Breastfeeding among women employed in Mexico's informal sector: strategies to overcome key barriers.

BACKGROUND: Rates of exclusive breastfeeding fall below recommended levels, particularly among women in paid employment. In Mexico, more than half of women are in informal employment, meaning they lack many of the protections that may support breastfeeding. METHODS: In-depth interviews with 15 key informants representing government agencies (n = 6 organizations), NGOs (n = 4), international organizations (n = 2), and academia (n = 2) in Mexico. Interviews were conducted between March and June 2023. To understand and describe barriers to breastfeeding among informally employed women in Mexico according to key informants and the current and potential policies to address these barriers, we conducted a qualitative thematic analysis. RESULTS: Current policies to promote, protect, and support breastfeeding predominantly apply to all employed women, but respondents expressed concern that they did not provide adequate protection for women in informal employment. Additional themes concerned the need for relevant programs to be institutionalized and coordinated, discussions of breastfeeding as a right, and the legal equivalence (whether true in practice or not) of formal and informal workers. CONCLUSIONS: Women employed in Mexico's informal sector face a dearth of maternity protections. According to key informants, few policies exist to promote, protect, and support breastfeeding among employed women, in general, but the economic vulnerability and challenging working conditions of women in informal employment exacerbates their situation. The lack of access to formal labor protections, such as paid maternity leave, creates a significant barrier to breastfeeding for women in the informal sector. Recommendations include short-term policies to fill gaps in social protection for informally employed women, as well as longer-term solutions such as the development of universal social protection programs and supporting formalization.

It is not a vacation of leisure: The effect of maternity-leave stigma on fertility intentions in China.

In response to the public's puzzle about why maternity leave has unexpectedly failed to improve fertility problem in the Chinese context of a widespread extension of maternity leave, our study concentrates on a prevailing stigmatization phenomenon of maternity leave in the workplace, proposes the construct "maternity-leave stigma", operationalizes it, and examines its probable detrimental effect on working individuals' fertility intentions drawing on conservation of resources theory, self-verification theory, and research on stigma and psychological contract violation. Conceptually, maternity-leave stigma is a kind of workplace stigma that primarily depicts the extent to which working individuals in the reproductive period view maternity leave or the event of taking maternity leave in a biased way. It mainly consists of four subdimensions called cognitive stigma, emotional stigma, moral stigma, and consequence stigma. Based on multiple analyses of the three-stage questionnaire survey data from working individuals of childbearing age in China, Study 1 (N1 = 296, N2 = 340) acquires a 12-item maternity-leave stigma scale with good reliability and validity and Study 2 (N2 = 340) substantiates that, working individuals' maternity-leave stigma tends to directly and indirectly inhibit their fertility intentions and their anticipatory psychological contract violation from organization is the crucial mediator. Moreover, working women are inclined to display a much stronger inhibiting effect of maternity-leave stigma on fertility intentions compared to working men. Our findings therefore resolve the public's puzzle, enrich workplace stigma, deepen the implementation effectiveness research of maternity leave policy, and are of practical implications for building a fertility-friendly society.

Pharmacy faculty expectations of and experiences with parental leave: A cross-sectional exploratory study.

INTRODUCTION: Parental leave policies have the potential to adversely impact faculty well-being and retention if not designed and deployed in a beneficial manner. This exploratory study aims to determine the perceptions of and experiences with parental leave for faculty at pharmacy institutions. METHODS: An exploratory, cross-sectional survey was sent to pharmacy school deans to distribute to faculty. The survey obtained demographic information and asked questions pertaining to parental leave experiences and expectations, including workload coverage and the perceived impact on performance evaluations. Comments regarding ideal parental leave were qualitatively summarized. RESULTS: Fifty-five respondents who had taken parental leave completed the survey, and 51 free text responses were received. A large effect size for the association between academic rank and planned timing of leave and a larger than medium effect size for the association with gender identity was identified. CONCLUSION: The availability, duration, and requirements of parental leave at pharmacy institutions have the potential to negatively impact faculty well-being and retention. This exploratory study provides initial insight into pharmacy faculty's experiences with and expectations of parental leave. Further research is needed to examine this issue on a broader scale and corroborate these findings.

Returning to work after maternity leave: a systematic literature review.

