Objective: to investigate immigrant Afghan women's emotional well-being and experiences of postnatal depression after childbirth and their use of health services. Design: telephone interviews were conducted at four months after birth, using a semi-structured questionnaire; and a further in-depth face-to-face interview with a small number of women approximately one year after the birth. Women's emotional health was assessed at four months using the Edinburgh Postnatal Depression Scale (EPDS), as well as women's own descriptions of their emotional well-being since the birth. Setting: women were recruited from four hospital antenatal clinics or postnatal wards in Melbourne, Australia, between October 2006 and May 2007. Participants: Immigrant women who were born in Afghanistan, spoke Dari/Persian or English, and had given birth to a live and healthy baby. Findings: Thirty nine women were interviewed at four months after birth; 41% reported feeling depressed or very unhappy since the birth and 31% scored as probably depressed on the EPDS. Ten women participated in further in-depth face-to-face interviews. Isolation, lack of support and being overwhelmed by life events were the most frequently reported contributing factors to women's emotional distress, and for many being a migrant appeared to intensify their experiences. The themes that emerged from both the telephone and face-to-face interviews revealed that some women were reluctant to discuss their emotional difficulties with health professionals and did not expect that health professionals could necessarily provide assistance. Key conclusions and implications for practice: in this study a significant proportion of immigrant Afghan women experienced emotional distress after childbirth. Women's experiences of emotional distress and help-seeking were at times affected by their status as immigrants and their perceptions of possible causes and treatment for their emotional health problems. Understanding the effects of migration on women's lives and paying careful attention to individual needs and preferences are critically important in providing care for immigrant Afghan women. © 2015 Elsevier Ltd.

Emotional well-being Afghan women Immigrant Help-seeking Health service Postnatal depression

Afghanistan nursing human Victoria ethnology interview Young Adult Humans maternal child health care Interviews as Topic Infant, Newborn female newborn pregnancy Maternal-child Health Services adult midwife Midwifery Depression, Postpartum Healthcare Disparities health care disparity