Factors associated with post-natal anxiety among primiparous mothers in Nepal

Background: In Nepal, new mothers are fatigued by childcare responsibilities because of lack of knowledge and preparation for their new role. Knowledge deficit and adherence to traditional health practices place infants at risk. Some cultural practices for the care of newborns may cause tetanus, hypothermia or other life-threatening illnesses. Maternal education, previous experience of newborn care, economic status, relationship problems with husband or mothers-in-law and dissatisfaction with social relations are the variables of interest for this study. Aims: To examine the association between socio-demographic variables and post-natal anxiety among primiparous mothers in Nepal. Design: The study was designed as a correlational study. Setting: A major maternity hospital in Kathmandu, Nepal. Participants: The sample were 216 primiparous mothers who were followed at 5-6 weeks after delivery. Methods: Three instruments were used for data collection: a demographics questionnaire, the Newborn Care Knowledge Questionnaire and the State-Trait Anxiety Inventory for Adults. Results: The mothers' knowledge of newborn care, general educational level and income were inversely related to maternal anxiety, that is, mothers with a lower educational level and socio-economic status demonstrated a higher level of post-natal anxiety. Poor relationships with husbands or mothers-in-law and low social support presented potential for the development of anxiety and depression during post-partum period. Conclusion: Maternal education, socio-economic status and knowledge of newborn care were major factors of post-natal anxiety. On the other hand, women with low income and education, poor relationships with their husbands or mothers-in-law, and insufficient social support are vulnerable to the development of moderate to severe anxiety. Health policy: Policy implications from these results indicate the need for support and funding from the Ministry of Health for education for women at hospitals, which must work together to offer newborn care education during the ante-natal and post-natal periods.