Archives of Women's Mental Health

, Volume 18, Issue 2, pp 177–185 | Cite as

Perinatal distress and depression in Malawi: an exploratory qualitative study of stressors, supports and symptoms

  • Robert C. Stewart
  • Eric Umar
  • Selena Gleadow-Ware
  • Francis Creed
  • Katie Bristow
Original Article


Quantitative studies have demonstrated that depression and anxiety in the perinatal period are common amongst women in low- and middle-income countries and are associated with a range of psychosocial and health-related stressors. In this exploratory qualitative study conducted in southern Malawi, we investigated the thoughts and emotions experienced by women in pregnancy and the postnatal period, their expectations of support from husband and others, problems and difficulties faced and the impact of these on psychological wellbeing. We conducted 11 focus group discussions with a total of 98 parous women. A thematic analysis approach was used. Three major themes were identified: pregnancy as a time of uncertainty, the husband (and others) as support and stressor, and the impact of stressors on mental health. Pregnancy was seen as bringing uncertainty about the survival and wellbeing of both mother and unborn child. Poverty, lack of support, HIV, witchcraft and child illness were identified as causes of worry in the perinatal period. Husbands were expected to provide emotional, financial and practical support, with wider family and friends having a lesser role. Infidelity, abuse and abandonment were seen as key stressors in the perinatal period. Exposure to stressors was understood to lead to altered mental states, the symptoms of which are consistent with the concept of common perinatal mental disorder. This study confirms and expands on evidence from quantitative studies and provides formative data for the development of a psychosocial intervention for common perinatal mental disorder in Malawi.


Qualitative Perinatal Depression Low- and middle-income countries 

Supplementary material

737_2014_431_MOESM1_ESM.docx (94 kb)
ESM 1(DOCX 93 kb)


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Copyright information

© Springer-Verlag Wien 2014

Authors and Affiliations

  • Robert C. Stewart
    • 1
    • 2
  • Eric Umar
    • 3
  • Selena Gleadow-Ware
    • 2
  • Francis Creed
    • 4
  • Katie Bristow
    • 1
  1. 1.Department of Mental Health and Wellbeing, Institute of Psychology, Health and SocietyUniversity of LiverpoolLiverpoolUK
  2. 2.Department of Mental Health, College of MedicineUniversity of MalawiZombaMalawi
  3. 3.Department of Community Health, College of MedicineUniversity of MalawiZombaMalawi
  4. 4.Institute of Brain, Behaviour and Mental HealthUniversity of ManchesterManchesterUK

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