Socio-demographic characteristics of postpartum mothers
A total of 308 mothers were included in the study, which was a 100% response rate. Among the study subjects, two hundred eighty-six (86%) were aged 25-45 years and almost 85% were married. The majority of the participants, 206(66.9%) had attended formal (modern) education. Regarding ethnicity, the majority of the study participants, 234(76%) were Amhara and 62(20.1%) were Oromo. Two hundred sixty-eight (87%) of the participants earn a monthly income greater than 2500 Ethiopian Birr. Almost sixty percent of the participant's religion, 191(62%) were orthodox Christian followers (Table 1).
Obstetric and clinical characteristic of postpartum mothers
From 308 study participants, the majority of respondents 254(82.5%) were multigravida (give birth > 1) and 54(17.5%) were primigravida (having a first child). Almost 80% of participants had two or more living children during the study period. Regarding termination of pregnancy, 53(17.2%) had experienced termination and 39(12.7%) had experienced the death of their child. Forty-eight (15.6%) participants reported that the recent pregnancy was unplanned. Moreover, the sex of the last baby 189(61.4%) were male and the rest were female. Regarding the desired sex of the last baby, 36(11.7%) of the respondents said that the sex of their infant was unwanted gender. Nearly 62% of participants, 190(61.7%) mode of delivery was a spontaneous vaginal delivery. Forty-seven, 47(15.3%) respondents had suffered from any diagnosed illness during their last pregnancy and 95(30.8%) study mothers reported their babies were admitted to the hospital at least once before (table 2).
Psychosocial factors (in last 6 months) of postpartum mothers
From the total study participants, 62(20.1%) responded that their family or a close relative had died. Almost one fifth (19.5%), participants reported that there was a serious illness, injury or assault during the recent pregnancy. Almost sixty, 59(19.2%) study participants had experienced parent or child death and 42(13.6%) participants reported that they were separated due to marital difficulty. In addition, 41(13.7%) study participants were unemployed / not been able to work in the last six months of the study period. Moreover, 40(13%) reported physical violence during the last pregnancy (table 3).
Substance use among postpartum mothers
Overall, 31(10.1%) of study participants reported the use of any substance before pregnancy and of these the majority of use was alcohol-related; i.e. 21(67.7%). The remaining used only Khat at least once in a lifetime. Regarding substance used during the last pregnancy, 18(5.8%) respondents used any kind of substance, and all of them used alcohol.
History of known illness among postpartum mothers
Of the total study participants, 31(10.1%) had a known history of mental illness. In addition, 44(14.3%) study respondents had a family history of known mental illness and 28(9.1%) had diagnosed diabetes mellitus and hypertension.
Social support among postpartum mothers
Social support status was assessed by using the Oslo-3 social support scale. From the total study participants, the majority 137(44.5%) had moderate social support, 114(37%) had poor social support and the rest had strong social support. During pregnancy, 175(56.8%), 111(36%), and 22(7.1%) had strong, moderate, and poor husband support respectively. Thirty-six percent, 112(36.4%) study participants had no practical support from a family member during pregnancy (such as cooking, washing, cleaning or child-rearing), and during puerperium.
Prevalence of postpartum depression and its associated factors
According to the Edinburgh Postnatal Depression Scale (EDPS), study participants who scored ≥ 13 are considered as having postpartum depression. Hence, the prevalence of postpartum depression among mothers who have postnatal care follow up was 15.6% [95% CI=11.7, 19.8].
Binary logistic regression was performed to assess the association of each independent variable with the outcome variable (postpartum depression). The variables that showed a significance level (p <0.05) during bivariate analysis were added to the multivariate regression model. Twenty-two independent variables were shown to be significantly associated during the bivariate analysis. The result of the multivariate analysis showed that only four variables were statistically significant. Being widowed/widower, having a hospitalized child, having died family or close relative, having poor social support showed a significant association with postpartum depression.
The results showed that women who were widowed/widower had an association with postpartum depression; having four times more likely to experience postpartum depression than those who were married [AOR=4.17, 95% CI=1.14, 15.20]. In addition, respondents who had poor social support were five times more likely to be depressed than those who had strong social support [AOR=5.11, 95% CI= 1.00, 26.18]. Respondents who had currently hospitalized children were nearly 3 times more likely to be depressed as compared to respondents who had a hospitalized child [AOR=3.32, 95%CI= 1.39,7.93]. In a similar dimension, participants who had experienced a death of a family member or close relative in the last six months were three times more likely to be depressed than those who did not experience this [AOR=2.92, 95%CI=1.01,8.50], (table 4).