The Postpartum Depression (PPD) is a common condition among mothers after one month of delivery. From different research studies, scholars reveal that nearly 15% to 20% of mothers experience PPD after birth. The challenge is that PPD has a gruelling effect not only on the mother but also places a child at risk of developing poor conditions while growing up. By definition, PPD is a complex mix of physical, emotional, and behavioural changes that happen in a woman after birth ( Accortt et al., 2016). In a depression scale, the PPD scores range from mild to severe depression. PPD links to chemical, social, and psychological changes associated with having a baby. The term describes a range of physical and emotional changes that many new mothers experience. In most cases, severe PPD may result to having crazy thoughts such as harming oneself or a child. In recent studies, there has been a discussion focusing on ethics and cultural perspective of PPD. For instance, there have been current debates on whether it would be ethical to screen for PPD ( Alhasanat-Khalil et al., 2018). The question that remains pending and debatable is what the ethical barriers which define how the medical community handles the cases of PPD are? With regards to culture, there have questions on some of the cultural issues that place some communities such as African American (AA) women at risk for PPD.
In this article, the focus is on both culture and ethics overview of the PPD. Some questions will lead the discussion. The first question is, what are ethical issues concerning PPD screening, and how do they impact the medical staffs' approach to PPD condition among the mothers? The second question is with regards to culture, and particularly African American Women. The leading problem is; how is African American society and culture exposing African America women to PPD?
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Ethics and PPD
The prevalence of PPD is very high in the population. Most research studies report that nearly 50% of the PPD cases are undiagnosed. Partly, some research blames the ethics conundrum on the PPD. Some of these research studies claim that the ethics environment for the PPD approach in the medical field is still unresolved, leading to an ethical dilemma which prevents medical staffs from handling this matter appropriately. The primary matter is screening. PPD prevention in the population involves detecting the depression signs after the child is born. In most case, the PPD occurs after four to six weeks after the child is born. From different research studies, screening for PPD is critical since the detecting and treatments for the PPD will help both the mother and the child ( Ahmed et al., 2018). However, screening is also an area which can further worsen off the condition. The screening means detecting the risk before it takes place and placing the mother in preventive mechanism to avoid the PPD. However, ethics restrain medical staffs in many ways.
The first ethical barrier is justice. The principle of justice implies that there is a need to balance justice between the mother and the child while handling the matter of PPD. Screening for PPD to some extent may result in depression for the mothers. In most cases, some vulnerable mothers may find the screening questions sensitive to them. In case such screening results mean that such mothers are a risk of developing PPD, depression, stress, and anxiety will come in, and this is likely to worsen their situation. On the other hand, such a result must also be used to treat the mother so that there is justice for the child who is likely to suffer in case the mother remains unattended. The doctor thus must find the right balance of justice to handle the matter. Other than that, the ethical principle of autonomy is also critical in this matter and sometimes acts as a significant barrier during PPD screening ( Gilbert, Balio& Bauer, 2017). Autonomy is the ethical principle which demands that a patient is granted the opportunity to make decisions that affect their lives. A conundrum comes about in a situation where the doctor suspects a mother and makes advancement to screen for PPD. In such a case, the doctor must detect the danger the mother exposes the kid ( Accortt et al., 2016). However, the doctor sometimes faces a lot of ethical dilemmas when the mother is uncomfortable with PPD screening. In this case, the doctor understands that in case the mother is PPD positive, the child is at risk. However, they have also to respect the Mothers autonomy, which presents a significant barrier in handling matters of the PPD.
The ethical principle of not harm is also another significant barrier the medical community has to battle on their way to reducing the high prevalence of the PPD among mothers in society. Doing no ham means minimizing harm while interacting with any patient. In the case of PPD, the doctor has to understand that the result of the PPD screening will harm some mothers ( Gilbert, Balio& Bauer, 2017). At the same time, the doctor also has to understand that mothers who show the signs and symptoms of PPD risk harming their children if clinicians do not treat them. It is upon the doctor to decide on whether to damage the child or harm the mother as the option allows them to harm or treat only one party. These ethical principles thus present the challenge to healthcare communities and make it difficult to find a lasting solution to cater to the overwhelming PPD in the population.
Culture and PPD
PPD is dependent on culture and society structure and status. In the United States of America, one of the risk factors for PPD is being African American Mother. Nearly 27% of all the case of the PPD affects African America women. Research studies reveal that African American culture has a massive say on the matter. Africa American society is affected by PPD because of racism. Racism is a factor which finds its roost during the American dark days of slavery. Most of the African American mothers get exposure to racism, and this leads to stress before and after birth, thus making them vulnerable to PPD. For instance, research by ( Alhasanat-Khalil et al., 2018). claims that PPD is twice high among the High-Class African American mothers than the middle and lower class White American mothers.
Further, African American society's culture also exposed African American mothers to PPD. The African American culture regards the women as inferior to men. In this sense, women in some case are left to battle most of the domestic issues. Further, some of them struggle with domestic violence in their homes since they do not enjoy many rights. The husbands have power and control the house. Such sense, coupled with other stress from the work, these ladies find themselves stress and thus are at risk of developing PPD. Some research describes such cultures as a lack of attention from husbands ( Ahmed et al., 2018). Lack of attention is a situation where the mothers have a feeling that their issues are less attended to by the husband. According to different research studies, this is a critical issue that faces most of the African American mothers ( Alhasanat-Khalil et al., 2018) . On the same matters, some research studies reveal that a good number of African American mothers are housewives. The husband is thus in charge of the financial welfare of the house. In case such husbands are less caring, some of the mothers find themselves battling depression to cater to the need of the child. These also expose them to the risk of PPD.
Finally, different research studies claim that nearly 67% of children born of African American are out of wedlock. It is an implication that single mothers are overwhelming among African American society. The single mother comes with numerous responsibility shouldered by a single person. The worst part of it is that getting a job in American by the minority group such as African American mothers is a challenge. It implies that there is a lot of stress among these individuals on how they care for their children( Accortt et al., 2016). Lack of support is thus one of the critical factors which expose the African American mothers to PPD. These individuals feel like the whole world is on their head, pressing them down. PPD comes in as a result of such thoughts; the mother gets affected.
PPD prevalence in society ties to culture and ethical barriers in the medical field. From the discussion, it is evident that ethical principles such as doing no harm, justice, and autonomy are acting as barriers that prevent medical individuals from making critical steps in the prevention of the PPD as a disease. On the other side, it is also evident that one of the risk factors for the PPD is culture and the society which creates an environment that increases the vulnerability of the mothers to PPD.
References
Accortt, E. E., Schetter, C. D., Peters, R. M., & Cassidy-Bushrow, A. E. (2016). Lower prenatal vitamin D status and postpartum depressive symptomatology in African American women: Preliminary evidence for moderation by inflammatory cytokines. Archives of women's mental health , 19 (2), 373-383.
Ahmed, A., Feng, C., Bowen, A., &Muhajarine, N. (2018).Latent trajectory groups of perinatal depressive and anxiety symptoms from pregnancy to early postpartum and their antenatal risk factors. Archives of women's mental health , 21 (6), 689-698.
Alhasanat-Khalil, D., Giurgescu, C., Benkert, R., Fry-McComish, J., Misra, D. P., &Yarandi, H. (2018). Acculturation and Postpartum Depression Among Immigrant Women of Arabic Descent. Journal of immigrant and minority health , 1-9.
Gilbert, A. L., Balio, C., & Bauer, N. S. (2017).Making the legal and ethical case for universal screening for postpartum mood and anxiety disorders in pediatric primary care. Current problems in pediatric and adolescent health care , 47 (10), 267-277.
