A Phenomenological Study on the Experiences ofWomen Suffering From Postpartum Depression in the Ho Municipality,Ghana

Abstract

One of the major complications that pregnancy and childbirth can expose women of reproductive age to is postpartum depression (PPD), with estimations indicating a rise in its prevalence in developing countries. PPD has been linked to adverse growth outcomes, emotional and physical health challenges, cognitive problems among others resulting in compromised health of the mother and her baby. This study described the experiences of postnatal mothers who developed PPD in the Ho Municipality. A phenomenological study design was employed where women receiving treatment for PPD in two hospitals in the Ho municipality were selected using a purposive sampling method. Existential phenomenology explores how people give meaning to their experiences, emphasizing the importance of context and the influence of the participants’ personal backgrounds and values. Interview guide was used to collect data from the study respondents. The data was analyzed using thematic content analyses approach. Three themes and nine subthemes emerged from the study. The study examined the experiences of postnatal women suffering from PPD in the Ho municipality. The effects of PPD were found in this study to have negative impact on the general well-being of the whole family. Healthcare providers can educate expectant mothers and families about these factors, promoting awareness and proactive measures to reduce the risk of PPD. Insights from this research can inform the creation of postpartum support programs that provide new mothers with the resources and support they need to cope with PPD.

Plain Language Summary

The purpose of this study was to explore the experiences of postnatal women suffering from Postpartum depression (PPD) in the Ho Municipality. The researchers aimed to understand the impact of PPD on mothers, their babies, and families, as well as the coping strategies employed by these women. The study employed a qualitative phenomenological research design and collected data through Interviews with postnatal women who were diagnosed with PPD in two hospitals. The study identified three main themes and their subthemes. The first theme, “Postnatal Mothers’ Unpleasant Experiences of PPD,” described the various emotional and psychological challenges these women faced, including anger, self-blame, insomnia, and anxiety about the future. The second theme, “Effects of PPD on Mother, Baby, and Family,” highlighted the negative impacts of PPD on the overall well-being of mothers, the growth of their babies, and family dynamics. The third theme, “Adapted Coping Strategies during PPD,” focused on the coping mechanisms employed by the women, such as self-medication and seeking support from family and friends. Based on their findings, the researchers concluded that PPD has detrimental effects on mothers’ and babies’ mental, emotional, and physical well-being. The study emphasized the importance of early education, awareness, and intervention for PPD, recommending that antenatal care services include counseling on PPD and regular screenings for its symptoms. Additionally, family support was identified as a crucial factor in helping women cope with PPD. The study’s implications suggest that addressing PPD requires a comprehensive approach involving healthcare providers, families, and society as a whole. Identifying and treating PPD early can lead to improved outcomes for both mothers and their babies.

Keywords

pregnancy childbirth postpartum depression mothers well-being thematic content analysis

Background

Women play diverse and integral roles in various spheres, contributing significantly to the well-being, development, and functioning of families, communities, and nations (Spjeldnæs, 2021). Mothers, in particular, hold a unique and pivotal position, as they are often the primary caregivers, educators, and nurturers of children. Beyond their roles within the family, women are active participants in the workforce, culture, politics, education, and numerous other areas, thereby shaping and enriching society in multifaceted ways (Corrigan et al., 2015).

However, the journey to motherhood and the roles women play are not without challenges. One significant challenge that underscores the vulnerability and well-being of mothers is the prevalence of postpartum depression (PPD; Mughal et al., 2023). PPD is a condition that affects women during the postpartum period, typically within the first year after childbirth. It is characterized by a range of emotional, psychological, and physical symptoms, such as persistent sadness, feelings of hopelessness, fatigue, and difficulty bonding with the newborn. PPD can undermine the emotional and mental well-being of mothers, potentially impacting their ability to care for and bond with their children (Mughal et al., 2023).

