Journal of Midwifery and Reproductive Health

Journal of Midwifery and Reproductive Health

Exploring the Experiences of Jordanian Rural Women with Postpartum Depression: A Qualitative Study

Document Type : Original Research Article

Authors
1 Associate Professor, Prince Al Hussein Bin Abdullah II Academy for Civil Protection, Al-Balqaʼ Applied University Amman-Jordan
2 Professor, Faculty of Nursing, Irbid National University, Irbid-Jordan
3 Associate Professor, Clinical Nursing Department, Faculty of Nursing, Applied Science Private University, Amman- Jordan
4 MSc of Nursing, Kettering Hospital Practice, Ohio-USA
5 Doctor of Medicine, Obstetrics & Gynecology Residency Program, Jordanian Royal Medical Services, Military King Talal Hospital, Mafraq-Jordan
6 MSc of Paramedics, Mental health Medic, Wilson Medic One, 190 Abernethy Rd, Belmont WA Australia
Abstract
Background & aim: Childbirth sometimes arouses intense emotional and psychosocial distress among the mothers, known as postpartum depression, reducing quality of life and health outcomes for mothers and their newborns. However, little is known about the experience of women living in rural settings with this condition. This study explores the experiences of women with postpartum depression in the rural areas of Jordan.
Methods: In this qualitative descriptive study, face-to-face semi-structured interviews were held with 12 women residing in rural Jordan, who were initially selected through purposive sampling at primary healthcare centers followed by snowball sampling to reach women in isolated rural areas. Data was audio-recorded, and analyzed using content analysis technique proposed by Hsieh and Shannon.
Results: Three overarching themes were identified, with various subthemes, as follows. (A) “Emotional and psychosocial status” including subthemes of (1) sadness and emotional instability, (2) fear and anxiety, and (3) loss of identity. (B) “Effects on Daily Life” consisting subthemes of (1) disrupted sleep and persistent fatigue, (2) disrupted relationship with partner, and (3) social withdrawal. (C) “Coping and Support” embracing subthemes of (1) support from partner, family and friends, (2) poor understanding by society, (3) professional healthcare support and therapy, (4) spirituality and religion, and (5) stigma and fear of seeking conventional support.
Conclusion: Postpartum depression inflicts negative psychosocial implications among the Jordanian rural women, and despite the available coping mechanisms, such as social support and spirituality, there is still evidence that societal stigma and a lack of understanding often hindered effective help-seeking.
Keywords
Subjects

