Misconceptions About Postpartum Depression: A Descriptive Phenomenological Study of Jordanian Women’s Perceptions

Abstract

Background/aim: Despite the fact that qualitative research on postpartum depression (PPD) has been extensively researched globally, women’s perceptions of PPD misconceptions are mostly ignored in developing countries like Jordan. Thus, this study aims to explore Jordanian women’s sociocultural perceptions and misconceptions about PPD using the descriptive phenomenological design. Methods: Fourteen women who had either a normal or caesarean (C-section) delivery and resided in Irbid, Northern Jordan, participated in semi-structured in-depth interviews, which lasted 15 to 25 min in May 2025. Data were gathered via field note transcriptions of interviews, and analysis followed Colaizzi’s data analysis methodology. Results: Among participants, five women (all C-section deliveries) reported a PPD diagnosis, while the remaining normal delivery women reported experiencing depression before giving birth. The women’s sociocultural perceptions and misconceptions about PPD were found to be reflected in a number of themes. The theme “perceiving PPD as normal baby blues” captures the general lack of awareness regarding this disorder. Three important themes—“myths”, “psychological”, and “spiritual and religious failure”—show how little is known about the causes. The two primary themes that are impacted by sociocultural perspectives are “stigma” and “mistrust of professional care services”. The accuracy and misconceptions around this disorder are summed up in four basic themes: “emotional misconceptions”, “cultural misconceptions”, “false beliefs about health”, and “think of PPD as indolence”. Conclusions: Jordanian women have limited understanding and misconceptions of PPD. Adopting culturally relevant awareness campaigns is essential to disseminating the knowledge required to facilitate improved treatment pathways.

1. Introduction

Postpartum depression (PPD) is a psychiatric condition affects 17% to 22% of women in the first year after giving birth [1,2]. PPD prevalence varies significantly by country, with middle-and low-income countries having greater prevalence rates than others [1,3,4,5]. PPD has a significant prevalence in the Middle East (27%), and its etiology includes poor financial standing, pregnancy-related challenges, low educational attainment, unplanned pregnancies, housewives, a lack of family social support, and formula feeding [6]. Studies on the prevalence of PPD in Jordanian women have shown that a considerable proportion (22–86%) are at a higher risk of developing the condition. Marital conflict, a difficult relationship with the mother-in-law, giving birth to a female baby, unplanned pregnancies, a lack of social support, perceived lack of parenting knowledge, time since the last delivery, insomnia, anxiety about motherhood, financial stress, dissatisfaction with overall care, and smoking were all identified as risk factors for PPD [7,8,9,10,11,12,13].

The etiology of PPD has been explained by a number of hypotheses, including hereditary predisposition and neurological pathogenesis involving hormonal fluctuations and inflammatory processes [14,15]. PPD has detrimental impacts on mothers’ psychological health, quality of life, and connection with their kids, partner, and family, as well as on children’s emotional, cognitive, and social development [16,17]. PPD screening ought to be a routine part of prenatal and postpartum care, with tools like the Beck Depression Inventory, the PPD Screening Scale, and the Edinburgh PPD Scale being used to identify women who may be at risk [18,19,20]. Treatment usually involves social support, cognitive behavioural therapy, interpersonal psychotherapy, and medication (such as antidepressants) [17,18,19,20]. In addition to ensuring that PPD is treated using psychotherapeutic and pharmacological approaches, consideration should be given to the safety and well-being of mothers and infants [16].

PPD is characterized by an abrupt onset, intense loneliness and sadness that are frequently experienced in silence, an inability to experience positive emotions, grief over the loss of oneself, feelings of being a bad mother, difficulty focusing, inability to control one’s thoughts, insecurity, and death-related thoughts [21]. The postpartum phase receives less attention from medical professionals compared to the gestation and delivery phases [22]. Lack of attention from medical professionals can have a significant impact on women’s perceptions of PPD, thereby causing misconceptions and reducing their desire to get treatment. This may result from a lack of understanding of PPD symptoms, insufficient time for psychological support, and poor education [23,24].

Misconceptions can lead to stigma, which discourages women with PPD from seeking therapy or assistance [17,25,26]. Due to cultural taboos, fear of being judged, and society’s views on parenting, women are reluctant to reveal symptoms and seek the help they need [25,26]. Therefore, it is critical to dispel and investigate myths regarding PPD in order to raise knowledge and understanding and enable women to seek therapy without feeling ashamed [17]. By doing this, they can get the help they need before the symptoms get worse.