One major complication that pregnancy and childbirth can expose women of reproductive age to is postpartum depression (PPD) (Tarar et al., 2021; S. Liu et al., 2017). According to Mughal et al. (2023), One in seven women can develop PPD while a report from the Centre for Disease Control, revealed the global prevalence of postpartum depression to be 11.1% for the year 2020 (Centers for Disease Control & Prevention, 2023). Empirical studies have shown that the prevalence of PPD is higher in developing countries (1.9%–82.1%) than in developed countries (5%–61.8%; Abd Elaziz & Abdel Halim, 2021; X. Liu et al., 2022; Norhayati et al., 2015).

PPD is “a debilitating condition occurring within four weeks following childbirth with peripartum onset, if the onset of mood symptoms occurs during pregnancy or within a month following delivery” (Adhikari et al., 2022; Tarar et al., 2021). The mothers who go through this condition experience low self-esteem, sadness, emptiness, guilt, eating disturbance, exhaustion, anhedonia, increased anxiety, and low energy among others.

Though PPD is considered a non-psychotic depressive episode after childbirth, it can significantly affect the physical as well as psychological well-being of the newborn baby and the mother (Yaksi & Save, 2021). PPD can compromise the mothers’ health and drastically lower the likelihood of their newborn children growing and developing healthily (Brummelte & Galea, 2016; Cline & Decker, 2012).

The risk factors of PPD among women from various background across the world differ in term of age, religion, culture, race, parity, history of abortion, lack of physical activities, and the sex of the baby (Adhikari et al., 2022; Fiavor & Eturu, 2022; Guo et al., 2013; Silverman et al., 2017). The major factors identified were classified into biological, social, and psychological (Abd Elaziz & Abdel Halim, 2021; Ea et al., 2021; Johar et al., 2020; Silverman et al., 2017). The above therefore indicate that after childbirth, the woman must be adequately cared for and supported in order to reduce their risks of developing PPD or treat the conditions before it progresses to critical levels.

Despite the prevalence of PPD, it remains a subject that receives limited attention, especially in developing countries like Ghana, where the reported prevalence is 16.8% (Saeed & Wemakor, 2019). Existing research has predominantly focused on the risk factors of PPD, while there is a dearth of studies exploring its effects (Guo et al., 2013; Sefogah et al., 2020). Ghana, as an underdeveloped nation facing challenges in providing standardized maternal healthcare, may have a higher prevalence of postnatal depression than reported (Dadi et al., 2022).

Postpartum depression (PPD) is a significant public health concern affecting mothers, infants, and families. Understanding its prevalence, risk factors, and impact on maternal and infant health is essential for developing effective prevention and intervention strategies. PPD can negatively impact infant health and development through disrupted mother-infant bonding, impaired caregiving, and increased risk of developmental delays. Researching the effects of PPD on mothers’ infants can inform early intervention efforts to promote healthy parent-child relationships and optimal child development (Saharoy et al., 2023).

To gain a comprehensive understanding of PPD, this study aims to delve into the lived experiences of postnatal mothers who have developed PPD in the Ho Municipality of the Volta Region of Ghana. This research seeks to shed light on the experiences and challenges faced by these mothers, thereby contributing to a more holistic understanding of PPD and its implications in the context of Ghana.

Review of Literature

Phenomenology approach focused on the participants’ subjective viewpoints and also acknowledged that each person’s experience is unique. Phenomenological research employed in this study emphasized the authenticity of the data, as it relies on participants’ direct descriptions of their experiences. This has reduced researcher bias and provided a more genuine reflection of participants’ perspectives.

