Skip to main content
Top
Published in: BMC Psychiatry 1/2018

Open Access 01-12-2018 | Research article

Living with severe perinatal depression: a qualitative study of the experiences of labour migrant and refugee women on the Thai-Myanmar border

Authors: Gracia Fellmeth, Emma H. Plugge, Suphak Nosten, May May Oo, Mina Fazel, Prakaykaew Charunwatthana, François Nosten, Raymond Fitzpatrick, Rose McGready

Published in: BMC Psychiatry | Issue 1/2018

Login to get access

Abstract

Background

Perinatal depression is an important contributor to maternal morbidity and mortality worldwide. Migrant women, particularly those resettling within low- and middle-income settings, are at increased risk of perinatal depression due to multiple stressors experienced before, during and after migration. Evidence on migrant perinatal mental health to date has focused largely on women in high-income destination countries, leaving the voices of displaced women in low-income settings unheard. This study addresses the current evidence gap by exploring the experiences of migrant women living on the Thai-Myanmar border.

Methods

In-depth interviews were conducted with pregnant and post-partum labour migrant and refugee women on the Thai-Myanmar border who had been diagnosed with severe depression. An interview guide covering women’s current and past life experiences, social support and the impact of depression on social and occupational functioning was used as a prompt. Thematic analysis was used to identify themes emerging from women’s narratives.

Results

Eleven pregnant and post-partum women with severe perinatal depression took part. Participating women provided extensive insight into the many difficult aspects of their lives that they perceived as contributing to their depression status. Predominant themes emerging from women’s narratives included difficult relationships with partners, challenging life situations, mechanisms for coping with depression and impressions of mental health care.

Conclusions

Labour migrant and refugee women with severe perinatal depression face a wide range of chronic stressors at the individual, household and community levels that are likely to have both short- and long-term negative effects on their mental well-being and day-to-day functioning. Participating women responded positively to the mental health support they received, and findings provide important insights into how services might further support their needs.
Appendix
Available only for authorised users
Footnotes
1
Devil’s Trumpet (also known as datura or jimsonweed) is a highly toxic genus plant belonging to the vespertine flowering plants species.
 
