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Postpartum mental health amongst immigrant women in Canada
A paper submitted in partial fulfillment of the course requirements of PUBH 1000
by:
Student number:
University of Lethbridge
[November 23, 2022]
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Postpartum Mental Health Amongst Immigrant Women in Canada: A Public Health Issue, Assignments of Public Health
This academic paper explores the prevalence of postpartum depression among immigrant women in canada, highlighting the unique challenges they face. It delves into key determinants of health, such as social support, income inequities, and language barriers, that contribute to their increased risk of developing postpartum depression. The paper also provides evidence-informed interventions, including cognitive-behavioral therapy and increased financial support, to address this public health issue.
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Postpartum mental health amongst immigrant women in Canada A paper submitted in partial fulfillment of the course requirements of PUBH 1000 by: Student number: University of Lethbridge [November 23, 2022]
Postpartum mental health amongst immigrant women in Canada Introduction Postpartum depression is a type of depression that a mother may endure in the weeks, months or even a year following giving birth to her child. Postpartum depression is one of the leading health issues that affect new mothers globally (Dharma et al., 2018). Symptoms of postpartum depression occur in about ten to sixteen percent of women during pregnancy (Lowe et al., 2021). This depression can linger for months or even years after the baby is born if not treated. The longer a depressive episode goes untreated, the more time it takes to recover and the greater the danger of suicide (Dharma et al., 2018). It is natural for many new mothers to feel low (baby blues) after birth. However, if the "baby blues" continue longer than two weeks and interfere with one's ability to care for herself and the baby, one may suffer from postpartum depression (Zhang et al., 2021). This paper aims to address postpartum depression amongst immigrant mothers as a public health issue, discuss the key determinants of health related to postpartum depression and proffer evidence-based recommendations to solve this issue. Description of the issue and why it is an important public health issue According to World Health Organisation, in 2022, 1 in 8 people or 970 million people worldwide had a mental disorder, with anxiety and depressive disorders being the most common. This prevalence increased in 2020 during the COVID-19 pandemic, which led to a significant surge in the number of people with anxiety and depressive disorders, making depression the leading cause of disability worldwide (World Health Organization, 2022).
residents in Canada (Statistics Canada, 2022). In this paper, we are considering immigrant women in Canada. Compared to Canadian-born women, immigrant women in Canada have a higher risk of postpartum depression (Hrabok et al., 2020 and Stewart et al., 2008). Even though shared factors contribute to the development of postpartum depression in both Canadian-born and immigrant women, immigrant mothers face several significant barriers to their mental stability. These can include problems specific to their immigration or resettlement experience, including family separation, legal uncertainties, education, new country social mores, culture and socioeconomic determinants of health. Discussion of the key determinants of health-related to postpartum depression on immigrants and their impact on health Some examples of these socioeconomic determinants of health include poverty, un/underemployment, language difficulty, barriers to accessing health care and low/no social support) (Hrabok et al., 2020 and Saad, 2018). Lowe et al., (2021) emphasized in their study that social exclusion, poor working conditions and poverty are some of the social determinants linked to the health and well-being of immigrant women. Therefore, some of the key determinants of health that increase the risk of postpartum depression in immigrant mothers are: a) Social support: According to the Public Health Agency of Canada (2004), social support is one of the key social determinants of health. Social support is the cognitive appreciation of being connected to others and knowing that support is there when you need it (Lowe et al., 2021). Social support can be