Prevalence of Postpartum Depression

Empirically, many women across the globe experience this health complication but there is a huge disparity between the prevalence of postpartum depression in developed countries and its prevalence in developing countries. These observations are supported by empirical evidence revealed by study findings such as that of Yaksi and Save (2021) and Woldeyohannese et al. (2021) who reported a prevalence of postpartum depression of 9.9% among Turkish women, a prevalence of 18.6% in sub-Saharan, respectively. More specifically, 27.5% of postnatal women experience postpartum depression in Ghana, while 27%, 6.6%, 12%, 15%, and 27.1% of women in Egypt, China (S. Liu et al., 2017), Nepal (Ojha & Ram Bhandari, 2019), and Uganda respectively (Atuhaire et al., 2021). Many researchers have reported that the prevalence of postpartum depression will significantly increase especially in developing countries where the delivery of maternal health care services is still challenging and depriving mothers of quality healthcare services (Atuhaire et al., 2020; Woldeyohannes et al., 2021). Similarly, Johar et al. (2020) investigated the antenatal risk factors for postpartum depression in Gelis trial by recruiting 1,583 mothers in their postnatal period. These women were included in the study while they were still pregnant and studied through pregnancy period and during postnatal period. Information on the sociodemographic characteristics of the participants were collected using questionnaires in a prospective study design. The findings of the study showed that gestational weight gain (GWG), pre-pregnancy body mass index, pre-pregnancy obesity, history of anxiety or depression symptoms significantly increased the participants risk of developing postpartum depression (Johar et al., 2020).

Risk Factors of Postpartum Depression

The high rate of postpartum depression is associated with several factors as shown in many studies however, according to Fazraningtyas et al. (2020), the exact factors that contribute to the development of postpartum depression is not well known but it is believed that not one factor is responsible for postpartum depression (Fazraningtyas et al., 2020). Instead, a combination of factors has been shown empirically to contribute to the chances of a woman after childbirth developing postpartum depression as described below. In 2018, Kerie et al. (2018) aimed to determine the prevalence and risk factors of postpartum depression among Ethiopian mothers. For the study, a total of 408 postnatal women were selected in a cross-sectional study design. The analysis of data done using SPSS revealed that 138 (33.82%) of the study participants experienced postnatal depression and the risk factors that were identified to contribute to this occurrence were unplanned pregnancy, maternal age, history of chronic physical illness, neonatal death, and unstable maternity conditions (Kerie et al., 2018).

Effects of Postpartum Depression

The dire nature of postpartum depression is that it does not only affect the mother but the newborn baby also. Studies have shown that when postpartum depression is left untreated, its symptoms can persist even into the second year after childbirth thereby distorting the social life, and physiological wellbeing of the mother (Abulaiti et al., 2022; Brummelte & Galea, 2016; Oyetunji & Chandra, 2020). Children born to mothers who were diagnosed of postpartum depression after childbirth also become emotionally challenged during their growth process (Chrzan-Dętkoś et al., 2022). They develop irrational social lifestyles which is not common with other children born to mothers who did not suffer from postpartum depression. According to Avon, children whose mothers are diagnosed of postpartum depression when they were born have four times chances of developing bad behaviors in their third and fourth year than children whose mothers did not exhibit symptoms of postpartum depression after childbirth (Chrzan-Dętkoś et al., 2022; Shorey et al., 2018).

Methods

Study Design

This study has adopted a qualitative research approach with a phenomenological study design. This approach, influenced by existentialist phenomenology, acknowledged the unique individual perspectives of participants. Existential phenomenology explores how people give meaning to their experiences, emphasizing the importance of context and the influence of the participants’ personal backgrounds and values. It often involves a hermeneutic (interpretive) approach to understanding experiences.

By advantage, phenomenology allows researchers to delve deeply into participants’ experiences, thoughts, and feelings. It provided a rich and nuanced understanding of how individuals make sense of the world around them. Phenomenology focused on the participants’ subjective viewpoints and also acknowledged that each person’s experience is unique. Phenomenological research employed in this study emphasized the authenticity of the data, as it relies on participants’ direct descriptions of their experiences. This has reduced researcher bias and provided a more genuine reflection of participants’ perspectives.

This study was carried out in two selected hospitals in the Ho Municipality. The Hospitals have fully functional maternity offering postnatal care services to women following childbirth.

Research Questions

What are the unpleasant experiences faced by Postnatal Mothers with PPD?

