Factors associated with depressive symptoms among postpartum mothers in a rural district in Uganda

Objective: across Africa the prevalence of postpartum depression is a major health problem affecting mothers, their infants and families. The purpose of this study was to explore the factors associated with postpartum depressive symptoms (PDS) among women living in a rural Ugandan district. Design: descriptive correlation design. Setting: Young-Child's Clinic of a public hospital, providing postpartum care services to approximately 450 women and their babies per month in a rural district of Uganda. Participants: 202 postpartum women who have lived in the rural district both during pregnancy and postpartum period following birth of the current infant of age ≤12 weeks. Measurements: PDS were measured using the Edinburgh Postnatal Depression Scale (EPDS). Findings: participants' mean age and number of children were 24±4.33 years and 2.85±1.26 children, respectively. Majority of participants were married (61%), delivered the current infant by normal vaginal delivery (91%) at a health facility (86%) and experienced no complications (80%). The mean EPDS score for the sample was 9.5±0.18 and 43% of the participants were found to have PDS (scores ≥10). Statistically significant relationships were found between PDS and factors such as number of female sexual partners the husband has (r=0. 28, p≤0.01); current problems in marriage (r=0.22, p≤0.01), participant's parity (r=-0.24, p≤0.05), infant's ability to breast feed (r=0.28, p≤0.05) and husband support during the postpartum period (r=0. 20, p≤0.05). Conclusion: male partners of postpartum women are a major source of factors associated with PDS in rural areas. Implication for practice: midwifery practitioners in rural settings should emphasise psychosocial assessment and male involvement in postpartum care to increase opportunities of identifying mothers at risk of PDS and implementation of interventions targeting men.