Beyond the clinical threshold: unseen struggles of Chinese primiparas in postpartum transition——A phenomenological exploration

Background: Postpartum distress is more prevalent than postpartum depression (PPD) and poses a significant risk for the development of depressive symptoms in women. However, existing research has predominantly focused on universal depressive symptoms while overlooking potential mental health risk factors within specific cultural contexts. This study aims to explore the barriers and associated distress experienced by primiparas during their first postpartum year and to identify potential risk factors influencing their mental health within the context of Chinese culture. Methods: A descriptive phenomenological study design was used. Semi-structured interviews were conducted with 25 primiparas within one year of delivery during July and September 2022. Each conversation lasted between 32-56 min. Colaizzi’s seven-step phenomenological approach was utilized for data analysis. Findings: Six themes were identified, including (a) body weakness, pain, and sleep deprivation are highly prevalent during the "yue zi" period;(b) struggling with considerable effort, sacrifice, and obstacles in breastfeeding;(c) helplessness in childcare due to insufficient or unreliable social support; (d) confusion and difficulty in accessing scientific maternal and child health knowledge; (e) frustrating and increasing family conflicts centered on mother and mother-in-law relations; and (f) sticking to work or not can bring significant entanglement to primiparas. Conclusion: The findings of this descriptive phenomenological study show that primiparas face significant barriers and distress during the first-month confinement, a critical period for physical and mental recovery influenced by Chinese culture. Adequate professional and informational support, along with appropriate family support, especially from mothers-in-law is essential to alleviate stress. Interventions targeting multiple family members to improve relationship quality and enhance support are crucial for developing practical and effective interventions.