Index IntroductionThe challenges faced by immigrant mothersImpact of postpartum depression on the mother-child bondSupport for immigrant mothersConclusionReferencesIntroductionA population often overlooked and particularly susceptible to postpartum depression is the immigrant and refugee population. It is an important issue both culturally and systemically. There is substantial evidence to suggest that the impact of postpartum depression on mother and child can last a lifetime, affecting the bond between mother and child. The effects of postpartum depression are not limited to what the name suggests. There is substantial evidence to suggest that the impact of postpartum depression on the mother and baby can last a lifetime. Reduced mother-child interactions have been shown to subsequently cause impaired maternal caregiving behaviors (O'Hara & McCabe, 2013). Say no to plagiarism. Get a tailor-made essay on "Why Violent Video Games Shouldn't Be Banned"? Get an original essay Examples include: decreased breastfeeding rates, decreased coordination and interaction with the baby, hostility, and unresponsiveness (O'Hara & McCabe, 2013). There are also a number of implications for the future state of the mother-infant relationship, child behavior, cognitive development, and physical health (O'Hara & McCabe, 2013). This article will focus exclusively on the Surrey, BC area and the large South Asian immigrant population that resides in this area. Specifically, in Surrey, 37% of the immigrant population comes from India, followed by the Philippines (11%) and China (8.4%) (NewToBC, 2018). While postpartum depression is an issue that impacts the lives of many women in the general population, immigrant women face a unique set of sociocultural factors that place them at 1.5-2 times greater risk of developing this mental health problem ( Hassani, Shiri, Vigod, & Dennis, 2015). The Challenges Faced by Immigrant Mothers This essay will explore the context behind postpartum depression in South Asian immigrant populations, the social barriers they face to asking for help (such as language differences), and the deep stigma associated with mental illness. . It will also examine systemic barriers such as socioeconomic status, lack of education, and income and healthcare disparities that contribute to these women's lack of support. This essay will also highlight recommendations to improve health outcomes through culturally competent educational programs and resources and by creating awareness within the community to support the recovery of this population. Postpartum depression is classified under the umbrella of postpartum mood disorders (Perry, Hockenberry, Lowdermilk, & Wilson, 2013). Examples of postpartum mood disorders include postpartum anxiety, obsessive compulsive disorder, and psychosis (Perry et al., 2013). In addition to these mood disorders, women are four times more likely to be admitted to a psychiatric hospital within the first four weeks after giving birth (Perry et al., 2013). While up to 80% of women may experience sadness after the birth of a baby (characterized by mild sadness, tiredness, and unstable mood), postpartum depression is a major depressive disorder that impairs normal functioning (Vliegen, Casalin, & Luyten, 2014 ). . There are numerous risk factors associated with postpartum depression, including: history of depression and anxiety, stressful life events, poor social support, low socioeconomic status, being single, and obstetric complications (O'Hara & McCabe, 2013). THEsymptoms and criteria outlined by the DSM-5 include: depressed mood, change in appetite or weight, fatigue, decreased concentration, sleep disturbances, inappropriate guilt, psychomotor disturbances, or thoughts of self-harm or suicide (DelRosario et al., 2013). ). For the purposes of diagnosis of major depressive disorder, at least five of these symptoms must be present within a two-week period, and depressed mood is one of the five symptoms (DelRosario et al., 2013). To be classified as postpartum depression, these symptoms must be present within four weeks of giving birth (DelRosario et al., 2013). The DSM-5 criteria, however, are limited as they do not consider that depressive symptoms can manifest themselves even after this period of four weeks after giving birth (Brummelte & Galea, 2016). It also does not distinguish between pre- and postnatal onset of depressive symptoms, so the specific consequences of each type of onset cannot be classified (Brummelte & Galea, 2016). The etiology of postpartum depression has been studied based on the dramatic hormonal changes that occur during pregnancy. According to Brummelte & Galea (2016) post-pregnancy hormonal changes “coincide with the increased risk of developing depression during a woman's life” (p. 156). This suggests an intimate link between specific biomarkers (such as ovarian steroid hormones, glucocorticoids, and oxytocin levels) and the risk of developing postpartum depression or other postpartum mood disorders (Brummelte & Galea, 2016). These hypotheses, however, have been strongly contested in the literature. Although all women experience these dramatic hormonal changes, only a subset develops postpartum depression (O'Hara & McCabe, 2013). Furthermore, little evidence has been produced to support that postpartum hormone levels differ significantly between postpartum depressed and nondepressed women (O'Hara & McCabe, 2013). Decreased levels of omega-3 polyunsaturated fatty acids (PUFA) and docosahexaenoic acid (DHA), alterations of the hypothalamic-pituitary axis, thyroid dysfunction and genetic predisposition to environmental factors are other additional areas of research in the field of postpartum depression. (DelRosario et al., 2013). Impact of Postpartum Depression on Mother-Child Bonding On average, 20% of immigrant or refugee women experience postpartum depression in the first year after giving birth (Hassani et al., 2015). Immigrant women often come from lower socioeconomic statuses due to contributing factors such as lower incomes and lower education levels. They also may not have as much social support as Canadian women since they are in a foreign country and may not know many people. According to O'Mahony, Donnelly, Bouchal, & Este, (2012) other problems faced by immigrant women are "stressful migratory experiences, language barriers, marginalization and minority status, lowered socioeconomic status, lack of social support, poor physical health and difficulties adapt to host cultures” (p. 312). For many immigrant and refugee women, there is a profound stigma associated with postpartum depression postpartum depression.Many feel ashamed, feel isolated, discriminated against by their community or family members, or are too scared to connect with medical and social support (O'Mahony et al., 2012). poor understanding of mental illnesses and their symptoms (O'Mahony et al., 2012). Language differences may also hinder immigrant