Literature
1.
go back to reference Howard LM, Molyneaux E, Dennis CL, Rochat T, Stein A, Milgrom J. Non-psychotic mental disorders in the perinatal period. Lancet. 2014;384(9956):1775–88.CrossRefPubMed Howard LM, Molyneaux E, Dennis CL, Rochat T, Stein A, Milgrom J. Non-psychotic mental disorders in the perinatal period. Lancet. 2014;384(9956):1775–88.CrossRefPubMed
2.
go back to reference Stein A, Pearson RM, Goodman SH, Rapa E, Rahman A, McCallum M, Howard LM, Pariante CM. Effects of perinatal mental disorders on the fetus and child. Lancet. 2014;384(9956):1800–19.CrossRefPubMed Stein A, Pearson RM, Goodman SH, Rapa E, Rahman A, McCallum M, Howard LM, Pariante CM. Effects of perinatal mental disorders on the fetus and child. Lancet. 2014;384(9956):1800–19.CrossRefPubMed
3.
go back to reference Woody CA, Ferrari AJ, Siskind DJ, Whiteford HA, Harris MG. A systematic review and meta-regression of the prevalence and incidence of perinatal depression. J Affect Disord. 2017;219:86–92.CrossRefPubMed Woody CA, Ferrari AJ, Siskind DJ, Whiteford HA, Harris MG. A systematic review and meta-regression of the prevalence and incidence of perinatal depression. J Affect Disord. 2017;219:86–92.CrossRefPubMed
4.
go back to reference Fisher J, Cabral de Mello M, Patel V, Rahman A, Tran T, Holton S, Holmes W. Prevalence and determinants of common perinatal mental disorders in women in low- and lower-middle-income countries: a systematic review. Bull World Health Organ. 2012;90(2):139g–49g.CrossRefPubMed Fisher J, Cabral de Mello M, Patel V, Rahman A, Tran T, Holton S, Holmes W. Prevalence and determinants of common perinatal mental disorders in women in low- and lower-middle-income countries: a systematic review. Bull World Health Organ. 2012;90(2):139g–49g.CrossRefPubMed
5.
go back to reference Fellmeth G, Fazel M, Plugge E. Migration and perinatal mental health in women from low- and middle-income countries: a systematic review and meta-analysis. BJOG. 2017;124(5):742–52.CrossRefPubMed Fellmeth G, Fazel M, Plugge E. Migration and perinatal mental health in women from low- and middle-income countries: a systematic review and meta-analysis. BJOG. 2017;124(5):742–52.CrossRefPubMed
6.
go back to reference Collins CH, Zimmerman C, Howard LM. Refugee, asylum seeker, immigrant women and postnatal depression: rates and risk factors. Arch Womens Ment Health. 2011;14(1):3–11.CrossRefPubMed Collins CH, Zimmerman C, Howard LM. Refugee, asylum seeker, immigrant women and postnatal depression: rates and risk factors. Arch Womens Ment Health. 2011;14(1):3–11.CrossRefPubMed
7.
go back to reference IOM. Migrant well-being and development. In: World Migration Report 2013. Geneva: International Organization for Migration; 2013. IOM. Migrant well-being and development. In: World Migration Report 2013. Geneva: International Organization for Migration; 2013.
8.
go back to reference IOM. Migrants and cities: new partnerships to manage mobility. In: World Migration Report 2015. Geneva: International Organization for Migration; 2015.CrossRef IOM. Migrants and cities: new partnerships to manage mobility. In: World Migration Report 2015. Geneva: International Organization for Migration; 2015.CrossRef
9.
go back to reference Anderson FM, Hatch SL, Comacchio C, Howard LM. Prevalence and risk of mental disorders in the perinatal period among migrant women: a systematic review and meta-analysis. Arch Womens Ment Health. 2017;20(3):449–62.CrossRefPubMedPubMedCentral Anderson FM, Hatch SL, Comacchio C, Howard LM. Prevalence and risk of mental disorders in the perinatal period among migrant women: a systematic review and meta-analysis. Arch Womens Ment Health. 2017;20(3):449–62.CrossRefPubMedPubMedCentral
10.
go back to reference Shishehgar S, Gholizadeh L, DiGiacomo M, Green A, Davidson PM. Health and socio-cultural experiences of refugee women: an integrative review. J Immigr Minor Health. 2017;19(4):959–73.CrossRefPubMed Shishehgar S, Gholizadeh L, DiGiacomo M, Green A, Davidson PM. Health and socio-cultural experiences of refugee women: an integrative review. J Immigr Minor Health. 2017;19(4):959–73.CrossRefPubMed
11.
go back to reference Norhayati MN, Hazlina NH, Asrenee AR, Emilin WM. Magnitude and risk factors for postpartum symptoms: a literature review. J Affect Disord. 2015;175:34–52.CrossRefPubMed Norhayati MN, Hazlina NH, Asrenee AR, Emilin WM. Magnitude and risk factors for postpartum symptoms: a literature review. J Affect Disord. 2015;175:34–52.CrossRefPubMed