How does PPD affect mothers, their babies, and families?

Which coping strategies are employed by mothers during PPD?

Sampling and Data Collection Technique

This study has adopted a qualitative research approach with a phenomenological study design. This approach, influenced by existentialist phenomenology, acknowledged the unique individual perspectives of participants. Purposive sampling was employed in this study and data saturation was reached after the 17th participant (Gray, 2017). Data were collected through a semi-structured interview guide. The researchers first visited the hospitals to obtain consent from the hospitals’ management. Field notes were kept during all the interviews and included in the transcribed data. The researcher first visited the Ho Municipal Hospital to obtain consent from the hospital administrator. With the help of doctors, nurses and midwives, the researchers identified postnatal women suffering from postpartum depression. The researcher then approached the identified women suffering from postpartum depression and explain the purpose of the current study with utmost privacy ensured. Interview-guide was used to collect data from these participants. The interview guide was developed after the researcher has conducted thorough review of previous articles on the subject. The participants also completed a questionnaire about their socio-demographic characteristics and these included parameters such as age, marital status, parity, educational level, and other relevant information. The interaction between researcher and the participant will form the critical part of the interview. A field note was kept by the researcher during all the interviews. All interviews were conducted in English language since it is an official language. Each interview lasted between 30and 45 min. Participants were invited to review and provide feedback on the researcher’s interpretations of their experiences to ensure the accuracy and validity of the findings. Researchers engaged in the process of phenomenological reduction, which involves setting aside preconceived notions and interpretations to focus on the essential structures of the lived experiences described by participants. Researchers also employed bracketing, acknowledging and setting aside their own biases, assumptions, and experiences to maintain a phenomenologically-oriented perspective and ensure the authenticity of participants’ experiences.

Inclusion and Exclusion Criteria

This study included women in their postnatal period diagnosed of postpartum depression and residents of Ho Municipality for at least 6 month.

Women who have met this criterion however were severely ill and mentally unstable during time of study were however excluded from participating.

Data Analysis

Phenomenological data analysis involves exploring, interpreting, and understanding the lived experiences of participants. Before diving into analysis, researchers immerse themselves in the data by reading or listening to interview transcripts and reviewing any observational notes. This step helps researchers become familiar with the participants’ descriptions and contexts.

Researchers also engaged in bracketing, which is the suspension of their preconceived beliefs, biases, and assumptions to approach the data with an open and unbiased perspective. This step is essential to ensure that the researcher’s interpretations do not impose external biases on the analysis.

Using Nvivo software for qualitative research, codes were developed into themes and sub-themes for the write-up. This software allows for coding, sorting, and retrieval of data. Three researchers were involved in carrying out coding. Researchers engage in open coding to identify and extract meaningful units of data, often referred to as “codes.” These codes represent elements of the participants’ experiences. During this stage, data is fragmented into smaller, more manageable pieces for analysis. Codes are generated through a systematic and inductive process, allowing themes and patterns to emerge naturally from the data. After generating a substantial number of codes, researchers start to group them into categories based on their similarities and relationships. Categories are a way of organizing and structuring the data to make sense of the participants’ experiences.

Researchers work to identify and define overarching themes that capture the essence of the participants’ experiences. Themes are derived from the categories and represent the most significant aspects of the phenomenon under investigation. Thematic analysis involves seeking connections and relationships between different categories and codes.

Researchers ensured the validity and reliability of the identified themes. This often involves member checking, where researchers return to participants to validate the findings and gather their feedback on the themes.

Confidentiality was ensured by using respondents (P) instead of real identity.