women's ability toaccess resources (Hassani et al., 2015). Creating resources that are available in multiple languages ​​or use plain/plain English are possible strategies. Furthermore, dissemination of educational programs through different media and community events will help address this at-risk population (Bodolai, Celmins, & Viloria-Tan, 2014). It is essential to use culturally competent teaching methods, as well as providing access to affordable or free educational services. resources for immigrant women after giving birth. According to Moller and Burgess, educational brochures can help increase mental health awareness in South Asian women (p. 208, 2016). Community health promotion and education programmesCentres should also be established. The goals of this education plan would be to provide important information and create awareness among immigrant women in Surrey, BC regarding PPD and resources available in the community. Because many South Asian immigrant women may be reluctant to ask questions or express concerns, in-person presentations will be limited to mothers only and not their spouses, partners, or other family members. Postpartum depression should be divided into several categories. The first session should provide an overview of PPD: what it is, what causes it, what the symptoms are and how it is diagnosed. The second part should cover topics to engage women in knowledge and provide them access to resources and tips to help overcome PDD. Many women may feel stigmatized and have a lack of support from family members when dealing with postpartum depression (Hassani et al., 2015). Therefore, special care must be taken to ensure that women understand that their emotions are not something to be ashamed of. For this health education plan, the three different learning areas (affective, cognitive, psychomotor) must be considered (Stoeckel & Miller, 2017). This is so that the health education/promotion provided is the most effective. Sociocultural education theory should also be applied. The following teaching methods should be applied such as power point, brochures, videos, Internet/Youtube videos, brainstorming sessions, round tables and artistic methods etc. to express themselves. In addition to other strategies, postpartum depression screening should be emphasized for immigrant women due to their elevated risk. Screening should be offered in various languages ​​to accommodate the diverse immigrant populations in Surrey, BC. Health workers should also refer migrant women in the prenatal stage for screening. It is important that immigrant women are screened because many may not have the mental health skills to understand that they are suffering from postpartum depression (Hanna, Jarman & Savage, 2004). One possible screening tool that may be implicated is the Edinburgh Postnatal Depression Scale (EPDS). it is a 10-item self-report scale that assesses both mood and emotional states to detect postpartum depression (Hanna et al., 2004). Scores above 10 indicate symptoms of postpartum depression and further testing is needed (Fritz & McGregor, 2013). Using this scale, it provides clinicians with critical data and allows them to refer women for psychiatric evaluation and access to other community services (Hanna, Jarman & Savage, 2004). This screening tool has been used worldwide and has been translated and validated into Punjabi and has been shown to be effective in South Asian populations (Fritz & McGregor, 2013). It is the only culturally appropriate screening toolfor postpartum depression, as other screening tools focus exclusively on Western populations and may not take into account different cultural beliefs (Fritz & McGregor, 2013). For example, the translated EPDS takes into account that Punjabi women may face discrimination after the birth of their child if it is a girl due to the preference for males in Punjabi culture (Fritz & McGregor, 2013). They may also respond better to questions on paper due to fear of talking about their problems out loud and maintaining their privacy (Fritz & McGregor, 2013). This will allow them to respond honestly and the answers will not be based on the expectations others have set for them. Due to the large portion of Surrey's South Asian immigrant population residing from Punjab, this will reduce the cultural and language barriers they face. They may also be more likely to undergo screening if it is developed specifically for their cultural needs because they will be able to understand the context. Support for immigrant mothers Creating a safe environment, in which women feel at ease and will not be judged for their feelings, it is essential to raise awareness on this issue. Immigrant women, in particular, face social isolation and language barriers that put them at high risk of suffering from postpartum depression. Having culturally competent and aware healthcare workers who can meet their individual needs is important to accommodate cultural differences (Bodolai et al., 2014). Specifically, in the South Asian community women prefer to discuss their problems with other women and may be reluctant to involve men (Fritz & McGregor, 2013). Therefore, it is crucial that women (whether as translators or family doctors) are involved in care to ensure a safe space for them. Furthermore, providing women with translators to reduce language disparities will make them feel more comfortable and allow them to express concerns about their health (Bodolai et al., 2014). By applying cultural competence, it will allow healthcare professionals to establish relationships with their patients, improve communication and treatment adherence (Austin & Boyd, 2019). According to Austin & Boyd (2019), people who had negative views about accessing mental health services were less likely to use them. In South Asian cultures experiencing mental illness is considered very shameful. Helping to reduce the stigma or shame that many women experience when struggling with postpartum depression is also a consideration to improve client safety. Health care providers can reduce stigma by being empathetic and addressing patients' concerns, rather than being dismissive of the symptoms women experience after giving birth. Furthermore, this stigma can also be reduced by creating support groups with other immigrant women (Bodolai et al., 2014). This would not only reduce the stigma of postpartum depression, but also reduce social isolation, increase self-esteem, and help relationships between women (Bodolai et al., 2014). Creating initiatives aimed at immigrant women in Surrey, BC can help ensure that adequate resources are provided to both mother and child. In addition to creating these resources, community involvement is also an important consideration. Through community engagement techniques, South Asian women (as well as other stakeholders and community members) can feel more empowered. Empowerment helps improve health outcomes as members of the.0000000000000013