The descriptive phenomenological approach, which is based on the theory of Edmund Husserl, aims to understand each person’s unique and subjective experiences. The validity of the data is emphasized because it is founded on first-hand reports of the experiences of the participants. This method values participants as experts in their lived experiences, enabling a comprehensive analysis of the subtleties of the human experience [27]. This method can also be helpful in understanding how patients perceive health and healthcare [28].

Many qualitative studies have been conducted on the lived experiences of women who are suffering from PPD. The three primary themes among these women were feeling misunderstood when they sought professional assistance, the fact that their symptoms did not align with their partner’s prevalent conception of PPD, and the disparities in parenting approaches or ways of thinking between generations [29]. Women reported feeling helpless over their own lives due to low resilience, conflicting emotions toward their family, unequal support from healthcare providers compared to their own needs, and a sense of helplessness and hopelessness brought on by their newfound motherhood and financial concerns [30].

Though several studies have emphasized the need to explore the lived experiences of women with PPD [29,30], cultural attitudes and misconceptions have made managing the disorder even more difficult. Healthcare sectors in Jordan have embraced the maternal health campaign [31], although postpartum disorders like PPD are not well understood. Studies in Jordan have mostly focused on investigating the risk factors and prevalence rates of PPD rather than figuring out how women view the disorder [7,8,9,10,11,12,13]. The dearth of these studies results in a knowledge gap that makes it more difficult to identify culturally relevant interventions that work for women with PPD. Thus, this study explored sociocultural perceptions and misconceptions about PPD (not clinical experiences per se) among women in Irbid, Jordan, using a descriptive phenomenological design.

2. Materials and Methods

2.1. Study Design

This qualitative study employed a descriptive phenomenological approach. Husserl’s eidetic idea served as the foundation for descriptive phenomenology, which seeks to investigate and characterize authentic occurrences. In order for experience to occur, Husserl had to comprehend the basis of knowledge from which everything originates [32]. The phenomenological method is suitable because it allows for a thorough examination and study of the nuances of the human experience [27], and may help to clarify how patients view healthcare and health [28,32]. The consolidated standards for reporting qualitative research (COREQ) were followed in the preparation of the study methodology (

Table 1. Summary of qualitative research reporting (COREQ).

Research Team and Reflexivity
Features	Questions	Descriptions
Interviewer	Which author(s) led the focus group or the interview?	First author
Qualifications	What qualifications did the authors have? (Ph.D., MD, etc.)	All authors hold PhDs, with the exception of one who holds a master’s degree
Employment	At the time of the study, what was their occupation?	First author: Dr. Associate Professor Psychiatric Nursing Second author: Dr. Assistant Professor, Community Health Nursing Third author: Dr. Assistant Professor, Occupational and Community Health and Safety Fourth author: Dr. Associate Professor, Nursing Paramedics Fifth author: Dr. Associate Professor, Adult Health Nursing Sixth author: Dr. Associate Professor, Maternity and Newborn Nursing Seventh author: Dr. Assistant Professor, Community Women’s Health Eighth author: M.Sc., Practitioner Nurse Ninth author: Dr. Researcher, Public Health
Gender	Which gender were the authors?	First, second, fifth, sixth, seventh, and eighth authors: Female Third, fourth and ninth authors: Male
Experience	What experiences do the authors have?	Detailed information is given in Section 2.2
Status of relationships	Did the authors and women have a relationship prior to the study’s conduct?	No relationship
Details of the interviewee regarding the interviewer	What details, such as the author’s objectives and motivations for doing the research, were known to the women?	Women were aware that the first two authors who involved in data collection held doctorates in nursing
Features of the interviewee	What traits were mentioned about the interviewer? (For instance, research interests, bias, presumptions, and motivations)	The objectives of the study were explained to women at the start of interview
Study design and methods
Theory and methodological orientation	Which methodological approach—discourse analysis, ethnography, phenomenology, and content analysis, for example—was chosen to support the study?	Phenomenology approach
Sampling	How were the women chosen? (e.g., snowball, sequential, convenient, deliberate)	Detailed information is given in Section 2.3
Approach technique	How were the women contacted? (For instance, in person, over the phone, or by letter)	In person
Sample size	How many women took part in the study?	14 women
Exclusion	How many women dropped out or refused to participate? Why?	No woman declined to take part
The environment in which data is collected	In what location were the data gathered? (for instance, at home, a clinic, or the office)	Private room
Non-participants’ presence	Were the women and the authors the only ones present?	Yes
The sample’s description	Which features of the sample are most significant? (For instance, date, demographic data)	Detailed information is given in Section 2.3
Interview guide	Did the authors include questions, prompts, and guidelines? Did a pilot study test them?	The first author provided all guidelines to participants. The interview was not pilot tested
Repeat interviews	Were interviews done more than once? If so, how many?	No
Audio/visual recording	Was data collection in the study done by visual or auditory recording?	Notes only
Field notes	During and/or following the focus group or interview, were field notes taken?	Yes
Duration of interview	How long did the focus groups or interviews last?	15 to 25 min
Data saturation	Was the topic of data saturation discussed?	Yes
Transcripts returned	Did participants receive their transcripts back for revisions or comments?	No
Data analysis and results
Number of data coders Description of the coding tree	How many authors worked as data coders? Did authors provide a description of the coding tree?	The first through fourth authors The final code tree is represented by the titles and subtitles in Section 3.2
Themes derived	Did the themes emerge from the data or were they predetermined?	Yes
Software	What kind of software was employed for data analysis?	Data analysis was done manually
Participant control	Were women asked to comment on the results?	No
Quotations	Were quotes from women used to highlight ideas or conclusions? Was every quote categorized, for example, by the number of women?	Yes
Consistent data and results	Were the results consistent with the data that was presented?	Yes
The main themes’ clarity	Were the findings presenting the key themes?	Yes
The main sub-themes’ clarity	Was there a discussion of minor concerns or a summary of the various cases?	Yes