1.        Zhao XH, Zhang ZH. Risk factors for postpartum depression: An evidence-based systematic review of systematic reviews and meta-analyses. Asian Journal of Psychiatry. 2020; 53: 102353.
2.        Shorey S, Chee CYI, Ng ED, Chan YH, San Tam WW, Chong YS. Prevalence and incidence of postpartum depression among healthy mothers: A systematic review and meta-analysis. Journal of Psychiatric Research. 2018; 104: 235-248.
3.        Wang Z, Liu J, Shuai H, Cai Z, Fu X, Liu Y, et al. Mapping global prevalence of depression among postpartum women. Translational Psychiatry. 2021; 11(1): 543.
4.        Liu X, Wang S, Wang G. Prevalence and risk factors of postpartum depression in women: a systematic review and meta-analysis. Journal of Clinical Nursing. 2022; 31(19-20): 2665-2677.
5.        Shovers SM, Bachman SS, Popek L, Turchi RM. Maternal postpartum depression: risk factors, impacts, and interventions for the NICU and beyond. Current Opinion in Pediatrics. 2021; 33(3): 331-341.
6.        Taybeh E. A focus on postpartum depression among Jordanian mothers. International Journal of Social Psychiatry. 2022; 68(2): 403-410.
7.        Saharoy R, Potdukhe A, Wanjari M, Taksande AB. Postpartum depression and maternal care: exploring the complex effects on mothers and infants. Cureus. 2023; 15(7).
8.        Bornstein MH, Suwalsky JT, Breakstone DA. Emotional relationships between mothers and infants: Knowns, unknowns, and unknown unknowns. Development and Psychopathology. 2012; 24(1): 113-123.
9.        Hardin JS, Jones NA, Mize KD, Platt M. Affectionate touch in the context of breastfeeding and maternal depression influences infant neurodevelopmental and temperamental substrates. Neuropsychobiology. 2021; 80(2): 158-175.
10.    Paddy A, samoah-Gyimah K, Nkyi A. Psychosocial determinants of postpartum depression and maternal well-being among postnatal women. Open Journal of Psychiatry. 2021; 11(3): 138-159.
11.    Holm DM, Wohlfahrt J, Rasmussen ML, Corn G, Melbye M. A quantitative comparison of two measures of postpartum depression. BMC Psychiatry. 2022; 22(1): 202.
12.    Mattar B, Abu-Rmeileh NM, Wahdan Y. Postpartum depression symptoms: prevalence, risk factors, and childbirth experiences in Palestine. BMC Public Health. 2024; 24(1): 1357.
13.    Anokye R, Acheampong E, Budu-Ainooson A, Obeng EI, Akwasi AG. Prevalence of postpartum depression and interventions utilized for its management. Annals of General Psychiatry. 2018; 17(1): 8.
14.    Yoneda K, Hababeh M, Kitamura A, Seita A, Kamiya Y. Prevalence and characteristics of Palestine refugee mothers at risk of postpartum depression in Amman, Jordan: A cross-sectional study. The Lancet. 2021; 398: S28.
15.     Hamadneh S, Hamadneh J, Abdalrahim A, ALBashtawy M, Suliman M, Alolayaan M, et al. Prevalence and Related Factors of Postpartum Depression among Jordanian Mothers with a History of COVID-19 during Pregnancy or After Childbirth in a Developing Country. Iranian Journal of Nursing and Midwifery Research. 2024; 29(2): 263-267.
16.    Kim H, Sefcik JS, Bradway C. Characteristics of qualitative descriptive studies: A systematic review. Research in Nursing and Health. 2017; 40(1): 23-42.
17.    Mezmir EA. Qualitative data analysis: An overview of data reduction, data display and interpretation. Research on Humanities and Social Sciences. 2020; 10 (21): 15–27.
18.     Hsieh HF, Shannon SE. Three approaches to qualitative content analysis. Qualitative Health Research. 2005; 15(9): 1277-1288.
19.    Lincoln YS. Naturalistic inquiry. sage; 1985.
20.    Johnson S, Simon A, Michele M. The lived experience of postpartum depression: A review of the literature. Issues in Mental Health Nursing. 2020; 41(7): 584-591.
21.    Akhtar A, Sullivan P, Alam Y, Locke A. Using hybrid qualitative analysis to explore lived experience of motherhood and postnatal depression: A thematic-dialogical approach. Methods in Psychology. 2024; 11: 100161.
22.    Atuhaire C, Rukundo GZ, Brennaman L, Cumber SN, Nambozi G. Lived experiences of Ugandan women who had recovered from a clinical diagnosis of postpartum depression: A phenomenological study. BMC Pregnancy and Childbirth. 2021; 21(1): 826.
23.    Asadi M, Noroozi M, Alavi M. Identifying women’s needs to adjust to postpartum changes: A qualitative study in Iran. BMC Pregnancy and Childbirth. 2022; 22(1): 115.
24.    Johansson M, Benderix Y, Svensson I. Mothers’ and fathers’ lived experiences of postpartum depression and parental stress after childbirth: a qualitative study. International Journal of Qualitative Studies on Health and Well-being. 2020; 15(1): 1722564.
25.    Asadi M, Noroozi M, Alavi M. Exploring the experiences related to postpartum changes: perspectives of mothers and healthcare providers in Iran. BMC Pregnancy and Childbirth. 2021; 21(1): 7.
26.    Amer SA, Zaitoun NA, Abdelsalam HA, Abbas A, Ramadan MS, Ayal HM, et al. Exploring predictors and prevalence of postpartum depression among mothers: Multinational study. BMC Public Health. 2024; 24(1): 1308.
27.    Malik A. Ignored sufferers: a phenomenological inquiry into the lived experiences of postpartum depression among men. Advances in Mental Health. 2025; 23(1): 21-35.
28.    Holopainen A, Hakulinen T. New parents’ experiences of postpartum depression: A systematic review of qualitative evidence. JBI Evidence Synthesis. 2019; 17(9): 1731-1769.
29.    Elmore Elmore S. Postpartum depression in Jamaica: Exploring the lived experiences. 2023.
30.    Ellis S. African American Maternal Mental Health: Postpartum Depression in African American Mothers (Doctoral dissertation, Adler University).
31.    De Jesus RP, Santos III AD, Tiongaon M. Struggling against internal turmoil: Exploring the lived realities of women who suffered from postpartum depression. Journal of Women’s Healthcare and Midwifery Research SRC/JWHMR-131.  2024; 118: 2-9.
32.    Hanach N, Radwan H, Issa WB, Saqan R, de Vries N. The perceived mental health experiences and needs of postpartum mothers living in the United Arab Emirates: A focus group study. Midwifery. 2024; 132: 103977.
33.    Deep TM, Block SG, Naples FL. Depression, psychiatry & medication management, therapy: In-Person & virtual, trauma. More than the baby blues: Understanding postpartum depression.  2025.
34.    Alshowkan A, Shdaifat E. Factors influencing postpartum depression in Saudi women: A cross-sectional descriptive study. Women’s Health Nursing. 2024; 30(2): 164-173.
35.    Amjad M, Majeed A, Imran K. Experiences of Postpartum Depression in Pakistan: A Phenomenological Study. Research Journal of Psychology. 2025; 3(1): 48-63.
36.    Ladd W. Remembering Postpartum Depression in Later Life: An Interpretative Phenomenological Analysis. Qualitative Report. 2021; 26(4).
37.    Fusar-Poli P, Estrade A, Mathi K, Mabia C, Yanayirah N, Floris V, et al. The lived experience of postpartum depression and psychosis in women: a bottom-up review co-written by experts by experience and academics. World Psychiatry. 2025; 24(1): 32-45.
38.    Dagnaw FT, Addis WD, Tesfa D, Desale AT, Issa NA, Belachew YY, et al. Determinants of postpartum depression among mothers in Debre Tabor town, North-central, Ethiopia: Community-based unmatched case-control study. Frontiers in Global Women’s Health. 2022; 3: 910506.
39.    Maxwell D, Robinson SR, Rogers K. “I keep it to myself”: A qualitative meta‐interpretive synthesis of experiences of postpartum depression among marginalised women. Health and Social Care in the Community. 2019; 27(3): e23-e36.
40.    Tesfaye W, Ashine B, Tezera H, Asefa T.  Postpartum depression and associated factor among mothers attending public health centers of Yeka sub city, Addis Ababa Ethiopia. Heliyon. 2023; 9(11).
41.    Saeed Q, Shafique K, Chaudhry N. Lived experiences of mothers with postnatal anxiety: A qualitative phenomenology study from Pakistan. BMJ Open. 2024; 14(5): e078203.
42.    Maabreh RS, Eyadat AM, Ashour A, Al-Shloul MN, Alhusban RY, Yehia DB, et al. Misconceptions about postpartum depression: A descriptive phenomenological study of Jordanian women’s perceptions. Psychiatry International. 2026; 7(1): 12.