PURPOSE: Working women often experience difficulties associated with balancing family and career, particularly if they choose to have children. This systematic literature review aimed at investigating women's experience in returning to work after maternity leave. METHODS: The review was conducted using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses. The literature search led to the identification of 52 articles, which underwent data extraction and qualitative analysis. RESULTS: Results were organized in 5 categories: (1) Work-life balance; (2) Women's mental and physical health; (3) Job-related wellbeing and working experience; (4) Breastfeeding. Women's both mental and physical health seem connected to a longer maternity leave and a greater coworkers' and supervisors' support. Returning to work seems to constitute one of the most important barriers for exclusive breastfeeding or breastfeeding continuation. A shorter duration of maternity leave, a higher workload and the lack of occupational policies supporting breastfeeding seem to be hindering factors. Partner and family support, and the opportunity for fathers to work under a flextime system after childbirth seem to increase both breastfeeding initiation and duration. Women who continue breastfeeding after returning to work seem to experience more family-to-work conflict and overload. CONCLUSIONS: This paper show that there are still many understudied aspects in exploring women's experience of returning to work after maternity leave. This represents an important gap in the literature, since returning to work represents a particularly critical time in women's personal and occupational life, in which challenges and barriers may arise, potentially affecting their experience in the immediate future and years to come.

Identifying distinct subtypes of mother-to-infant bonding using latent profile analysis in a nationwide Japanese study.

BACKGROUND: Mother-to-infant bonding (MIB) is foundational for nurturing behaviors and an infant's development. Identifying risk factors for difficulties or problems in MIB is vital. However, traditional research often dichotomizes MIB using cutoff thresholds, overlooking its underlying complexities. This research utilizes latent profile analysis (LPA) to discern MIB subtypes in a nationwide Japanese dataset. METHODS: We conducted LPA on data from the Mother-to-Infant Bonding Scale (MIBS), collected from 3,877 postpartum women within one year of childbirth. To empirically validate the derived profiles, we examined their associated risk factors, focusing on sociodemographic, health, and perinatal variables. RESULTS: Four distinct MIB profiles emerged. Profile 1 indicated minimal difficulties, while Profile 4 exhibited severe multifaceted difficulties. Profiles 2 and 3 showed moderate difficulties distinguished by lack of positive affection and presence of negative affection (especially indifference), respectively. Compared to Profile 1, women in Profiles 2-4 had a higher likelihood of postpartum depression and low family support. Each profile also presented unique risk factors: medium family support in Profile 2, maternal working status in Profile 3, and pre-pregnancy underweight status in Profile 4. Notably, both Profiles 3 and 4 were also linked to increased feelings of loneliness since the onset of the COVID-19 pandemic. CONCLUSION: This study represents the first application of LPA to MIB, revealing distinct subtypes and their respective risk profiles. These insights promise to enhance and personalize early interventions for difficulties in MIB, affirming the necessity of acknowledging MIB's heterogeneity.

Transforming Perceptions: The Impact of a Formal Parental Leave Policy on Surgical Trainees.

OBJECTIVE: Surgical trainees who welcome a new child during residency often face challenges related to appropriate parental leave. To address this, we instituted a comprehensive family medical leave policy within our training program and assessed resident perceptions before and after the policy's introduction. We hypothesized that this new formal policy would enhance feelings of support amongst all (not just childbearing) trainees. DESIGN: A web-based survey to gauge resident perceptions on parental leave was distributed to all residents at a single academic general surgery residency at 2 intervals: prior to policy implementation and 1 year after policy implementation. SETTING: The study was conducted at a single institution, academic general surgery residency program. PARTICIPANTS: All general surgery residents at the institution were included (n = 95). RESULTS: About 40 out of 95 (42%) residents participated in the initial survey and 25 of 95 (26%) completed the subsequent survey. There was a significant improvement in resident reported satisfaction with the policy from pre to post: 15% pre to 68% post, p < 0.001, report the policy frequently supported trainees' needs, 20% pre to 88% post, p < 0.001, perceived the policy as fair. Most residents (90.0% pre and 80.0% post) perceived pregnancy as a risk during surgical training. There were no differences in perception of the new policy between residents who were parents and residents who were not parents. CONCLUSIONS: The introduction of a comprehensive family medical leave policy improved all surgical trainees' (including nonparents) perception of policy effectiveness and policy fairness. This is counter to the published perception that parental leave creates a burden on fellow trainees. However, pregnancy remains a stressor for the individual new parent. Surgical programs can develop supportive formal family medical leave policies; it is important to address the inherent systemic and cultural barriers surrounding childrearing during surgical training.

