School of Nursing, College of Medicine, National Taiwan University, Taipei, Taiwan.
Department of Nursing, National Taiwan University Hospital, Taipei, Taiwan.
PLoS One. 2020 Apr 8;15(4):e0231340. doi: 10.1371/journal.pone.0231340. eCollection 2020.
Women's participation in decision-making in the household is an indicator of women's empowerment. Few studies have compared domestic decision-making power and its effect on postpartum health between immigrant and native-born women. This study aimed to examine the effect of domestic decision-making power and social support during pregnancy on predicting postpartum depressive and physical symptoms among immigrant and native-born mothers in Taiwan.
This prospective study recruited 177 marriage-based immigrant mothers and 230 native-born women who were at least twelve weeks pregnant from hospitals, clinics and health centers. Data were collected in the 2nd or 3rd trimester of pregnancy and at 3 months postpartum from March 2013 to March 2015. Postpartum depression and the severity of postpartum physical symptoms were measured using the Edinburgh Postnatal Depression Scale, and a 17-item, 4-point Likert scale, respectively. Linear regression was used to examine the relationship between "domestic decision-making power and social support during pregnancy" and "depressive and physical symptoms at 3 months postpartum." Women who had lower domestic decision-making power and social support during pregnancy had higher postpartum depressive and physical symptoms. Those women with full-time employment and insufficient family income had higher postpartum depressive symptoms. Though immigrant women scored lower in domestic decision-making power and social support than native-born women, they had lower mean scores in postpartum depressive and physical symptoms. After accounting for the abovementioned factors, immigrant women remained at lower risk for postpartum depressive and physical symptoms than native-born women. There was significant interaction between domestic decision-making power and immigrant status, suggesting that the association between domestic decision-making and postpartum depressive and physical symptoms was smaller for immigrants than for native women.
Domestic decision-making power and social support during pregnancy are protective predictors of postpartum depressive and physical symptoms. However, the effect of domestic decision-making power appeared to be less salient for immigrants, probably due to the "healthy immigrant effect" and/or lower expectations toward domestic decision-making power among immigrants. The finding that immigrant women demonstrated a lower level of domestic decision-making power suggests that empowerment issues need to be addressed among immigrants.
女性在家庭中的决策权是衡量其赋权程度的一个指标。很少有研究比较移民和本地出生女性的家庭决策权及其对产后健康的影响。本研究旨在探讨怀孕期间的家庭决策权和社会支持对预测台湾移民和本地出生母亲产后抑郁和身体症状的影响。
这项前瞻性研究招募了 177 名基于婚姻的移民母亲和 230 名至少怀孕 12 周的本地出生妇女，她们来自医院、诊所和保健中心。数据于 2013 年 3 月至 2015 年 3 月期间在怀孕第 2 或第 3 个三个月和产后 3 个月收集。产后抑郁和产后身体症状的严重程度分别采用爱丁堡产后抑郁量表和 17 项 4 点 Likert 量表进行测量。线性回归用于检验“怀孕期间的家庭决策权和社会支持”与“产后 3 个月的抑郁和身体症状”之间的关系。怀孕期间家庭决策权和社会支持较低的女性产后抑郁和身体症状较重。那些有全职工作和家庭收入不足的女性产后抑郁症状较重。尽管移民女性在家庭决策方面的得分和社会支持低于本地出生女性，但她们的产后抑郁和身体症状平均得分较低。在考虑到上述因素后，移民女性产后抑郁和身体症状的风险仍低于本地出生女性。家庭决策和移民身份之间存在显著的交互作用，这表明家庭决策与产后抑郁和身体症状之间的关联对移民来说较小。
怀孕期间的家庭决策权和社会支持是产后抑郁和身体症状的保护预测因素。然而，家庭决策的影响对移民来说似乎不那么明显，这可能是由于“健康移民效应”和/或移民对家庭决策权的期望较低。移民女性表现出较低的家庭决策权表明需要解决移民的赋权问题。