12.
go back to reference Fellmeth G, Plugge EH, Carrara V, Fazel M, Oo MM, Phichitphadungtham Y, Pimanpanarak M, Wai NK, Mu O, Charunwatthana P, Nosten F, Fitzpatrick R, McGready R. Migrant perinatal depression study: a prospective cohort study of perinatal depression on the Thai-Myanmar border. BMJ Open. 2018;8(1):e017129.CrossRefPubMedPubMedCentral Fellmeth G, Plugge EH, Carrara V, Fazel M, Oo MM, Phichitphadungtham Y, Pimanpanarak M, Wai NK, Mu O, Charunwatthana P, Nosten F, Fitzpatrick R, McGready R. Migrant perinatal depression study: a prospective cohort study of perinatal depression on the Thai-Myanmar border. BMJ Open. 2018;8(1):e017129.CrossRefPubMedPubMedCentral
13.
go back to reference Spitzer RL, Williams JB, Gibbon M, First MB. The structured clinical interview for DSM-III-R (SCID). I: history, rationale, and description. Arch Gen Psychiatry. 1992;49(8):624–9.CrossRefPubMed Spitzer RL, Williams JB, Gibbon M, First MB. The structured clinical interview for DSM-III-R (SCID). I: history, rationale, and description. Arch Gen Psychiatry. 1992;49(8):624–9.CrossRefPubMed
14.
go back to reference Dunlop N. Invisible people: stories of migrant labourers in Thailand. Bangkok: Raks Thai Foundation; 2011. Dunlop N. Invisible people: stories of migrant labourers in Thailand. Bangkok: Raks Thai Foundation; 2011.
15.
go back to reference Pearson R, Kusakabe K. Thailand's hidden workforce: Burmese migrant women factory workers. London: Zed Books; 2012. Pearson R, Kusakabe K. Thailand's hidden workforce: Burmese migrant women factory workers. London: Zed Books; 2012.
16.
go back to reference The Border Consortium, Annu Rep: January–December 2015. 2016. The Border Consortium, Annu Rep: January–December 2015. 2016.
17.
go back to reference QSR International. NVivo qualitative data analysis software, version 11: QSR International Pty Ltd; 2015. QSR International. NVivo qualitative data analysis software, version 11: QSR International Pty Ltd; 2015.
18.
go back to reference Braun V, Clarke V. Using thematic analysis in psychology. Qual Res Psychol. 2006;3(2):77–101.CrossRef Braun V, Clarke V. Using thematic analysis in psychology. Qual Res Psychol. 2006;3(2):77–101.CrossRef
19.
go back to reference Pope C And Mays, N, eds. Qualitative research in health care. Third Edition. 2006, Blackwell Publishing Ltd: Oxford.CrossRef Pope C And Mays, N, eds. Qualitative research in health care. Third Edition. 2006, Blackwell Publishing Ltd: Oxford.CrossRef
20.
go back to reference Ziebland S, McPherson A. Making sense of qualitative data analysis: an introduction with illustrations from DIPEx (personal experiences of health and illness). Med Educ. 2006;40(5):405–14.CrossRefPubMed Ziebland S, McPherson A. Making sense of qualitative data analysis: an introduction with illustrations from DIPEx (personal experiences of health and illness). Med Educ. 2006;40(5):405–14.CrossRefPubMed
21.
go back to reference Halim N, Beard J, Mesic A, Patel A, Henderson D, Hibberd P. Intimate partner violence during pregnancy and perinatal mental disorders in low and lower middle income countries: a systematic review of literature, 1990-2017. Clin Psychol Rev. 2017; Halim N, Beard J, Mesic A, Patel A, Henderson D, Hibberd P. Intimate partner violence during pregnancy and perinatal mental disorders in low and lower middle income countries: a systematic review of literature, 1990-2017. Clin Psychol Rev. 2017;
22.
go back to reference Breckenridge J, Yang T, Poon AWC. Is gender important? Victimisation and perpetration of intimate partner violence in mainland China. Health Soc Care Community. 2018; Breckenridge J, Yang T, Poon AWC. Is gender important? Victimisation and perpetration of intimate partner violence in mainland China. Health Soc Care Community. 2018;
23.
go back to reference Gelaye B, Rondon MB, Araya R, Williams MA. Epidemiology of maternal depression, risk factors, and child outcomes in low-income and middle-income countries. Lancet Psychiatry. 2016;3(10):973–82.CrossRefPubMedPubMedCentral Gelaye B, Rondon MB, Araya R, Williams MA. Epidemiology of maternal depression, risk factors, and child outcomes in low-income and middle-income countries. Lancet Psychiatry. 2016;3(10):973–82.CrossRefPubMedPubMedCentral
24.
