Examining the Social Patterning of Postpartum Depression by Immigration Status in Canada: an Exploratory Review of the Literature.

Abstract

Postpartum depression (PPD) refers to a woman's experience with any depressive episode occurring within the first year of the postpartum period (Stewart et al., 2008;53(2):121-4). While PPD is a global phenomenon, the distribution of PPD within populations is not universal. Indeed, evidence from the Canadian literature confirms a significant disparity in PPD outcomes, as the prevalence rate of PPD is markedly increased among immigrant women (Stewart et al., 2008;53(2):121-4), and immigration status emerges as an important risk factor for PPD. However, these two findings alone do not explain the reasons why this particular social patterning emerges. This review essay synthesizes findings on the prevalence and risk of PPD among immigrant women in Canada. It then draws on recent literature to propose three key mechanisms underlying why this social patterning emerges, namely (1) social support, (2) socioeconomic status, and (3) life stressors. These mechanisms are analyzed through the World Health Organization's conceptual framework of the social determinants of health (WHO, 2010;Statistics Canada, 2017). Additionally, this review essay seeks to assess the current state of intervention strategies piloted in Canada for PPD prevention and highlight gaps in the literature on intervention strategies for immigrant women specifically.