, Browne D, Jonas W, Meaney M, Atkinson L, Steiner M, Fleming AS Maternal anxiety from pregnancy to 2 years postpartum: transactional patterns of maternal early adversity and child temperament. Arch Women Ment Health. 2015; 18:(5)693-705 https://doi.org/10.1007/s00737-014-0491-y

Ali NS, Mahmud S, Khan A, Ali BS. Impact of postpartum anxiety and depression on child's mental development from two peri-urban communities of Karachi, Pakistan: a quasi-experimental study. BMC Psychiatry. 2013; 13:(1) https://doi.org/10.1186/1471-244X-13-274

Almazeedi H, Alsuwaidan MT. “Integrating Kuwait's Mental Health System to end stigma: a call to action”. J Ment Health. 2014; 23:(1)1-3 https://doi.org/10.3109/09638237.2013.775407

Anxiety disorders in pregnancy and the postpartum period. 2013. https://www.intechopen.com/books/new-insights-into-anxiety-disorders/anxiety-disorders-in-pregnancy-and-the-postpartum-period (accessed 21 May 2019)

Bajurna B, Galeba A, Szwarc A, Petermichl D, Marcinkowski JT. Anxiety and fear that accompany women in pregnancy and in postpartum period. Hygeia Public Health. 2014; 49:(3)543-548

Bener A, Sheikh Gerber Prevalence of psychiatric disorders and associated risk factors in women during their postpartum period: a major public health problem and global comparison. Int J Womens Health. 2012; 4:191-200 https://doi.org/10.2147/IJWH.S29380

Dennis CL, Falah-Hassani K, Brown HK, Vigod SN. Identifying women at risk for postpartum anxiety: a prospective population-based study. Acta Psychiatr Scand. 2016; 134:(6)485-493 https://doi.org/10.1111/acps.12648

Dennis CL, Falah-Hassani K, Shiri R. Prevalence of antenatal and postnatal anxiety: systematic review and meta-analysis. Br J Psychiatry. 2017a; 210:(5)315-323 https://doi.org/10.1192/bjp.bp.116.187179

Dennis CL, Brown HK, Falah-Hassani K, Marini FC, Vigod SN. Identifying women at risk for sustained postpartum anxiety. J Affect Disord. 2017b; 213:131-137 https://doi.org/10.1016/j.jad.2017.02.013

Desmarais SL, Pritchard A, Lowder EM, Janssen PA. Intimate partner abuse before and during pregnancy as risk factors for postpartum mental health problems. BMC Pregnancy Childbirth. 2014; 14:(1) https://doi.org/10.1186/1471-2393-14-132

Falah-Hassani K, Shiri R, Dennis CL. Prevalence and risk factors for comorbid postpartum depressive symptomatology and anxiety. J Affect Disord. 2016; 198:142-147 https://doi.org/10.1016/j.jad.2016.03.010

Field F. Postpartum anxiety prevalence, predictors and effects on child development: a narrative review. Infant Behav Dev. 2018; 51:24-32 https://doi.org/10.1016/j.infbeh.2018.02.005

Hanlon C, Whitley R, Wondimagegn D, Alem A, Prince M. Postnatal mental distress in relation to the sociocultural practices of childbirth: an exploratory qualitative study from Ethiopia. Soc Sci Med. 2009; 69:(8)1211-1219 https://doi.org/10.1016/j.socscimed.2009.07.043

Lovibond SH, Lovibond PF. Manual for Depression Anxiety Stress Scale, 2nd edn. Sydney: Psychology Foundation of Australia; 1995

Mamisachvili L, Ardiles P, Mancewicz G, Thompson S, Rabin K, Ross LE. Culture and postpartum mood problems: similarities and differences in the experiences of first- and second-generation Canadian women. J Transcult Nurs. 2013; 24:(2)162-170 https://doi.org/10.1177/1043659612472197

Martini J, Petzoldt J, Einsle F, Beesdo-Baum K, Höfler M, Wittchen HU. Risk factors and course patterns of anxiety and depressive disorders during pregnancy and after delivery: A prospective-longitudinal study. J Affect Disord. 2015; 175:385-395 https://doi.org/10.1016/j.jad.2015.01.012

Michels A, Kruske S, Thompson R. Women's postnatal psychological functioning: the role of satisfaction with intrapartum care and the birth experience. J Reprod Infant Psychol. 2013; 31:(2)172-182 https://doi.org/10.1080/02646838.2013.791921

Mohammad KI, Gamble J, Creedy DK. Prevalence and factors associated with the development of antenatal and postnatal depression among Jordanian women. Midwifery. 2011; 27:(6)e238-e245 https://doi.org/10.1016/j.midw.2010.10.008

Mohammad K, Kassab M, Gamble J, Creedy DK, Foster J. Factors associated with birth weight inequalities in Jordan. Int Nurs Rev. 2014; 61:(3)435-440 https://doi.org/10.1111/inr.12120

