Postpartum depression and maternal adjustment: An investigation into some risk factors
The aim of the present study was to determine whether it was possible to identify changes in levels of postpartum depression and maternal adjustment and attitude in primiparae before and after birth. It aimed, furthermore, at assessing certain risk factors that could provide an understanding of the etiological factors (causes, determinants) influencing postpartum levels of depression and maternal adjustment and attitude. The study focused on risk factors among married and unmarried primiparae (first time mothers), with a view to establishing vulnerability profiles of the respective groups. The specific risk factors that formed part of the investigation were social support, personality (neuroticism) and life events. All the subjects investigated were recruited from the Mitchells Plain Maternity and Obstetrics Unit. A sample of 70 subjects, in the third trimester of pregnancy, voluntarily participated in the first part of this study. Of these, 26 belonged to the married group and 44 belonged to the unmarried group. As a result of the attrition factor, 57 subjects constituted the final sample for analysis. The final sample comprised 20 married and 37 unmarried subjects. Subjects were followed up four to eight weeks postpartum. Results revealed that there were no significant changes in levels of depression between the married and unmarried groups, either before or after delivery. Of significance was that with the event of birth, the depression scores amongst women rated high in neuroticism decreased significantly. Married women with high social support satisfaction scores were found to have low depression scores. Similarly, married women who experienced fewer negative life events had lower levels of depression than did the unmarried women who experienced fewer negative life events. The maternal adjustment and attitude scores did not change before or after birth, except in the married group. The married group showed a significant increase in scores on the maternal adjustment and attitude scores after the birth of the child. Regarding personality (neuroticism), the high neuroticism scorers had significantly lower maternal adjustment and attitude than did the low neuroticism scorers. As was the case with social support and depression, married women with high social support had a higher maternal adjustment and attitude. A significant effect of negative life events on maternal adjustment and attitude was only found for the married women (after delivery) who experienced a low number of life events. A stepwise multiple regression analysis was performed, in order to yield a model in which the depression and maternal adjustment and attitude scores would be predicted by risk factors. The finding of this analysis for both depression and maternal attitude and adjustment was not significant. Social Identity theory was suggested as a possible interpretation of these results. Future research which views social identity as a factor in understanding postpartum depression and maternal adjustment and attitude has been proposed .