Postpartum Blues: The Risks Depend on Where You Live

Culture strongly shapes the stresses on new mothers

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A group of studies that looked at the best data available from more than 40 countries across the globe found that the incidence of postpartum depression in mothers ranges from 3 to 63 percent, with Malaysia and Pakistan at the bottom and top, respectively. The rate for U.S. mothers is 10 to 15 percent. Although mothers in all corners of the world agree that lack of social support or an unhelpful partner can make them feel depressed, there are also many factors they do not agree on. One mother's blessing is truly another's curse.

Weight loss
In places where thin equals beautiful, such as France and the U.S., the struggle to return to prepregnancy weight is often a source of distress. Not so in Uganda, where weight loss and food scarcity are a cause for concern, and the weight gain is welcomed.

The mother-in-law
Mothers in all nations studied identified their mother-in-law as a source of friction, except in Sweden. This friction was more acute in Asian countries, where there is a strong tradition of postnatal rituals that may be imposed by the mother-in-law.

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Breast-feeding
In countries such as Ireland and the U.S., where there is a perception that “good” moms breast-feed, many are anxious about nursing. In countries such as Uganda and Botswana, where it is the norm, mothers do not consider it an issue.

Hormones
It can take months or years for a woman's hormones to return to prepregnancy levels. One survey found that this was not a source of distress for moms in Japan or Uganda. In Europe, however, mothers felt a hormone imbalance contributed to sadness.

Depression treatment
In one study that asked mothers from four continents what would help relieve their depression, all responded that hands-on help, emotional support and a confidant would help. Only in the U.S. did mothers mention antidepressants.

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