given formally through social work and healthcare professionals and informally through family and friends. The support of family, friends, and community not only helps people solve problems of adversity but is also crucial in providing a sense of belonging and control over life’s overwhelming situations. The Public Health Agency of Canada (2004) stated that care and respect received through social relationships help the well-being of people and serve as buffers against mental, emotional, and physical health problems. Therefore, a lack of social networks and support is linked with heightened risks for distress, depression, and mental illness (Puyat, 2013 and Sethi, 2013). Immigration causes separation from loved ones, so most immigrant mothers lack social support leading to a depressive state and other mental health problems. This is evident in studies of Ahmed et al. (2008) and Stirling Cameron et al. (2021), where immigrant mothers attributed their postpartum depression to social isolation, feeling overwhelmed, and financial insecurity. b) Income inequities and financial insecurity: Income is an important social determinant of health. Income levels determine majorly the general living conditions, influence mental functioning, and influence health-related behaviours of people (Mikkonen and Raphael, 2019). Comparing income levels , immigrant women are much more likely to have lower personal and family incomes and more need for financial support. (Sword et al. 2006). Poverty, poor working conditions and reduced work status are some social determinants associated with the health and well-being of migrant women (Lowe et al., 2021). The higher the financial needs the higher the rate of depressive symptoms. c) Education and language: Education is a key determinant of health that has a direct impact on immigrant women. The ability to communicate in a common language is important for people to access and use health,
their children and families. Therefore, postpartum depression affecting immigrant mothers is a public health issue which requires effective and culturally adaptive treatment. References: Ahmed, A., Stewart, D. E., Teng, L., Wahoush, O., & Gagnon, A. J. (2008). Experiences of immigrant new mothers with symptoms of depression. Archives of Women's Mental Health , 11 (4), 295–303. https://doi.org/10.1007/s00737-008-0025- Alberta Health Services. (n.d.). Postpartum depression. Alberta Health Services. Retrieved February 11, 2022, from https://www.albertahealthservices.ca/info/Page16138.aspx Canadian Council for Refugees. (2010, September 1). Refugees and Immigrants: A glossary. Refugees and Immigrants: A glossary | Canadian Council for Refugees. Retrieved November 22, 2022, from https://ccrweb.ca/en/glossary Ferguson, D. (2021). Evidence based treatment of depression. CAMH. Retrieved November 23, 2022, from https://www.camh.ca/en/camh-news-and-stories/evidence-based-treatment-of- depression Guruge, S., Sidani, S., Wang, L., Sethi, B., Spitzer, D., Walton-Roberts, M., & Hyman, I. (2019, March 4). Understanding social network and support for older immigrants in Ontario, Canada: Protocol for a mixed-methods study. JMIR aging. Retrieved November 23, 2022, from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6715096/
Dharma, C., Lefebvre, D. L., Lu, Z., Lou, W. Y., Becker, A. B., Mandhane, P. J., Turvey, S. E., Moraes, T. J., Azad, M. B., Chen, E., Elliott, S. J., Kozyrskyj, A. L., Sears, M. R., & Subbarao, P. (2018). Risk for maternal depressive symptoms and perceived stress by ethnicities in Canada: From pregnancy through the preschool years. The Canadian Journal of Psychiatry , 64 (3), 190–198. https://doi.org/10.1177/ Lowe, S. A., McDonald, S., Senthilselvan, A., Nykiforuk, C. I., Chari, R., & Pabayo, R. (2021, December 22). Is neighbourhood income inequality associated with maternal mental health? A longitudinal analysis of pregnant and new mothers living in Calgary, Alberta. BMJ open. Retrieved November 21, 2022, from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8704958/ Mental illness and addiction: Facts and statistics. CAMH. (2022). Retrieved November 21, 2022, from https://www.camh.ca/en/driving-change/the-crisis-is-real/mental-health- statistics Mikkonen , J., & Raphael, D. (2019, April). Social Determinants of Health: A quick guide for health - kids new to ... Retrieved November 24, 2022, from https://kidsnewtocanada.ca/uploads/documents/Social_Determinants_of_Health.pdf Puyat, J. H. (2013, June 19). Is the influence of social support on mental health the same for immigrants and non-immigrants? - journal of immigrant and minority health. SpringerLink. Retrieved November 23, 2022, from https://link.springer.com/article/10.1007/s10903-012-9658-7#citeas
pregnant women. Journal of Affective Disorders , 279 , 1–8. https://doi.org/10.1016/j.jad.2020.09.