Postnatal Depression in First-Time Mothers: Prevalence and Relationships Between Functional and Structural Social Support at 6 and 12 Weeks Postpartum

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Postnatal depression (PND) is a significant public health issue, with variable prevalence and a dearth of research on risk and protective factors. This quantitative longitudinal study of 512 first-time mothers identified the prevalence of PND and examined the relationships between functional and structural social support at 6 and 12 weeks postpartum. The prevalence of PND was 13.2% at 6 weeks and 9.8% at 12 weeks. At 6 and 12 weeks, the only social support dimension independently associated with PND was total functional social support. At-birth formal structural support and emotional functional support were independently predictive of PND at 12 weeks.

Section snippets

Conceptual Framework

The social exchange theory was chosen as a conceptual framework for this research because it is concerned with the exchange of activity between at least two people (Blau, 1964, Homans, 1961). Social exchange can cover a number of activities to include the provision of information (informational support), hands-on services (instrumental support), emotive sharing of experiences (emotional support), and offering approval to each other (appraisal support). These activities are the functional

Study Design and Sample

A quantitative longitudinal design was used. A convenience sample of first-time mothers was recruited in the Republic of Ireland. Eligibility criteria for selection were as follows: first-time mother, 18 years or older, medically uncomplicated pregnancy, full-term at delivery, singleton baby, baby discharged with mother, English as first language, and white Caucasian. Power analysis indicated that the study had an 80% power to identify an OR of 3 (associated with risk of PND at one level of

Sociodemographic Characteristics of the Participants

Demographic data revealed that 33.6% of respondents were in the 31–35-year age category and 30.1% were in the 27–30-year category. Twenty percent of respondents were educated to secondary school level; and a further 72%, to university/third level. One fifth (20%) stated their occupation in the category “clerical”; 17%, in the category “associate professionals”; 9.5%, in the category “health associate professionals”; 8.7%, in the category “health and education professionals”; and the remainder,

Discussion

The prevalence rate of PND in this study at 6 weeks was 13.2%, which is comparable with previous research in Ireland, where prevalence rates of PND varied from 11.4% to 28.6% (Crotty and Sheehan, 2004, Cryan et al., 2001, Greene et al., 1991, Lane et al., 1997, Martin, 1977, O'Neill et al., 1990). The variance could be attributed to the high representation of mothers with a previous history of depression in one study (Cryan et al., 2001) and mothers with single status in another (Greene et al.,

Conclusion

The results from this study indicate that the prevalence of PND is significant for first-time mothers, ranging from 13.2% at 6 weeks to 9.8% at 12 weeks. The best predictors of PND at 12 weeks were formal structural support and emotional functional support at birth, which has important implications for clinical practice. Strategies for encouraging greater health care professional support in the early postpartum period and facilitating and mobilizing emotional functional social support from both

Acknowledgment

This research was funded through a Health Research Board Nursing and Midwifery Clinical Fellowship Award. The authors would like to thank the midwives for their valuable contribution to this study.

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