) [33].

2.2. Research Team and Reflexivity

The first author (RM), who is an active faculty member, specializes in psychiatric nursing. The second through seventh authors (AE, AA, MA, RA, DY, and HA) are active faculty members and possess extensive field study experience in community/adult health nursing and occupational and community health and safety. They have also worked on projects that incorporated qualitative data analysis. The eighth author (SA) has experience working as a practitioner nurse, providing care for women with mental health conditions. The last author (NA) is a public health researcher who has expertise in creating surveys and methodology procedures, such as gathering and evaluating data. The study team examined how their disciplinary backgrounds would influence their interpretations while discussing evolving codes and themes in frequent sessions.

2.3. Setting and Participants

The study was carried out in Irbid, the largest city in Northern Jordan, which was chosen because 67% of the 462 women who were evaluated for PPD had the disorder, making it one of the highest rates among women in the North [8,10]. Women were selected from the general community based on the following criteria: (1) they had to be at least 18 years old and live in Irbid; and (2) they had experienced pregnancy and childbirth during the past 24 months, whether or not they were diagnosed with PPD.

Saturation was evaluated to ensure that sufficient data had been acquired to accurately depict the aim of the study. Data saturation was used to calculate the sample size, and it was capped at 20. However, the first author, who conducted the sample selection, halted at 14 women upon saturation during data collection; these were the participants whose answers were analyzed and reported. After conferring with the study team, the first author agrees that more data collection is no longer necessary because interviews yield no new themes that are already well-established, and saturation is therefore considered to have been achieved. The study’s goal and methodology were described to women by the first author, who also got their signed informed consent to take part.

2.4. Data Collection

A comprehensive semi-structured interview and field notes were employed as data collection methods. Phenomenological research design commonly uses semi-structured interviews and field notes as popular and effective methods for gathering comprehensive, descriptive data about lived experiences [34]. With semi-structured interviews, researchers can use open-ended questions in a predetermined but flexible framework to probe deeply into participants’ experiences [34]. Taking handwritten field notes provides an additional source of information by recording the interview’s context. Nonverbal clues, contextual information, and the researcher’s thoughts can all be captured in these notes, leading to a more comprehensive knowledge of the topic being studied [34,35]. Field notes have the primary benefit of being the most cost-effective choice in terms of both time and money. The fact that concepts and recollections from interviews would probably be forgotten later in the study process makes field notes even more crucial [36]. In general, combining these methods can lead to a more robust and reliable description of the phenomena, assist in confirming findings and uncover potential biases, and give a deeper knowledge of the lived experience by capturing the context of the interview [37].

A semi-structured interview form was developed by the research team. The form was created by the first author after consulting with their research team. In the first section of the form, questions regarding age, education, employment, marital status, delivery method, number of children, and PPD diagnosis were asked. Four basic open-ended questions that are intended for use in the semi-structured interviews are included in the second section. The descriptive phenomenological literature on exploring the lived experiences of women with PPD served as the foundation for the development of these questions [29]. The research team validated the interview questions without conducting any pilot testing. We do not invite women to review transcripts or findings since there is a risk that they may not always recognize their own experience. Other justifications include avoiding taking up their time to evaluate transcripts and being worried that they may feel under pressure to make revisions. The data collection was carried out in May 2025.

