Objective:  The purpose of this study was to examine the prevalence of perinatal depression and the risk factors and related variables impacting the occurrence of depression in a group of diverse, low-income women.  The study contrasted the relationship between sociodemographic variables, depression, self-esteem, self-efficacy, maternal confidence, social support, stress.

Design: A descriptive, correlational design incorporating both qualitative and quantitative research methods.

Setting: A health department in Southeast North Carolina.

Patients/Participants: A convenience sample of sixty low-income mothers participating in the prenatal program at the health department were surveyed during the third trimester of their pregnancy and again between 6-8 weeks following delivery. 

Methods: Focus groups were used to explore perceptions and experiences during the perinatal period.  In addition, participants completed a Demographic Questionnaire, Beck Depression Inventory, Edinburgh Postnatal Depression Scale, Rosenberg Self-Esteem Scale, General Self-Efficacy Scale, Stress Scale, Maternal Confidence Questionnaire, and the Multidimensional Scale of Perceived Social Support.

Results:  The mean age of the participants was 25.4 years, 50.8% had completed some college/college degree, and 26.2% reported past history of depression. Of the sample, the majority were white (52.5%), 27.9% black, and 19.7% Hispanic.  A majority of the participants (60.7%) scored above 10 on the BDI during the 3^rd trimester whereas 44.2% scored above 10 on the BDI at 6-8 weeks postpartum.  Moderate depression was reported by 24.6% of the participants during the 3^rd trimester of pregnancy and 13.4% reported moderate depression at 6-8 weeks postpartum. There were significant positive correlations between the BDI and EPDS at both time periods (r = .582, p = .000 and r = 0.738, p = .000).   There were no significant differences in mean depression scores across ethnic groups for either time period (F = 0.997, p = 0.375; F = 0.051, p = 0.950).  There were significant negative correlations between depression level, self-esteem, and social support; age and general self-efficacy.  There were significant positive correlations between self-esteem, social support and self-efficacy.

Conclusion/Implications for nursing practice: Study results demonstrated that there were not significant differences in depression levels across ethnic groups, however participants overall reported significantly higher depression levels in the 3^rd trimester of pregnancy as compared with 6-8 weeks postpartum.  These findings support the need for heightened assessment and management of depression not only after delivery, but also during pregnancy.  In addition, self-reports of mood changes before pregnancy were significantly related to depression scores during the 3^rd trimester of pregnancy and at 6-8 weeks postpartum.

Keywords:  postpartum depression, self-efficacy, social support