Socio-Demographic characteristics
A total of 308 mothers were included in the study with a response rate was 100%. 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%) were 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 monthly income greater than 2500 Ethiopian Birr. Almost sixty percent of the participant’s religion, 191 (62%) were orthodox Christian followers. Out of the total participants, almost eighty-five percent of study subjects were married (Table 1).
Obstetric and clinical characteristic
From 308 study participants, the majority of respondents 254(82.5%) were multigravida (give birth ≥ 2) and 54(17.5%) were prim gravida (give birth for the first time). Almost 80% of participants had two or more living child during the study period. Regarding abortion, 53(17.2%) were experienced abortion and 39(12.7%) were experienced the death of their child. Forty-eight (15.6%) of 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%) were delivered spontaneously through vagina. 47 (15.3%) respondents were suffered from any diagnosed illness during their last pregnancy and 95(30.8%) study mothers reported their babies were admitted to hospital at least once before (Table 2).
Psychosocial factors
From the total study participants, 62(20.1%) were responded that their close family or relative has died. 60(19.5%) reported there is serious diagnosed illness, Injury or assault happened to their close relative. 59(19.2%) were experienced parent or child death and 42(13.6%) participant 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 month of the study period and also 40 (13%) were hit, slapped, kicked, physically hurt during last pregnancy (Table 3).
Substance use among postpartum women
From the total study subjects 31 (10.1%) state that they had used any substance before pregnancy; out of them the majority were used alcohol; i.e. 21(67.7%). The remaining have used only Khat at least once in a lifetime. Regarding substance used during the last pregnancy 18 (5.8%) respondents have used any kind of substance, and of them all were used alcohol.
Previous psychiatric illness
Of the total study subjects, thirty-one (10.1%) study subjects had known the previous history of psychiatric illness. In addition, 44(14.3%) study respondents had family history of known psychiatric illness and 28(9.1%) were diagnosed with chronic medical illness (DM, HTN).
Social support among postpartum women
Social support status was assessed by using 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. Regarding husband support during pregnancy 175 (56.8%), 111(36) and 22(7.1%) strong, moderate and poor support respectively. 112(36.4%) study participants had no practical support from family member during pregnancy (such as cooking, washing, cleaning or child-rearing), and during puerperium.
Prevalence of postpartum depression and associated factors
Out of the total subjects, 48(15.6%) had a score of EDPS ≥ 13. Hence, the prevalence of postnatal 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 significant level (p <0.05) during Bivariate analysis were added to the multivariate regression model. The model that contained twenty-two independent variables shown to be a significant associated in the bivariate analysis. The result of the multivariate analysis showed that only four variables are statistically significant. Widowed/widower, having hospitalized child, has a close family or relative died, poor social support) were a significant association with postpartum depression.
The result showed that study subjects who were widowed/widower were associated with postpartum depression: having four times higher in odds when compared with those who were married (AOR = 4.17, 95% CI = 1.14, 15.20). In addition, respondents who had poor social support were higher in odds to be depressed than those who had strong social support (AOR = 5.11, 95% CI = 1.00, 26.18). Respondents who had hospitalized child were nearly 3 times more likely to be depressed as compared to the respondents who had hospitalized child (AOR = 3.32, 95%CI = 1.39,7.93). In similar dimension, participants who had close family or relative died in last six month were three times more likely to have postpartum depression than those who had no died close family or relative AOR = 2.92, 95%CI = 1.01,8.50), (Table 4).