The following were the questions on the semi-structured interview form:

(1)

Whenever you hear the term “PPD”, what comes to your mind? what do you think it is, and how would you describe it?

(2)

Do you know what causes PPD?

(3)

What have you heard people saying about those having PPD, and how do you think such talks affect women having PPD, in terms of their care and treatment?

(4)

You must have heard people at least say something about PPD. What are some of the things they say that you really think are not true or accurate?

The first author conducted 14 interviews and meticulously transcribed them. All participant responses were recorded and no follow-up interviews were performed. Additionally, 14 field notes, which included descriptions of participant verbatim words and nonverbal reactions, were gathered by the second author based on observations made during the interviews. Each participant knew that the researchers had a doctorate, and they had no personal connection to them. The participants who willingly consented to take part in the study set the time for the interviews. Each interview was carried out in a private setting and lasted 15 to 25 min. The field notes and interview transcripts were first transcribed in Arabic by the first and second authors, and then translated into English for analysis. The study’s Arabic and English bilingual experts (HA, SA, and NA) would decide on the translation in the event of disagreements. Back-translation techniques were employed to guarantee that the transcriptions’ English meanings were equivalent. The experts’ in-depth knowledge of Arabic language and Jordanian culture might lessen bias and eliminate difficulties with automatic coding and theme identification.

2.5. Data Analysis

The original coding was completed manually based on the interview questions and the study’s objectives. The following phases from Colaizzi’s description [38] were followed in the data analysis process: (1) the interview transcripts and field notes were read independently by the first and second authors who collected the data in order to comprehend women’s perceptions of PPD misconceptions; (2) statements that were relevant to the research questions were extracted. These statements, which frequently took the shape of actual quotes from women, encapsulated important elements of their experiences. The fundamental meaning or essence pertinent to the research question was contained in these statements, which were referred to as “meaning units”; (3) explain the meaning of the statements, which required a process of introspection and interpretation to investigate the underlying meanings included in the statements that were extracted. The third and fourth authors conducted a thorough analysis to comprehend the subtleties, feelings, and revelations that women expressed; (4) Themes were derived from the meanings by identifying significant keywords that appeared frequently in the meaning. The first four authors found that the meaning units shared common patterns. Women’s perceptions of PPD misconceptions were encapsulated in themes that were derived from these patterns; (5) themes that were comparable or connected to a larger idea were grouped together, and broad subthemes were created; (6) the findings were incorporated into a thorough explanation of the topic by crafting a cohesive and thorough narrative that encapsulated the essence of women’s perceptions; and (7) the findings were verified for accuracy and reliability by forwarding the data to the fifth through last authors.

2.6. Rigor

The first seven authors, along with the last author, had experience with qualitative research methods and conducting interviews. Every step of the study’s methodology was fully revealed for reliability. The participants’ statements were directly included prior to the analysis in compliance with the verifiability principle. This guaranteed the transparency of the data used to support the research findings. The first four authors were engaged in interactive meetings throughout the data collection and analysis. They coded separately during the data coding step to guarantee uniformity. In the event of discrepancies, the final coding would be decided by five highly qualified researchers (RA, DY, HA, SA, and NA) who were given access to the results of the interview analyses in order to boost the research’s credibility.

2.7. Ethical Considerations

Ethical approval was granted by the Irbid National University Faculty of Nursing Research Ethics Committee (Ref: IRB0015). Consent was acquired prior to the interview since participation was completely voluntary. To maintain confidentiality during and after the study was completed, all responses were anonymized, and data was gathered without a third party’s involvement. To keep participants comfortable during the recruitment and interview processes, sensitive and stigmatizing terms like mental illness were avoided. If any woman is observed exhibiting uncontrollable and unsettling emotional reactions, the interview would be terminated immediately.

3. Results

3.1. Participants’ Characteristics

Data saturation was achieved after interviewing 14 women whose information is shown in

Table 2. Participants’ characteristics.