Parental leave and family building experiences among head and neck surgeons in the United States: Career impact and opportunities for improvement.

BACKGROUND: The availability of paid parental leave is an important factor for retention and wellness. The experiences of head and neck surgeons with parental leave have never been reported. METHODS: A survey was electronically distributed to head and neck subspecialty surgeons in the United States. Responses were collected and analyzed. RESULTS: Male surgeons had more children and took significantly less parental leave than women. Thirty percent of respondents reported that parental leave negatively impacted compensation, and 14% reported a delay in promotion due to leave, which impacted women more than men. The vast majority reported they are happy or neutral about covering those on leave. Most respondents utilized paid childcare, and approximately one quarter of respondents spending 11%-20% of their income on childcare. CONCLUSIONS: This study illuminates the current disparities regarding parental leave-taking within the subspecialty of head and neck surgery in the United States. Women surgeons are more likely to be impacted professionally and financially.

ABM Position Statement: Paid Maternity Leave-Importance to Society, Breastfeeding, and Sustainable Development.

Background: Paid maternity leave benefits all of society, reducing infant mortality and providing economic gains. It is endorsed by international treaties. Paid maternity leave is important for breastfeeding, bonding, and recovery from childbirth. Not all mothers have access to adequate paid maternity leave. Key Information: Paid leave helps meet several of the 17 United Nations' Sustainable Development Goals (2, 3, 4, 5, 8, and 10), including fostering economic growth. A family's expenses will rise with the arrival of an infant. Paid leave is often granted with partial pay. Many low-wage workers earn barely enough to meet their needs and are unable to take advantage of paid leave. Undocumented immigrants and self-employed persons, including those engaging in informal work, are often omitted from maternity leave programs. Recommendations: Six months of paid leave at 100% pay, or cash equivalent, should be available to mothers regardless of income, employment, or immigration status. At the very minimum, 18 weeks of fully paid leave should be granted. Partial pay for low-wage workers is insufficient. Leave and work arrangements should be flexible whenever possible. Longer flexible leave for parents of sick and preterm infants is essential. Providing adequate paid leave for partners has multiple benefits. Increasing minimum wages can help more families utilize paid leave. Cash benefits per birth can help informal workers and undocumented mothers afford to take leave. Equitable paid maternity leave must be primarily provided by governments and cannot be accomplished by employers alone.

A call to uncover the availability, structure, and effects of parental leave policies at academic pharmacy institutions.

Parental leave is often an initial barrier to achieving family-career integration, and thus discussing this issue within the broader academic pharmacy community may have important implications for policy development and change. This commentary aims to reveal the implications of inadequate parental leave policies on faculty while highlighting the benefits well-developed policies can have for both parents and their children. Additionally, we put forth a call to action for additional research into the availability and structure of parental leave policies at pharmacy institutions and the effects such policies have on faculty wellbeing, retention, and job satisfaction.

Examining the impact of a change in maternity leave policy in Canada on maternal mental health care visits to the physician.

PURPOSE: Maternity leave is a critical employee benefit that allows mothers to recover from the stress of pregnancy and childbirth and bond with their new baby. We aimed to examine the association between the extension of a maternity leave policy and maternal use of mental health services and prescription drugs in a universal public healthcare system. METHODS: This study uses administrative medical records from 18,000 randomly selected women who gave birth three months before and after an extension of the maternity leave policy. More specifically, mothers who gave birth after January 1st 2001, were entitled to 50 weeks of paid maternity leave, while mothers who gave birth before that date were entitled to only 26 weeks of paid maternity leave. Medical records were analyzed over a seven-year period (i.e., from October 1998 to March 2006). We examined the number and costs of mothers' medical visits for mental health care in the five years following delivery, as well as maternal use of prescribed medication for mental health problems. RESULTS: We found that mothers with extended maternity leave had - 0.12 (95%CI=-0.21; -0.02) fewer medical visits than mothers without a more generous maternity leave and that the cost of mental health services was Can$5 less expensive per women. These differences were found specifically during the extended maternity leave period. CONCLUSIONS: The extra time away from work may help mothers to balance new family dynamics which may result in less demand on the healthcare system.

