The expectations of the mother or the society she lives in can play a part in causing postpartum depression.
A few years ago I read an article that said the instances of PPD was lower or non existent in 3rd world countries. The author wrote that it was due to large, extended families and the community coming together to provide care and support for the mother and new baby. "Families" are larger, consisting of grandmothers, aunts, sisters, and cousins. When a baby is born, everyone comes together. They all help with household chores and emotional support. The older women teach the new mothers about what to expect and mothering.
When I was in college (which was admittedly 15 years ago,) I took an anthropology course. In other cultures the mother and infant are often in seclusion for a particular amount of time after birth. This is to give them time to recuperate. Admittedly some cultures shroud this with superstition. Maybe these customs don't affect whether a woman gets postpartum depression, but it would provide rest, recuperation, and time to adjust. Personally I think there would be a different atmosphere and attitude concerning having a new baby. There wouldn’t be the same "life must go on," push to get back to normal life. Relatives come in and care for other children, do housework, and care for the mother. For example traditional Brunei Malay custom says new mothers must rest for 40 days, then there is a ceremony on the 40th day. Native Americans, like the Hopi had a 20-day seclusion with a ceremony on the 20th day. In India women, under
Ayurveda, are secluded for about 6 weeks after giving birth. They are instructed to rest, avoid housework, given massages, have a special diet, and meditate. In the Old Testament, in Leviticus chapter 12 women who had just given birth were required to be in seclusion for 40 days. Although this related ritual cleanliness and the purification custom of the time, I think this served a greater purpose. It provided formal recognition of a life change and transition time.
In our modern culture there is no formal transition for women who have just given birth. There is an attitude that "life must go on. Women have babies all the time. It’s no big deal." There is a lack of meaningful help for new mothers, unless a woman has the finances to hire appropriate help. It’s common for a first time mother to be inexperienced caring for a baby, or to have never changed a diaper before. Their own mothers or other relatives may live far away (or be emotionally absent) therefore unavailable for helping.
Personally, I do think that some these issues could have been a factor in my PPD. There was little support, as far as anyone teaching me about baby care or help around the house after I had my first son. I had little experience with babies. I had no clue what to do with a crying baby. When my husband and I got home from the hospital, We looked at each other and said, "what now?" We were both in shock. My husband, baby, and I were shut in the house for 2 weeks living off pizza delivery and heating up microwave dinners. I was scared to death to be left alone with the baby. I didn’t know what to do. I could barely change a diaper.
Just yesterday I met a woman who was waiting to pick up her kids from school. She was standing in the office, holding her little baby. She said the baby was less than 24 hrs old. She was standing there, dressed, awake, and acting like it was no big deal. My jaw dropped. I couldn’t believe it. I didn’t know whether to feel sorry because she had no one to help her or not. 24 hrs after I had given birth, I was exhausted. I looked like a zombie, and could barely walk.
With urbanization and "westernization" there are also changes taking place abroad. Studies in the 1980's suggested that depression at the time was rare in China and postpartum depression was non existent among Chinese women. However subsequent studies show depression may no longer be rare. A study published in 2001 among 959 Chinese women showed 13.5% suffered from 1 or more forms of psychiatric disorder in the first 3 months postpartum. In another study of PPD in China at http://wvuerin.blogspot.com/2008/08/postpartum-depression-in-china-vs.html is said that China is just beginning to learn about mental health issues, and the country lacks the resources to combat PPD. China has comparable rates of PPD to that of the us. Contemporary Chinese women face more isolation and less support that their counterparts of the past. They also lack role models, like the us has celebrities that come out in the media like Brooke shields.
On the other hand, another reason that PPD could be nonexistent or lower in some other cultures is that the culture just doesn’t recognize it. For example, the Chinese language supposedly doesn’t have a word in the language to separate "depression" from "sadness." Some places women are taught to not discuss their feelings. There could be a stigma attached to mental illness, so it no one talks about it. Some cultures attribute illnesses (physical and mental) to spiritual forces, and treat illness with magic, spells, amulets, etc. Are women in these other cultures suffering from something that could be PPD but suffering in silence and fear? Or is it being attributed to something else?
If you have any comments, I'd love to hear from you.
next blog, I will be discussing disconntment & unfulfillment
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