Characteristics	Frequencies
Age in years
Between 18 and 29	6 (42.9%)
Between 30 and 49	7 (50%)
50 and over	1 (7.1%)
Education Level
Basic primary school	3 (21.4%)
Secondary school	6 (42.9%)
Certificate/Diploma/Degree	5 (35.7%)
Employment
Not employed	6 (42.9%)
Employed	8 (57.1%)
Number of children
1 child	4 (28.6%)
Between 2 and 3 children	8 (57.1%)
4 and over	2 (14.3%)
Marital status
Married	13 (92.9%)
Single/Separated/divorced	1 (7.1%)
Type of delivery
Normal delivery	9 (64.3%)
C-section delivery	5 (35.7%)
PPD diagnosis
Yes	5 (35.7%)
No	9 (64.3%)

. The table indicates that 50% of the women were between the ages of 30 and 49, which is a comparatively greater percentage. The largest disparity was observed in the marital status category, with 92.9% of women being married. Most women had a normal birth and not diagnosed with PPD (64.3%), had two or three children and were employed (57.1%), and completed secondary school (42.9%).

Five women (35.7%) with a history of C-section deliveries reported having a PPD diagnosis. This finding is in line with several studies that showed PPD risk may increase when a C-section is performed [39].

3.2. Thematic Outcomes

Table 3. Thematic outcomes.

Interview Questions	Subtheme	Main Theme
General perceptions of PPD	Lack of recognition	Perceiving PPD as normal baby blues
Perceived causes	Spiritual and religious weakness belief	Linking PPD to spiritual and religious failure
	Idle mind	Psychological causes
	External trivial factors	Myths about causes
Cultural and community beliefs	Stigma	Stigma
	Negative consequences of speaking out and seeking help	Mistrust of professional care services
Accuracy and misconceptions	Misjudgement of the mothers’ feelings	Emotional misconceptions
	Cultural comparison	Cultural misconceptions
	Myths in transmission	False beliefs about health
	Unfavorable social perception	Think of PPD as indolence

shows that themes and subthemes represented women’s sociocultural perceptions and misconceptions about PPD. Five code names were assigned to C-section delivery women with PPD (P1, P2, P10, P12, and P13). The remaining vaginal delivery women were identified by their code names, which were P3, P4, P5, P6, P7, P8, P9, P11, and P14. Ten themes and subthemes were emerged, creating a coding tree that served as a guide for discussion and analysis. The final coding tree is shown in titles and subtitles. The Supplementary Table S1 presented an audit trail that included data synthesis through the extraction and abstraction of findings in common themes and subthemes.

3.2.1. General Perceptions of PPD

The main theme was determined to be “perceiving PPD as normal baby blues,” from which the subtheme of “lack of recognition” emerged. Women reported that they were unable to distinguish between PPD and baby blues and thought PPD was simply the latter.

One of the respondents noted “To be honest, I didn’t know much about it…nothing from a…personal perspective” (P1, C-section delivery).

According to another respondent, “I was suffering after giving birth…but I just didn’t realize it was depression” (P10, C-section delivery).

P13 (C-section delivery) expressed “It is just some sort of sadness and low moods that I feel and all mothers can experience after they give birth…I have seen it many times in women with little babies…it is nothing more than just low feelings among mothers”.

P7 (normal delivery) mentioned “What PPD is…I don’t know…the first three months of my pregnancy were painful…I was under a lot of stress…which became worse during the second month”.

3.2.2. Perceived Causes

Under perceived causes, three themes surfaced to explain the women’s beliefs about the causes of PPD: linking PPD to spiritual and religious failure, psychological causes, and myths about causes.

Linking PPD to spiritualand religious failure

The first theme, which women attributed to a conviction in spiritual and religious failure, links PPD to spiritual and religious weakness belief, which is the subtheme that emerged. It is a common misperception that PPD has a spiritual component or originates from spiritual/religious reasons that go beyond traditional medical knowledge.

According to P6 (normal delivery), “[PPD] has to do with the spiritual strength of a person… [and] those who are weak in faith are more likely to experience it”.

P14 (normal delivery) expressed “God provides help…but if a woman is away from God…it is not typical for her to feel good”.

P2 (C-section delivery) stated “I’m Muslim…and I base all of my decisions on my religious convictions…but I still have a lot to learn especially on how to care for my baby while I have a disorder”.

Psychological causes

The second theme, which women ascribed to psychological causes, connects PPD to idle mind, the subtheme that arose. An idle mind is a complicated interaction between the possibility of negative thought patterns and unconscious choices. Women stated that PPD is just a disorder brought on by a person’s mental health and the activities they typically partake in.

P1 (C-section delivery) expressed “When I was depressed after giving birth…I thought that magic of separating couples was done to me”.

P12 (C-section delivery) stated “After giving birth…I felt that I needed someone to talk to…someone who could sympathize with me…someone who could support me…”.

