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Abstract
To deliver the level of care infants need for survival, the Homo genus evolved to engage in cooperative breeding. In fact, a large cross-cultural review found that most cultures have a set of structured postpartum practices to protect women and infants during the immediate postpartum - all requiring social support. Cooperative breeding researchers have focused on non-maternal support to older offspring and on infant outcomes, without regard for the vulnerable immediate postpartum or the reciprocal mother-infant impact. Considering the well-being of the infant without consideration for that of the mother, or vice versa, limits understanding of this integrated system. By including maternal mental health in the immediate postpartum, my project served to advance the cooperative breeding model, thereby providing a conceptual framework to further understand the development of postpartum depression. Finally, cooperative breeding models have examined social support primarily in terms of its presence or absence overlooking the fact that practices vary locally and recipients will thus expect and value different forms of support.
Postpartum depression afflicts approximately 13% of women globally, with exceptionally high rates in Latin America. While it often resolves with only minor impact on subsequent quality of life, it does not always do so. In addition to creating serious mental health consequences for mothers, postpartum depression can result in serious and sometimes fatal results for infants. Despite our species' expectation of postpartum social support, very few studies have examined the relationship between mental health and postpartum practices, and among the few that have, there are methodological limitations that I addressed in this dissertation.
My study objectives were: (1) describe the local cultural model of postpartum social support in Coatepec, Veracruz, Mexico; (2) determine the congruence of women's postpartum experiences with their cultural expectations; and (3) determine if there is a relationship between the degree of congruence and maternal depressive symptoms. I hypothesized that mothers whose postpartum experience was more closely aligned with their cultural expectations would experience fewer postpartum depressive symptoms than those whose experience was less aligned with expectations.
Eighteen local women were interviewed to detail their postpartum practice, the cuarentena. Forty-eight additional women were interviewed during their third trimester, and approximately 40 days postpartum. The prenatal interview gathered demographics and baseline depression. The postpartum interview assessed depression, congruence of received with expected support, infant health, and birth experiences. Onset of COVID-19 allowed post hoc assessment of its impact on maternal mental health and cuarentena adherence.
In Coatepec, the cuarentena is highly valued, widely practiced, and requires social support. Practice of the cuarentena made women feel comforted and good. There was no statistically significant association between adherence and depressive symptoms, yet postpartum depressive scores were higher for women who practiced the cuarentena ?a little? compared to those who practiced "a lot." Despite the pandemic, most followed the cuarentena with only minor modifications. The modification with the most salient impact was limiting visitors to adhere to public health recommendations. Maternal mood was reportedly negatively affected when women received fewer visitors than they would normally during the cuarentena.