Results

Sample Characteristics

Socio-Demographic Characteristics of the study respondents:

Socio-demographic characteristics	Frequency (N = 17)	Percentage (%)
Age category
15–19	6	35.3
20–24	4	23.5
25–29	3	17.6
30–34	2	11.8
35–39	2	11.8
Educational status
No Formal Education	7	41.2
Primary	5	29.4
Secondary	3	17.6
Tertiary	2	11.8
Marital status
Married	7	41.2
Single	10	58.8
Occupational status
Unemployed	9	52.9
Self-employed	5	29.4
Employed	3	17.6
Religious denomination
Christianity	10	58.8
Islam	5	29.4
Traditional	2	11.8
Parity
0–1	11	64.7
2–4	5	29.4
4+	1	5.9

Research Question Results

Summary of the Themes and Subthemes that emerged:

Themes	Subthemes
Theme A: Postnatal mothers unpleasant experiences of PPD	A1. Anger and self-blame
	A2. Insomnia
	A3. Low self-esteem and Self-harm
	A4. Anxiety about the future
Theme B: Effects of PPD on mother, baby, and family	B5. Impact on the well-being of the mother
	B6. Impact on the well-being of the baby
	B7. Impact on the well-being of the family
Theme C: Adapted coping strategies during PPD	C8. Self-medication
Theme C: Adapted coping strategies during PPD	C9. Response to family and friends’ supports

Theme A: Postnatal Mothers Unpleasant Experiences of PPD

The study found out that postnatal mothers included in the study experienced depression differently and per the data collected through interviews, four subthemes were noted and these included anger and self-blame, insomnia, self-harm, and anxiety about the future.

Subtheme A1: Anger and Self-Blame

According to some postnatal mothers, their depression period was characterized by excessive anger where they constantly and over little matters got angry at themselves, and blamed everyone around them. Some respondents reported;

It was strange how I got angry at very little things which could not have caused me to get angry earlier before childbirth. Any time my baby was crying I became angry to the point that I could ignore the cry of the baby and distance myself from the baby. When my parents tried to talk to me, I got angry at them too, and started insulting them. Sometimes I tell them not to involve themselves in the matters of my baby and I. It became serious to the point that I reacted violently at situations. (P16, 22 years)

Hmm in fact, I feel my dreams have been shattered, because of financial constraints and unexpected pregnancy. All these and many experiences irritated me and I was not happy of my conditions. (P9, 19 years)

Seeing myself as a young girl who was supposed to be in school or doing something important and now faced with the reality of taking care of a child. I was not happy of my unexpected pregnancy and got irritated by a lot of things. (P7, 17 years)

Subtheme A2: Insomnia

Difficulty sleeping was one of the major experiences some of the postpartum mothers faced. The responses of some respondents are mentioned in the passages below;

I remember not long after I gave birth … I found it difficult to sleep at night. I could stay awake doing nothing before I realized it was daybreak. This resulted in severe headache and bodily pain. I kept on having sleepless nights until I started the treatment for depression at the hospital here. (P3, 25 years)

For several days after giving birth, I could not sleep to the point that I began to have serious headaches. Even though I forced myself to sleep so that the headache could stop, but it did not. (P9, 19 years)

Subtheme A3: Low Self-Esteem and Self-Harm

Some of the postnatal mothers indicated that, they occasionally felt like harming themselves out of shame.

Already I had a child, and I was not sure who the father was. People insulted me in the community and said a lot of things I really did not like. And now I got pregnant again to a different man I am not married to. And hearing what people were saying got me so ashamed to the point that I felt like leaving the community without taking the baby. Other times, I thought of just poisoning myself. (P14, 21 years)

I was very ashamed of myself when people visited to greet me for having a child. The thing is, I was not married and my mother was a leader in church. I knew people would be talking about me saying bad things. Because of that I sometimes think of drugging myself and die. (P8, 28 years)

Subtheme A4: Anxiety About the Future

Some postnatal mothers affirmed that they were very worried about what was going to happen to them in the future as they were very unsure of the next step they were going to take.