Successful return to work in anaesthesia after maternity leave: a qualitative study.

Returning to work after maternity leave poses significant challenges, with potential long-term implications including decreased engagement or attrition of clinicians. Many quantitative studies have identified challenges and supports for women during pregnancy, maternity leave and re-entry to clinical practice. This qualitative study explored the experiences of anaesthetists returning to clinical work after maternity leave, to identify influential factors with the aim of providing a framework to assist planning re-entry. We conducted semi-structured interviews with 15 anaesthetists. Attendees of a re-entry programme were invited to participate, with purposive sampling and snowball recruitment to provide diversity of location and training stage, until data saturation was reached at 13 interviews. Five themes were identified: leave duration; planning re-entry; workplace culture; career impact and emotional impact. Leave duration was influenced by concerns about deskilling, but shorter periods of leave had logistical challenges, including fatigue. Most participants started planning to return to work with few or no formal processes in the workplace. Workplace culture, including support for breastfeeding, was identified as valuable, but variable. Participants also experienced negative attitudes on re-entry, including difficulty accessing permanent work, with potential career impacts. Many participants identified changes to professional and personal identity influencing the experience with emotional sequelae. This research describes factors which may be considered to assist clinicians returning to work after maternity leave and identifies challenges, including negative attitudes, which may pose significant barriers to women practising in anaesthesia and may contribute to lack of female leadership in some workplaces.

Maternity Leave Satisfaction Among Physicians Compared with Nonphysician Professionals.

Objective: The objective of this study was to compare maternity leave satisfaction between physicians and nonphysicians. Currently, paid maternal leave is not guaranteed in the United States, resulting in palpable dissatisfaction among parents. Previous studies have shown associations between length of paid leave and career satisfaction and maternal happiness. Materials and Methods: A Qualtrics® electronic survey was distributed to female professionals through email and social media from April 2019 to March 2020. Inclusion criterion was ≥1 child by birth or adoption, or active pregnancy. Continuous and categorical data were analyzed using two-sample t-test and chi-square, respectively. Results: Of 808 respondents, 77% were physicians. Mean age at birth/adoption of first child was higher in physicians versus nonphysicians (32.1 years vs. 29.7 years; p < 0.001). Physicians took shorter maternity leave than nonphysicians (10.9 weeks vs. 12.0 weeks, p = 0.017) with half of that time paid by employers (5.4 weeks vs. 5.9 weeks, p = 0.2). Dissatisfaction was high among physicians (85.1%) and nonphysicians (92.4%) that correlates with maternity leave compensation dissatisfaction (49% vs. 71.3%, p < 0.001). Thirty-four percent of physicians versus 41% of nonphysicians stated that their health was negatively impacted by maternity leave length. Physicians and nonphysicians reported similar incidences of depression, and breastfeeding, delivery, and other postpartum complications. When queried, 38.8% of physicians and 57% of nonphysicians said they would desire >16 weeks of paid maternity leave (p < 0.001). Conclusions: In conclusion, dissatisfaction among professional women on maternity leave duration and compensation is high in the United States. Given health implications for both mother and child, this should invite further discussion and changes.

Maternity protection policies and the enabling environment for breastfeeding in the Philippines: a qualitative study.