go back to reference Connelly CD, Hazen AL, Baker-Ericzen MJ, Landsverk J, Horwitz SM. Is screening for depression in the perinatal period enough? The co-occurrence of depression, substance abuse, and intimate partner violence in culturally diverse pregnant women. J Women's Health (Larchmt). 2013;22(10):844–52.CrossRef Connelly CD, Hazen AL, Baker-Ericzen MJ, Landsverk J, Horwitz SM. Is screening for depression in the perinatal period enough? The co-occurrence of depression, substance abuse, and intimate partner violence in culturally diverse pregnant women. J Women's Health (Larchmt). 2013;22(10):844–52.CrossRef
25.
go back to reference Falb KL, McCormick MC, Hemenway D, Anfinson K, Silverman JG. Violence against refugee women along the Thai-Burma border. Int J Gynaecol Obstet. 2013;120(3):279–83.CrossRefPubMed Falb KL, McCormick MC, Hemenway D, Anfinson K, Silverman JG. Violence against refugee women along the Thai-Burma border. Int J Gynaecol Obstet. 2013;120(3):279–83.CrossRefPubMed
26.
go back to reference Meyer S, Murray LK, Puffer ES, Larsen J, Bolton P. The nature and impact of chronic stressors on refugee children in ban Mai Nai Soi camp, Thailand. Glob Public Health. 2013;8(9):1027–47.CrossRefPubMed Meyer S, Murray LK, Puffer ES, Larsen J, Bolton P. The nature and impact of chronic stressors on refugee children in ban Mai Nai Soi camp, Thailand. Glob Public Health. 2013;8(9):1027–47.CrossRefPubMed
27.
go back to reference Ezard N, Thiptharakun S, Nosten F, Rhodes T, McGready R. Risky alcohol use among reproductive-age men, not women, in Mae La refugee camp, Thailand, 2009. Confl Health. 2012;6(1):7.CrossRefPubMedPubMedCentral Ezard N, Thiptharakun S, Nosten F, Rhodes T, McGready R. Risky alcohol use among reproductive-age men, not women, in Mae La refugee camp, Thailand, 2009. Confl Health. 2012;6(1):7.CrossRefPubMedPubMedCentral
28.
go back to reference Stewart RC, Umar E, Tomenson B, Creed F. A cross-sectional study of antenatal depression and associated factors in Malawi. Arch Womens Ment Health. 2014;17(2):145–54.CrossRefPubMed Stewart RC, Umar E, Tomenson B, Creed F. A cross-sectional study of antenatal depression and associated factors in Malawi. Arch Womens Ment Health. 2014;17(2):145–54.CrossRefPubMed
29.
go back to reference Fernando GA, Miller KE, Berger DE. Growing pains: the impact of disaster-related and daily stressors on the psychological and psychosocial functioning of youth in Sri Lanka. Child Dev. 2010;81(4):1192–210.CrossRefPubMed Fernando GA, Miller KE, Berger DE. Growing pains: the impact of disaster-related and daily stressors on the psychological and psychosocial functioning of youth in Sri Lanka. Child Dev. 2010;81(4):1192–210.CrossRefPubMed
31.
go back to reference Seguin M, Lewis R, Amirejibi T, Razmadze M, Makhashvili N, Roberts B. Our flesh is here but our soul stayed there: a qualitative study on resource loss due to war and displacement among internally-displaced women in the republic of Georgia. Soc Sci Med. 2016;150:239–47.CrossRefPubMed Seguin M, Lewis R, Amirejibi T, Razmadze M, Makhashvili N, Roberts B. Our flesh is here but our soul stayed there: a qualitative study on resource loss due to war and displacement among internally-displaced women in the republic of Georgia. Soc Sci Med. 2016;150:239–47.CrossRefPubMed
32.
go back to reference Bartolomei L, Eckert R, Pittaway E. “What happens there… follows us here”: resettled but still at risk: refugee women and girls in Australia. Refuge. 2014;30:45–56. Bartolomei L, Eckert R, Pittaway E. “What happens there… follows us here”: resettled but still at risk: refugee women and girls in Australia. Refuge. 2014;30:45–56.
33.
go back to reference Schmied V, Black E, Naidoo N, Dahlen HG, Liamputtong P. Migrant women's experiences, meanings and ways of dealing with postnatal depression: a meta-ethnographic study. PLoS One. 2017;12(3):e0172385.CrossRefPubMedPubMedCentral Schmied V, Black E, Naidoo N, Dahlen HG, Liamputtong P. Migrant women's experiences, meanings and ways of dealing with postnatal depression: a meta-ethnographic study. PLoS One. 2017;12(3):e0172385.CrossRefPubMedPubMedCentral
Metadata
Title
Living with severe perinatal depression: a qualitative study of the experiences of labour migrant and refugee women on the Thai-Myanmar border
Authors
Gracia Fellmeth
Emma H. Plugge
Suphak Nosten
May May Oo
Mina Fazel
Prakaykaew Charunwatthana
François Nosten
Raymond Fitzpatrick
Rose McGready
Publication date
01-12-2018
Publisher
BioMed Central
Published in
BMC Psychiatry / Issue 1/2018
Electronic ISSN: 1471-244X
DOI
https://doi.org/10.1186/s12888-018-1815-7

Other articles of this Issue 1/2018

BMC Psychiatry 1/2018 Go to the issue