Contextual Effect of Place 0f Birth Delivery on Depression in Karanganyar, Central Java

Abstract

Background: Postpartum depression is a common mental health problem that usually occurs in women after childbirth. According to WHO, there are 377 million people in depression worldwide. In Indonesia, the prevalence of depression sufferers is 3.7%, and those who experience anxiety are 3.3%. Postpartum depression that is not immediately treated can cause an impact in nursing, namely communication and response is reduced, the existence of negative interactions, the existence of hostility, the existence of impaired competence. This study aimed to analyze the determinants of postpartum depression at the individual level and the contextual effect of place of birth delivery. Subjects and Method: This was a cross sectional study conducted in Karanganyar, Central Java, from November to December 2018. A sample of 200 postpartum mothers was selected by random sampling. The dependent variable was postpartum depression. The independent variables were stress level, work, income, education, pregnancy status, parity, coping strategy, and labor compli­cation, husband support. Data on depression were measured by the Edinburgh Postnatal Depression Scale (EPDS). Data on stress were measured by Depression Anxiety Stress Scale 42 (DASS 42). Data on coping mechanism were measured by Brief Cope (Coping Orientation for Problem Experiences). The other data were collected by questionnaire and analyzed by a multilevel logistic regression. Results : Postpartum depression was influenced by husband support (b = -2.42; 95% CI= -4.73 to -0.12; p= 0.039), employment (b = -3.43; 95% CI = -5.51 to -1.35; p<0.001), income (b = -3.32; 95% CI= -6.18 to -0.46; p= 0.023), education (b= -2.69; 95% CI = -4.83 to -0.55; p= 0.014), pregnancy status (b= -3.16; 95% CI= -5.79 to - 0.54; p= 0.018), parity (b = -2.92; 95% CI = -5.14 to -0.71; p= 0.010), coping strategies (b= -2.38; 95% CI= -4.46 to -0.21; p= 0.032), complication (b = 3.39; 95% CI= 0.79 to 5.98; p= 0.011), and stress level (b= 2.68; 95 % CI= 0.35 to 5.12; p= 0.024). There was a contextual effect of place of birth delivery on postpartum depression (ICC= 20.15%). Conclusions: Postpartum depression is influenced by husband support, employment, income, education, pregnancy status, parity, coping strategies, complication, and stress level. There is a contextual effect of place of birth delivery on postpartum depression. Keywords: postpartum mother, depression, stress, coping strategy Correspondence: Ahadyah Miftahul Jannah. Masters Program in Public Health, Universitas Sebelas Maret, Surakarta. Jl. Ir. Sutami No. 36 A, 57126, Surakarta, Central Java. Email: ahadyahmj@gmail.com. Mobile: +6281228349874. Journal of Maternal and Child Health, 2019, 4(3): 212-221 https://doi.org/10.26911/thejmch.2019.04.03.08