It is our parents that have been helping but they are farmers and they do not make enough money. This made me so worried because I wanted to become a nurse. Now that I have given birth, I am not sure my parents can afford to send me back to school any moment soon. Besides, they are the ones caring for the child and myself so the pressure was too much for them. (P17, 17 years)

My husband and I decided to wait a while before having another child because our finances were not in good standing. So, we did not really plan for this baby. Now we have a lot more responsibilities with little resources and this gets me so worried that I lose focus sometimes. It is not easy but we are inside like that hoping things will change for the better. (P5, 35 years)

Theme B: Effect of PPD on the Family

PD can adversely impact the life of the mother and her baby as well as the whole family.

Subtheme B4: Impact on the Well-Being of the Mother

Mothers going through PPD suffer from many forms of mental instability, loss of concentration which are put forth in the responses below;

It was difficult for me to concentrate. I can start doing something now and before I realize my mind is on different things like the pain I felt during childbirth, or the way some of my siblings used to insult or talk about me having a child at this age. I become so sad and sometimes I left whatever work I started. (P17, 17 years)

I didn’t know if I was getting mad or what. When I am too worried and sad about my experience, I can leave the baby without breastfeeding until someone hears the cry of the baby and comes to force me to breastfeed the baby. Sometimes, I will go and sit somewhere and start talking to myself and crying because I thought all hopes were lost. (P13, 29 years)

I knew it was not good, but I could not help it. My mind was roaming on different things, and I was getting worried on how to come out of the shame of having a child while not married. (P9, 19 years)

Subtheme B5: Impact on the Wellbeing of Baby

The study also found that PPD among postnatal mothers has negative effects on the babies. The negative impacts of PPD on babies were malnutrition, lack of sleep and excessive crying, poor hygiene, child neglect, and poor growth. These were noted from the responses the postnatal women gave as follows;

My baby was not eating well during those times I was so depressed. I saw that the baby was growing slim as compared to how she looked when I gave birth to her. People also said that my baby was losing weight. The baby was always crying and not sleeping well. (P13, 29 years)

There were times I left the baby unclean. She was smelling because she urinated and defecated in the diaper. It is not that I didn’t want to clean her or feed her. (P17, 17 years)

I was not having time for my baby as compared to now. If she is crying, I will just go and breastfeed her and leave her back on the bed. Sometimes it is my aunt who will take care of her from morning to evening. But now, I can play, breastfeed and bathe her. (P2, 24 years)

Subtheme B6: Impact on the Wellbeing of the Family

The effect of PPD on the well-being of the family as a whole was described by the respondents in the following ways;

It has not been easy for my family at all. They no longer have time for themselves because they are always taking care of me and making sure that nothing happens to the baby and me. (P8, 28 years)

I became a burden on my family. They have to leave everything and take care of the baby and myself…they were afraid something bad would happen to me so, they were always worried and they had to spend a lot of money just to make sure I was okay. (P12, 16 years)

Theme C: Adapted Coping Strategies During PPD

The study found out that mothers suffering from PPD coped with the condition in two different ways among which were self-medication, and response to family and friends’ support.

Subtheme C7: Self-Medication

Some postnatal women said in order to forget the worry and thinking which made them sadder, they take sleeping tables to make them sleep and relax. These observations were made from the following responses of some of the postnatal mothers:

It was difficult for me to sleep, and I was restless, yet I was not doing anything. To avoid that I took sleeping tablets to help me sleep. By the time I woke, things came down a bit. (P11, 34 years)

I was crying a lot and it was making my head ache most of the time. Because of that I always keep painkillers with me. I also used sleeping tablets too when I could not sleep at night. (P9, 19 years)

Subtheme C8: Support System

While some took medications to help them manage the depression, the study found out that other postnatal mothers sought the support of their relatives to which they responded positively.