Osman AH, Hagar TY, Osman AA, Suliaman H. Prevalence of depression and anxiety disorders in peri-natal Sudanese women and associated risks factors. Open J Psychiatr. 2015; 05:(04)342-349 https://doi.org/10.4236/ojpsych.2015.54039

Reichenheim ME, Moraes CL, Lopes CS, Lobato G. The role of intimate partner violence and other health-related social factors on postpartum common mental disorders: a survey-based structural equation modeling analysis. BMC Public Health. 2014; 14:(1) https://doi.org/10.1186/1471-2458-14–427

Rudman A, El-Khouri B, Waldenström U. Women's satisfaction with intrapartum care? a pattern approach. J Adv Nurs. 2007; 59:(5)474-487 https://doi.org/10.1111/j.1365-2648.2007.04323.x

Shlomi Polachek I, Huller Harari L, Baum M, Strous RD. Postpartum anxiety in a cohort of women from the general population: risk factors and association with depression during last week of pregnancy, postpartum depression and postpartum PTSD. Isr J Psychiatry Relat Sci. 2014; 51:(2)128-134

Shrestha S, Adachi K, Petrini MA, Shrestha S. Factors associated with post-natal anxiety among primiparous mothers in Nepal. Int Nurs Rev. 2014; 61:(3)427-434 https://doi.org/10.1111/inr.12118

Webster J, Linnane JWJ, Dibley LM, Hinson JK, Starrenburg SE, Roberts JA. Measuring social support in pregnancy: can it be simple and meaningful?. Birth. 2000; 27:(2)97-101 https://doi.org/10.1046/j.1523-536x.2000.00097.x

Yelland J, Sutherland G, Brown SJ. Postpartum anxiety, depression and social health: findings from a population-based survey of Australian women. BMC Public Health. 2010; 10:(1)771-788 https://doi.org/10.1186/1471-2458-10-771

Zeidner M, Matthews G. Anxiety 101.New York (NY): Springer Publishing Company; 2010

Sociocultural factors associated with the development of postnatal anxiety symptoms

02 June 2019
10 min read
Volume 27 · Issue 6

Abstract

Background

Postnatal anxiety is relatively common when transitioning to parenthood; however, there are relatively few studies assessing postnatal anxiety in Middle Eastern women.

Aim

To identify the prevalence of postnatal anxiety among Jordanian women and associated sociocultural factors.

Method

A descriptive cross-sectional design was used with 324 women. Participants completed the Depression, Anxiety, and Stress Scale (DASS) and Maternity Social Support Scale at 6-8 weeks postpartum in addition to a sociodemographic data form.

Findings

Some 45.4% of women scored above ‘mild’ on the DASS scale. Postnatal anxiety was significantly associated with low levels of support, giving birth to a female baby, financial difficulties, and having four or more children. Findings revealed a high level of postnatal anxiety among Jordanian women.

Conclusion

There is a need for routine assessment, ongoing support, counselling and emotional care, which are important to enhance maternal satisfaction and psychological wellbeing.

Childbirth and the postpartum period expose women to various social, biological and psychological changes. Although these changes may lead to individual growth and fulfilment, some women may also be vulnerable to mental distress associated with depression and anxiety (Mohammad et al, 2011). Postnatal anxiety is a relatively common phenomenon when transitioning to motherhood (Zeidner and Matthews, 2010). Worldwide, the prevalence of postnatal anxiety is estimated at 3–43%, with relatively little difference in rates between developed and developing countries (Falah-Hassani et al, 2016; Dennis et al, 2017a; Field, 2018).

Factors that give rise to postnatal anxiety are not clear, but a multi-factorial aetiology is commonly accepted (Anniverno et al, 2013). The development of postnatal anxiety has been associated with perinatal, interpersonal and sociocultural factors. Perinatal stressors include mode of birth, admission to the neonatal intensive care unit (NICU), previous experience of childbirth and prenatal loss (Michels et al, 2013; Desmarais et al, 2014; Shlomi Polachek et al, 2014; Falah-Hassani et al, 2016). Interpersonal and relationship stressors include marital dissatisfaction, intimate partner violence, low social support, and lack of child care support (Shrestha et al, 2014; Falah-Hassani et al, 2016; Field; 2018). Sociocultural factors include the relationship with the mother-in-law and sex of the baby, which may play an important role for many Asian and Middle Eastern women (Bener et al, 2012; Anniverno et al, 2013; Shrestha et al, 2014). A previous maternal or family history of psychiatric illness, financial difficulty, and having an unplanned pregnancy (Bener et al, 2012; Anniverno et al, 2013; Shrestha et al, 2014; Field, 2018) may also be associated with the development of postnatal anxiety.

Register now to continue reading

Thank you for visiting British Journal of Midwifery and reading some of our peer-reviewed resources for midwives. To read more, please register today. You’ll enjoy the following great benefits:

What's included

  • Limited access to our clinical or professional articles

  • New content and clinical newsletter updates each month