Challenges during the Postpartum Period, Perceptions of Postpartum Depression and Professional Help-Seeking Attitudes Among Korean Immigrant Women

Background and Purpose: Postpartum depression (PPD), defined as the onset of depressive symptoms within the first 12 months after giving birth (postpartum period), is a serious medical problem that can have severe consequences for new mothers and their infants. PPD is easily treated when identified early, however, when left undiagnosed and untreated, women with PPD can experience anxiety, sadness, hopelessness and thoughts of self-harm, all of which adversely impact maternal functional status, social and familial relationships, and  maternal-infant interactions. Despite such negative impacts, study findings indicate  that mothers with PPD do not consider their symptoms problematic or do not seek professional mental health treatment. . While PPD disproportionately affects immigrant women, including Asian Americans and studies examining PPD among  Korean women that have been conducted in Korea, limited research has examined the perceptions of PPD or professional help-seeking behaviors among Korean immigrant women living in the U.S.. The current study sought  to narrow this gap by answering two questions: 1) What are the postpartum challenges among Korean immigrant women? and 2) What are the perceptions of PPD and professional mental health help-seeking attitudes among Korean immigrant women?

Methods: Using a qualitative design, 11 immigrant Korean women who live in the San Francisco Bay Area in California had given birth in the past 13 months, completed the Edinburgh Postnatal Depression Screening Scale (EPDS) and participated in a semi-structured, individual, in-depth interview. Participants were married, between 22 - 44 years of age, and had been in the US between 1 – 25.5 years. Most (n = 10, 91. %) gave birth vaginally, 64 % had male infants, and 55% were breastfeeding. EPDS scores indicated 27.3% were at risk of developing PPD.

Findings: Thematic analysis of interview data revealed eight themes. Regarding challenges during the perinatal period (research question 1), participants reported biosocial challenges (e.g., sleep deprivation) (Theme 1) and contextual challenges (e.g., navigating the health care system, language barriers) (Theme 2), desire for professional caregiving help for mothers after delivery and during postpartum (Theme 3), and the importance of social support (Theme 4). For research question 2 (the perception of PPD and professional help seeking), participants reported they were awareness of the PPD concept (Theme 5), yet they normalized PPD symptoms and emphasized on personal willpower (Theme 6). They also stated that when problems (e.g., postpartum depression) arose, considering professional help would be the last resort (Theme 7), because of the stigma attached to professional help-seeking (Theme 8).

Discussion and Implications: Although Korean women identified triggers for depressive symptoms in line with women in the general population (e.g. poor social support, sleep disturbance), Korean women believed PPD would naturally heal with time and that symptoms were not severe enough to warrant help-seeking. Greater understanding of the postpartum experiences of Korean immigrant women in the U.S. and their perceptions of depression is needed to better inform social workers during the vulnerable postpartum period. Social workers working with Korean women must be knowledgeable about how depression is perceived to promote positive maternal-infant outcomes.