I was leaving with my parents, so any time they noticed I was behaving strangely, they will ask me to sit and relax and allow them to do whatever work I was supposed to do. I was lucky they noticed that I was depressed, and they constantly advised me to make me understand that the future is still bright. (P6, 20 years)

My siblings did not want me to lose hope during those times. I was much worried about my life and my education. So, they constantly cited instances where some girls while in school stopped to give birth, and after that they returned to school and now, they are big people in society. I tried to believe them and that help me sometimes to stop worrying and crying alone in the room. (P14, 21 years)

Discussion

The results of this study revealed that 6 (35.3%) of the respondent were between the ages of 15 and 19. The age range of 20 to 24 year was found to have the second-highest population, accounting for 4 (23.5%) of research respondents. The study also discovered that more than 11 (64.7%) of the postnatal mothers had a parity level of 0 to 1, indicating that the majority of them were either first-time or second-time mothers. These findings are therefore in line with those of Weobong et al. (2015) and Sefogah et al. (2020), who indicated that young mothers are more likely than older mothers to have PPD. Also, the high proportion of the population of women of reproductive age ranges between the ages of 15 and 24. This is supported by the Ghana Statistical Survey (2021) that about 43.8% of the total population of women are in their reproductive ages within the Municipality. The study also discovered that the majority of study respondents did not complete their tertiary education, with only 2 (11.8%) having done so and 41.2% having never received any type of formal education. Out of the 17 study respondents, only 3 (17.6%) were employed. The high rate of unemployment among the postpartum mothers revealed by study may be attributed to the respondents’ low levels of education.

The experiences of PPD vary among mothers as some tend to experience more anger than others while the experiences of some are mainly characterized by anxiety and behavioral changes (Atuhaire et al., 2021; Johnson et al., 2020; Watkins et al., 2011). Similarly, the current study found out that each postnatal mother experienced depression differently and these differences were based on the symptoms they most exhibited. Thus, the findings of this study are consistent with the findings of Atuhaire et al. (2021) and Johnson et al. (2020).

Some of the respondents acknowledged that since they were becoming mothers for the first time, adjusting to their new roles has been quite difficult. The majority of them also stated that they were angry with themselves and having trouble juggling motherhood responsibilities. Therefore, it was clear that these women would typically become weary, especially if they had no one to support them, consequently causing them to get angry at the least provocation. This aligned with the study by Johnson et al. (2020). Most of the postnatal mothers were young and should be in school, having much freedom, and depending on their parents. Now, depriving themselves of these privileges as a result of pregnancy and childbirth, make them angry whenever they are faced with exhaustive motherhood challenges.

It was observed from the study that most respondents blame themselves for the pregnancy, hence they were filled with regrets which they sometimes expressed in response to challenging situations related to motherhood (Muskens et al., 2022).

The findings of the study reported a low level of self-esteem and self-harm intentions. This is in line with the findings of Atuhaire et al. (2021). The feelings of self-harm have the potential to increase the risk of suicidal thoughts and actual suicides if untreated (Abrahams et al., 2016). Nevertheless, the study did not record any self-harm attempts among these respondents. Notably, self-harm is a serious act that previous studies conducted have observed among first-time mothers (Johannsen et al., 2020; Olfson et al., 2017). Sometimes these postnatal mothers think of harming their babies or partners instead of themselves leading to homicidal thoughts (Johannsen et al., 2020).

Anxiety about the future was another finding made in this study. Some of the postnatal mothers reported that they were constantly thinking about what would happen next as they are now mothers. The presence of a new life in the family comes with additional financial responsibilities. Mothers and partners who barely make enough income are more stressed as they were anxious about how to generate income for the family (Lindberg et al., 2021; Sarlo, 2013).

The study found that PPD has effects on the baby, mother, and family with previous studies having documented similar observations. The effects may account for high tolls of morbidity and mortality if adequate care is not given to the woman and her baby during the depression (Corrigan et al., 2015; McKelvey & Espelin, 2018; Slomian et al., 2019; Woldeyohannes et al., 2021). Aside from these, PPD increases the infant’s risk of being affected by common illnesses as he or she is deprived of exclusive breastfeeding (Dadi et al., 2020). In this study, some mothers had difficulties feeding their newborn babies, depriving them of adequate nutrients (Mellor et al., 2011), leading to poor growth and body wastage. Some respondents had poor relationships with their babies as well as relatives which resulted in limited social support. Unfortunately, these mothers were also observed to have poor physical health as they looked sick and very weak.

