What makes mothers happy and unhappy during pregnancy and postpartum? A qualitative investigation of beliefs from Gamo mothers in Southern Ethiopia

Depression during pregnancy and postpartum has implications for the health and well-being of mothers and infants, yet investigations have largely been limited to high-income countries. In this study, we explore Gamo mothers' perceptions of happiness, unhappiness, and emotional well-being during pregnancy and after birth. We interviewed 42 Gamo mothers of infants living in a rural highland community in Southern Ethiopia. We analyzed interviews to determine shared themes from mothers' descriptions of what brings happiness and unhappiness, and descriptions of what types of help can be provided to mothers experiencing emotional unwellness. Gamo mothers consistently said that resources and maternal/child health contributed to what makes mothers happy and unhappy during pregnancy and postpartum. During pregnancy, mothers' access to specific foods was largely associated with happiness, while limited access to these was associated with unhappiness, as were health issues of the infant and mother. Postpartum happiness was situated around a healthy, uncomplicated delivery and a healthy baby, whereas unhappiness was associated with a lack of resources. This study gives context to mothers' mental health and demonstrates underlying concerns mothers have in resource-limited, high-risk environments. Public health campaigns and local health officials should understand the context of mothers' concerns to address peripartum mental health.