‘I am happy because I am pregnant, but becoming a mother is not easy,’ the experience of pregnancy, antenatal depression, and perception of yoga in rural pregnant women in Maharashtra, a qualitative study

Abstract

Background

Antenatal depression is a significant public health problem. It is critical to understand the ‘experience’ of pregnancy and the overall socio-cultural context of pregnant women to design and implement interventions to address antenatal depression effectively. The evidence base in this field is predominantly in the form of quantitative cross-sectional studies. There are few qualitative studies from low- and middle-income country settings. This study is part of the formative work related to the development of a yoga-based intervention for antenatal depression in rural women in Maharashtra, India.

Methods

We contacted pregnant women in the antenatal clinic and community centres in the study area and completed 26 In-Depth Interviews (IDIs). Of the total sample, 16 women had depression (EPDS≥10). All IDIs were conducted in Marathi, audio-recorded, transcribed, and then translated into English. We used NVivo 9 (QSR) to store and code the data, and a thematic content analysis approach to analyse and synthesize the findings.

Results

Five main themes emerged from the data: 1) experience of pregnancy (positive as well as negative), 2) coping strategies used by women, 3) support they receive from family members and professional support, 4) gender expectations, and 5) perception of yoga practice during pregnancy.

Discussion

We found that most women experienced positive emotions about pregnancy, and this was even true for women who screened positive for probable depression. Women reported several psychological problems and felt that the physical symptoms they experienced and interpersonal problems affected their psychological well-being. Husbands, in-laws, and parents supported women during pregnancy. Interestingly, neither community health workers nor obstetricians discussed or provided psychological support. Rest, spending time on social media, and talking to family members were common coping strategies used by women. Women were aware of yoga as they had practiced it during school but reported challenges in undertaking yoga practice during pregnancy.