Also, as a result of depression, postnatal mothers developed risky behaviors including drug misuse, and intentions of self-harm. However, risky behaviors such as smoking and drinking were not observed among the respondents, but previous studies found a strong association between postpartum depression and these risky behaviors (Olfson et al., 2017). This is because family members of respondents noticed the state of these postnatal mothers and sought early medical attention.

According to Azale et al. (2018), postnatal women have different ways of adjusting to depression depending on their individual experiences. In this study, some respondents were involved in self-medication and enjoyed family support. These results are consistent with studies by Uzobo et al. (2022), which found that the majority of postnatal mothers tended to utilize available coping mechanisms to deal with the problems of PPD.

Implications for Practice

This study necessitates an urgent investigation into nurses and midwife’s knowledge of the postpartum depression. Future research may be needed to develop a specialized program that focuses on the identifying major precipitating factors of post-partum depression (PPD) taking into consideration the physical, psychosocial factors, and environmental factors. Stakeholders should prepare and implement effective strategies on how this condition can be mitigated among maternal mothers.

Strengths and Weaknesses

This research focused on capturing the richness and depth of individual lived experiences. Through in-depth interviews and analysis, the researchers generated detailed descriptions that provided insight into the essence of the phenomenon under study.

The method employed in this study helped the researchers to recognize the importance of subjective experiences and perspectives. By exploring individuals’ subjective experiences, researchers gained a deeper understanding of how individuals interpret and make sense of their world.

However, Phenomenological studies typically involves small, non-random samples, limiting the generalizability of findings to broader populations. The focus on individual experiences may not capture the full range of variability within a population.

Also, Data collection through methods like interviews and observations, as well as the subsequent analysis was time-consuming.

Conclusion

In this study, each postpartum mother had a unique experience with PPD, including anger, insomnia, future dread, self-blame, and plans to hurt oneself. Unwanted and unfavorable pregnancies, inadequate social support, and childbirth outcomes were the main influences on these experiences. The results of this study suggest that PPD creates an unfavorable environment for the mother and child’s well-being, and it is crucial to recognize and treat PPD as early in order to avoid its detrimental effects.

Understanding the risk factors associated with PPD through this research can inform preventive measures. Healthcare providers can educate expectant mothers and families about these factors, promoting awareness and proactive measures to reduce the risk of PPD. Insights from this research can inform the creation of postpartum support programs that provide new mothers with the resources and support they need to cope with PPD. These programs can be community-based or offered through healthcare facilities. Again, Policymakers can use these research findings to inform the development of policies related to maternal mental health. This might include policies related to maternity leave, access to mental health services, and insurance coverage for PPD treatment.

Footnotes

Acknowledgements

The authors wish to thank our hardworking research assistant John Yesuohene Ofori for his relentless effort in supporting this work.

Declaration of Conflicting Interests

The author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Funding

The author(s) disclosed receipt of the following financial support for the research, authorship, and/or publication of this article: The study was self-funded by the researchers.

Ethics Approval

For the purposes of ethics in research, an ethical clearance with Identification number UHAS-REC A.6[7]22-23 was obtained from the University of Health and Allied Sciences Research Ethics Committee. The ethical clearance certificate together with an introductory letter obtained from the School of Nursing and Midwifery were submitted to the management of the selected health facilities in order to gain permission for data collection. Verbal consent for participation was sought from each of the respondents. Respondents were made aware that participation is voluntary, and that information obtained would be valued, handled as confidential, and used for the purpose of the study only. Participation in this study had no guaranteed risk.

ORCID iD

Anita Fafa Dartey

Data Availability Statement

Due to the sensitive nature of this study, data will not be made available to preserve confidentiality.

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