BACKGROUND: The Philippines has enacted maternity protection policies, such as the 105-Day Expanded Maternity Leave Law and the Expanded Breastfeeding Promotion Act of 2009, to protect, promote, and support breastfeeding. This study aimed to review the content and implementation of maternity protection policies in the Philippines and assess their role in enabling recommended breastfeeding practices. It also identified bottlenecks to successful implementation from the perspectives of mothers and their partners, employers, and authorities from the government and non-government organizations involved in developing, implementing, monitoring, and enforcing maternity protection policies. METHODS: This study employed a desk review of policies, guidelines, and related documents on maternity protection, and in-depth interviews. Of the 87 in-depth interviews, there were 12 employed pregnant women, 29 mothers of infants, 15 partners of the mothers, 12 employers and 19 key informants from the government and non-government organizations. Respondents for the in-depth interviews were from the Greater Manila Area and were recruited using purposive snowball sampling. Data were collected from December 2020 to April 2021. RESULTS: The study shows that maternity protection policies in the Philippines are mostly aligned with the maternity protection standards set by the International Labour Organization. However, their role in improving breastfeeding practices is limited because: (1) not all working women have access to maternity protection entitlements; (2) the duration of maternity leave entitlements is inconsistent with the World Health Organization's recommended duration of exclusive breastfeeding; (3) there are gaps in policy implementation including: a lack of monitoring systems to measure the availability, functionality, and usage of lactation spaces; limited workplace support for breastfeeding; poor communication of maternity and paternity entitlements; and limited breastfeeding advocacy and promotion; and (4) there is limited integration between maternity protection and breastfeeding promotion interventions. CONCLUSIONS: There is a need to (1) strengthen communication about and promotion of maternity and paternity entitlements for mothers, fathers and employers, (2) improve monitoring and enforcement mechanisms to ensure utilization of entitlements among mothers, (3) develop modalities to extend the coverage of maternity entitlements to the informal sector, (4) fully cover paid leave entitlements from social insurance or public funding sources in line with International Labour Organization recommendations, and (5) revisit the limitations on the coverage of paternity entitlement.

Breastfeeding and infant care as 'sexed' care work: reconsideration of the three Rs to enable women's rights, economic empowerment, nutrition and health.

Women's lifelong health and nutrition status is intricately related to their reproductive history, including the number and spacing of their pregnancies and births, and for how long and how intensively they breastfeed their children. In turn, women's reproductive biology is closely linked to their social roles and situation, including regarding economic disadvantage and disproportionate unpaid work. Recognizing, as well as reducing and redistributing women's care and domestic work (known as the 'Three Rs'), is an established framework for addressing women's inequitable unpaid care work. However, the care work of breastfeeding presents a dilemma, and is even a divisive issue, for advocates of women's empowerment, because reducing breastfeeding and replacing it with commercial milk formula risks harming women's and children's health. It is therefore necessary for the interaction between women's reproductive biology and infant care role to be recognized in order to support women's human rights and enable governments to implement economic, employment and other policies to empower women. In this paper, we argue that breastfeeding-like childbirth-is reproductive work that should not be reduced and cannot sensibly be directly redistributed to fathers or others. Rather, we contend that the Three Rs agenda should be reconceptualized to isolate breastfeeding as 'sexed' care work that should be supported rather than reduced with action taken to avoid undermining breastfeeding. This means that initiatives toward gender equality should be assessed against their impact on women's ability to breastfeed. With this reconceptualization, adjustments are also needed to key global economic institutions and national statistical systems to appropriately recognize the value of this work. Additional structural supports such as maternity protection and childcare are needed to ensure that childbearing and breastfeeding do not disadvantage women amidst efforts to reduce gender pay gaps and gender economic inequality. Distinct policy interventions are also required to facilitate fathers' engagement in enabling and supporting breastfeeding through sharing the other unpaid care work associated with parents' time-consuming care responsibilities, for both infants and young children and related household work.

Facilitating transition from maternity leave to work for working mothers: A self-efficacy intervention study.

The return from maternity leave to work is a critical career transition period for working mothers. To help their readaptation to work, we developed and examined a training program for cultivating their work-family balance self-efficacy in a pretest-posttest design and investigated the time-lagged effect of the boosted self-efficacy on their employment attitude and in-role performance after they returned to work. Data were collected from 100 maternity leave takers from 16 companies in Japan before the training (Time 1), immediately after it (Time 2) and 6 months after returning to work (Time 3), and from their supervisors at Time 3. We found that maternity leave takers displayed an increase in work-life balance self-efficacy after the training. We also found that work-life balance self-efficacy after the training (Time 2) predicted the participants' in-role performance (Time 3) reported by their supervisors, but not employment attitude reported by the participants (Time 3). Our study thus offers preliminary evidence supporting the effectiveness of the training program in helping maternity leave takers' readaptation to work, potentially supplementing existing family-friendly policies.

Paid family leave and parental investments in infant health: Evidence from California.

