Immigrant Afghan women's emotional well-being after birth and use of health services in Melbourne, Australia.
OBJECTIVE
to investigate immigrant Afghan women's emotional well-being and experiences of postnatal depression after childbirth and their use of health services.


METHODS
telephone interviews were conducted at four months after birth, using a semi-structured questionnaire; and a further in-depth face-to-face interview with a small number of women approximately one year after the birth. Women's emotional health was assessed at four months using the Edinburgh Postnatal Depression Scale (EPDS), as well as women's own descriptions of their emotional well-being since the birth.


METHODS
women were recruited from four hospital antenatal clinics or postnatal wards in Melbourne, Australia, between October 2006 and May 2007.


METHODS
Immigrant women who were born in Afghanistan, spoke Dari/Persian or English, and had given birth to a live and healthy baby.


RESULTS
Thirty nine women were interviewed at four months after birth; 41% reported feeling depressed or very unhappy since the birth and 31% scored as probably depressed on the EPDS. Ten women participated in further in-depth face-to-face interviews. Isolation, lack of support and being overwhelmed by life events were the most frequently reported contributing factors to women's emotional distress, and for many being a migrant appeared to intensify their experiences. The themes that emerged from both the telephone and face-to-face interviews revealed that some women were reluctant to discuss their emotional difficulties with health professionals and did not expect that health professionals could necessarily provide assistance.


CONCLUSIONS
in this study a significant proportion of immigrant Afghan women experienced emotional distress after childbirth. Women's experiences of emotional distress and help-seeking were at times affected by their status as immigrants and their perceptions of possible causes and treatment for their emotional health problems. Understanding the effects of migration on women's lives and paying careful attention to individual needs and preferences are critically important in providing care for immigrant Afghan women.
Judith Lumley Centre, School of Nursing & Midwifery, La Trobe University, Melbourne, VIC, Australia. Electronic address: t.shafiei@latrobe.edu.au.
Touran
T
Shafiei
Judith Lumley Centre, School of Nursing & Midwifery, La Trobe University, Melbourne, VIC, Australia. Electronic address: r.small@latrobe.edu.au.
Rhonda
R
Small
Judith Lumley Centre, School of Nursing & Midwifery, La Trobe University, Melbourne, VIC, Australia. Electronic address: h.mclachlan@latrobe.edu.au.
Helen
H
McLachlan
D000328:Adult; D000346:Afghanistan / Q000208:ethnology; D019052:Depression, Postpartum / Q000453:epidemiology* / Q000208:ethnology / Q000451:nursing; D005260:Female; D054625:Healthcare Disparities; D006801:Humans; D007231:Infant, Newborn; D007407:Interviews as Topic; D000068101:Maternal-Child Health Services; D008880:Midwifery; D011247:Pregnancy; D014739:Victoria / Q000453:epidemiology; D055815:Young Adult
Afghan women; Emotional well-being; Health service; Help-seeking; Immigrant; Postnatal depression