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Postnatal mental distress in relation to the sociocultural practices of childbirth : an exploratory qualitative study from Ethiopia

Hanlon, Charlotte (author)
King's College London, Institute of Psychiatry, Health Services and Population Research Department, London, UK
Whitley, Rob (author)
Dartmouth Psychiatric Research Center, Dartmouth Medical School, Lebanon, NH, USA
Wondimagegn, Dawit (author)
Department of Psychiatry, Faculty of Medicine, Addis Ababa University, Addis Ababa, Ethiopia
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Alem, Atalay (author)
Department of Psychiatry, Faculty of Medicine, Addis Ababa University, Addis Ababa, Ethiopia
Prince, Martin (author)
King's College London, Institute of Psychiatry, Health Services and Population Research Department, London, UK
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 (creator_code:org_t)
Elsevier, 2009
2009
English.
In: Social Science and Medicine. - : Elsevier. - 0277-9536 .- 1873-5347. ; 69:8, s. 1211-1219
  • Journal article (peer-reviewed)
Abstract Subject headings
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  • Sociocultural patterning of the postnatal period in non-Western settings has been hypothesised to protect against postnatal depression. In 2004, in a predominantly rural area of Ethiopia, we conducted 25 in-depth interviews and five focus group discussions with purposively selected participants including perinatal women, fathers, grandmothers, traditional and religious leaders, birth attendants and community leaders. Our main objectives were (1) to examine societal recognition of problematic distress states in the postnatal period and relate this to Western conceptualisations of postnatal depression and (2) to relate the occurrence of distress states to sociocultural patterning of the postnatal period. Inductive analysis was employed to identify salient themes. Participants spontaneously described culturally problematic distress states occurring in the postnatal period, although did not consider them to be illness. Vulnerability and danger of the postnatal period was emphasised, with risk of supernatural attack and physical harm leading to distress states. Participants also spoke of how gender disadvantage and economic strain intersect with cultural patterning of the postnatal period, threatening mental health due to the resulting disappointed expectations and exclusion, as well as exacerbation of pre-existing problems. Cultural dissonance, where a person's beliefs or actions are out of kilter with strong prevailing cultural norms, may be an important risk factor for postnatal distress in rural Ethiopia, where the postnatal period is extensively culturally elaborated.

Subject headings

MEDICIN OCH HÄLSOVETENSKAP  -- Klinisk medicin -- Psykiatri (hsv//swe)
MEDICAL AND HEALTH SCIENCES  -- Clinical Medicine -- Psychiatry (hsv//eng)

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Whitley, Rob
Wondimagegn, Daw ...
Alem, Atalay
Prince, Martin
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Umeå University

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