This paper evaluates the effect of Paid Family Leave (PFL) on breastfeeding and immunizations- two critical parental investments in infant health - which we identify using California's 2004 PFL policy that ensured mothers up to six weeks of leave at a 55% wage replacement rate. We employ difference-in-difference and difference-in-difference-in-differences models for a large, representative sample of children (N = 314,532) born between 2000 and 2013 drawn from the restricted-use versions of the 2003-2014 National Immunization Surveys. Our most conservative estimates indicate that access to PFL is associated with at least a 15% increase in breastfeeding exclusively for at least six months. We find substantially large effects for disadvantaged mothers, adding to the existing evidence that access to state-sanctioned paid family leave might benefit children overall and disadvantaged children in particular.

The Importance of Parental Leave and Lactation Support for Surgeons.

Despite the growing population of surgeons who will spend the bulk of their potential childbearing years in medical school, training, or early in practice, the stigma associated with pregnancy remains. The challenges of childbearing for surgeons also extend to the pregnancy experience from a health perspective including increased rates of infertility, miscarriage, and preterm labor. Given the unique demands of a surgical practice, surgeons may experience pressure to minimize the disruption of their work during and after pregnancy. This may include attempts at carrying a full workload until the day of delivery, reducing the length of planned parental leave, and not requesting accommodations for time to express milk. Concern for discrimination, clinical productivity expectations, and promotion timelines can limit a surgeon's ability to receive pregnancy-related support and adequate parental leave. Though not all surgeons will choose to pursue pregnancy, we must still acknowledge the need to support these individuals. Furthermore, this support should not be limited to the pregnancy alone but include postpartum support including that related to family leave and lactation. Here, we provide an overview of just some of the challenges faced by surgeons in the pursuit of parenthood and present the arguments for accommodations related to pregnancy, parental leave, and lactation.

[What female surgeons wish for!] / Was Chirurginnen sich wünschen!

BACKGROUND: Surgical specialties have a recruitment problem. A magnification of the problem is often seen in the "feminization" of medicine but the causes are multifactorial. Female physicians of the association "Die Chirurginnen e. V." want to raise enthusiasm for their profession and strengthen the affinity for a surgical specialty by increasing the visibility and networking of female surgeons. The aim of this article is to present the results of a survey among female surgeons and to discuss them in the focus of the current shortage of personnel. METHODOLOGY: An anonymized online survey was conducted internally within the association ("Die Chirurginnen e. V.") in October 2022. The survey contained a total of 57 questions and was divided into 7 sections (demographic data, questions about wishes in professional life, private life, social life, towards professional associations, politics and the association). Descriptive statistics were used for the analysis. RESULTS: A total of 358 female surgeons participated in the survey. This represented a response rate of 25.5% of association members (as of October 2022: n = 1406). The mean age was 39.25 years (±8.06 years; range 25-65 years), 37% (n = 133) were in the specialty of orthopedic and trauma surgery and 26% (n = 93) were in the specialty of visceral surgery. The remainder were distributed across a variety of different surgical specialties. The desire for change was preferentially in the area of continuing surgical education, the implementation of working time models, and the organization of the personal workday (operating room time, administrative tasks, time for patients, bureaucracy). DISCUSSION: Motivated and dedicated surgeons are needed to counteract the already existing and increasingly severe shortage of manpower. In recent decades, the proportion of female students and physicians has been increasing, so the needs for recruitment must be increasingly considered. The disparity between men and women at the management level must be gradually resolved. In addition, alternative working models for both genders need to be established in daily practice. By providing a good compatibility of family/private life and career, surgery can remain an attractive profession for future generations.

Association between maternity leave policies and postpartum depression: a systematic review.

PURPOSE: Working mothers are at greater risk for postpartum depression. Maternity leave characteristics, including length, wage replacement and employment protection, could have relevant implications for mothers' mental health. We propose to explore whether there is an association between maternity leave characteristics and postpartum depression. METHODS: We conducted a systematic review searching for randomized controlled trials, quasi-experimental, cohort or cross-sectional studies on five databases using search terms including maternity and parental leave and depression, as well as references in relevant articles. We identified 500 articles and included 23 of those. We used the EPHPP Quality Assessment Tool for Quantitative Studies to assess the quality of the studies. RESULTS: Paid and longer maternity leaves tend to be associated with a reduction of postpartum depression symptoms in high-income countries. No studies explored the association between employment protection and postpartum depression. The quality of studies ranged from strong to weak, mostly influenced by study design. CONCLUSION: More restrictive maternity leave policies tend to be associated with higher rates of postpartum depression, although more research needs to be conducted in the Global South.