Abstract
BackgroundTraditional postpartum practices are intended to provide care to mothers, but there is mixed evidence concerning their impact on postpartum depression (PPD). It remains unknown if there is a unique impact of postpartum practices on PPD separately from other types of social support, or if practices differentially affect those with existing prenatal depression. In Pakistan, chilla (چله) is a traditional postpartum practice in which women receive relief from household work, additional familial support, and supplemental food for up to 40 days postpartum. This study aims to understand if chilla protects against PPD independent of other support and whether this relationship varies by prenatal depression status.MethodsData come from the Bachpan cohort study in rural Pakistan. Chilla participation and social support (Multidimensional Scale of Perceived Social Support) were assessed at 3 months postpartum. Women were assessed for major depressive episodes (MDE) with the Structured Clinical Interview, DSM-IV and for depression symptom severity with the Patient Health Questionnaire (PHQ-9) in their third trimester and at 6 months postpartum. Adjusted linear mixed models were used to assess the relationship between chilla participation and PPD.ResultsEighty-nine percent of women (N = 786) participated in chilla and almost 70% of those that participated took part in all of chilla’s aspects. In adjusted models, chilla participation was inversely related to MDE (OR = 0.56;95%CI = 0.31,1.03) and symptom severity (Mean Difference (MD) = − 1.54;95%CI: − 2.94,-0.14). Chilla participation was associated with lower odds of MDE (OR = 0.44;95%CI = 0.20,0.97) among those not prenatally depressed and with lower symptom severity among those prenatally depressed (MD = -2.05;95%CI:-3.81,-0.49).ConclusionsChilla is inversely associated with both MDE and symptom severity at 6 months postpartum above and beyond social support. Specifically, chilla is inversely associated with MDE among those not prenatally depressed and with lower symptom severity among those prenatally depressed. This relationship signals an opportunity for interventions aimed at preventing and treating PPD in this region to draw upon chilla and similar traditional postpartum practices in creating community-based, low-cost, sustainable interventions for maternal mental health.Trial registrationNCT02111915. Registered 18 September 2015. NCT02658994. Registered 22 January 2016. Both trials were prospectively registered.
Highlights
Traditional postpartum practices are intended to provide care to mothers, but there is mixed evidence concerning their impact on postpartum depression (PPD)
Though postpartum practices in Asian cultures are intended as supportive mechanisms for new mothers and the baby, there is mixed evidence concerning the impact of postpartum practices on PPD
Study design and participants Data come from the Bachpan study, a cluster randomized perinatal depression trial nested in a longitudinal birth cohort in rural Pakistan
Summary
Traditional postpartum practices are intended to provide care to mothers, but there is mixed evidence concerning their impact on postpartum depression (PPD). Postpartum practices are richly documented in Asian, Hispanic, African, and Jewish cultures and are described by anthropologists and cultural psychiatrists as customs that “mother the mother” through formalized social support [1, 3,4,5] They are intended to provide care to mothers by limiting their household activities, providing a special diet, taking care of their needs, and easing their transition into motherhood [1]. Such practices may have long term benefits on maternal and infant health, including maternal mental health, and need to be considered when thinking about protections against postpartum depression (PPD) [1, 4, 6]. Though postpartum practices in Asian cultures are intended as supportive mechanisms for new mothers and the baby, there is mixed evidence concerning the impact of postpartum practices on PPD
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Free) 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call
