Gender, poverty, and postnatal depression: a study of mothers in Goa, India

Am J Psychiatry. 2002 Jan;159(1):43-7. doi: 10.1176/appi.ajp.159.1.43.

Abstract

Objective: This study described the natural history of depression in mothers who recently gave birth in a low-income country and to investigate the effect of risk factors, particularly related to infant gender bias, on the occurrence and outcome of depression.

Method: The authors studied a group of pregnant mothers recruited during their third trimester of pregnancy from a district hospital in Goa, India. The mothers were interviewed at recruitment, 6-8 weeks, and 6 months after childbirth. Interview data included presence of antenatal and postnatal depression, obstetric history, economic and demographic characteristics, and gender-based variables (preference for male infant, presence of marital violence).

Results: Depressive disorder was detected in 59 (23%) of the mothers at 6-8 weeks after childbirth; 78% of these patients had had clinically substantial psychological morbidity during the antenatal period. More than one-half of the patients remained ill at 6 months after delivery. Economic deprivation and poor marital relationships were important risk factors for the occurrence and chronicity of depression. The gender of the infant was a determinant of postnatal depression; it modified the effect of other risk factors, such as marital violence and hunger. Depressed mothers were more disabled and were more likely to use health services than nondepressed mothers.

Conclusions: Maternal and infant health policies, a priority in low-income countries, must integrate maternal depression as a disorder of public health significance. Interventions should target mothers in the antenatal period and incorporate a strong gender-based component.

Publication types

  • Comparative Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Adult
  • Cross-Cultural Comparison*
  • Depression, Postpartum / ethnology*
  • Depression, Postpartum / psychology
  • Ethnic Groups / psychology*
  • Female
  • Follow-Up Studies
  • Gender Identity*
  • Humans
  • India
  • Infant, Newborn
  • Male
  • Poverty / psychology*
  • Pregnancy
  • Risk Factors
  • Sex*
  • Social Values
  • Spouse Abuse / ethnology
  • Spouse Abuse / psychology