According to the responder (P14, normal delivery), “It is something that occur to those who think too much about their problems…if you avoid too much thinking it is hard to get it”.

The responder (P7, normal delivery) mentioned “Women has to do with just being at home…being unable to do anything…being uninterested in anything…and harboring negative self-talk”.

Myths about causes

As the third theme explaining the reasons of PPD, the women discussed myths (about causes), which leads to the development of external trivial factors subtheme. PPD.

According to the responder (P9, normal delivery), “It is something that comes from spending too much time on watching sad TV stores or even when using the phone too much”.

P12 (C-section delivery) mentioned “When I’m depressed…I’m unable to leave my house and am always there…I’ve just been browsing Facebook news…and I can’t stop feeling worry about Gaza and Israeli strikes”.

3.2.3. Cultural and Community Beliefs

The stigma and mistrust of professional care services are the two themes that emerged from the cultural and community beliefs.

Stigma

The first theme is the tremendous stigma that has developed around those with PPD. Women claim that negative presumptions and rumors about those who have PPD.

P8 (normal delivery) expressed “talking about it would make people think that you are not normal…actually they would even think about you being crazy”.

P11 (normal delivery) also stated “You will be treated like a mad if you said that you are depressed and wish to get treatment for it”.

P13 (C-section delivery) noted “Being PPD is highly stigmatized in the general population, but also puts us Jordanians at a significant disadvantage…women are perceived as not in a pleasant mood by others”.

Mistrust of professional care services

The women’s collective mistrust of professional care services was the second theme, which clarified the cultural and communal beliefs of PPD. This led to the creation of negative consequences of speaking out and seeking help. The reluctance to seek medical help or other professional treatment may be due to the fear of talking about it.

The responder (P10, C-section delivery) stated “Some of my relatives even threatened me that if I talk about it to non-family members…they would take my baby away…and never to interact with me again”.

Other responder (P12, C-section delivery) expressed “I’m not living my best life right now…my husband told me not to have children again…which made me feel even more unhappy…and I simply could not sense his support”.

P13 (C-section delivery) mentioned “Not good at all, really like a really untruthful relationship…and I don’t feel like I trust her [Nurse]…and I can’t really confide her in everything…”.

According to P5 (normal delivery) “Mental health services don’t convince me…what is the psychiatrist going to do to me when I’m pregnant? what concerns me is how to take care of my baby after delivery…All he has to do is listen to me when I speak. How will things change? I remain depressed”.

3.2.4. Accuracy and Misconceptions

There was a faulty understanding of PPD in terms of who it can impact, how it is often perceived, and how it manifests. The accuracy and misconceptions revealed four themes: emotional misconceptions, cultural misconceptions, false beliefs about mental health, and view PPD as indolence.

Emotional misconceptions

The first theme is emotional misconceptions, which gives rise to the subtheme of misjudgement of the mothers’ feelings. PPD is thought to affect women who don’t have a deep affection for their babies.

According to P5 (normal delivery), “It is that kind of low mood that just arises when the mother doesn’t express love for [her] baby. Women is afraid that she wouldn’t be able to feel anything for her child…and she would like to think that she wouldn’t be able to handle this”.

P6 (normal delivery) noted “When a baby is upset…I think a mother finds it difficult to know what to do because she just lacks the emotional capacity to do it”.

P8 (normal delivery) also stated “All I expected is that the mother would fall deeply and instantly in love with her baby…but she didn’t “.

P12 (C-section delivery) said “After giving birth…I felt like my child was merely a passive presence with no contact…I attempted…but was unable to build a bond…”.

P13 (C-section delivery) mentioned “Maybe because I was in pain…I had to give birth by caesarean section…I felt sleepy…and needed to rest…I was depressed…and couldn’t give my child the care they needed”.

Cultural misconceptions

Cultural misunderstandings constitutes the second theme, from which the subtheme of cultural comparison was created. Women denounce PPD as a Western condition and object to the fact that similar conditions exist in their local communities.

One of the respondents (P1, C-section delivery) expressed “I think it is a condition of the West…that must be a condition of the Americans…not among our people…our mothers never had such a thing”.

Other respondent (P6, normal delivery) stated “It seems like there are a lot of things to worry about as a women when she live in a Western country. When a woman gives birth…there is typically so much going on [in my nation of origin] that she do have time to feel down”.

False beliefs about mental health

The third theme is false beliefs about health, and the subtheme of myths in transmission stems from this. It was a common misconception among women that PPD is communicable and can be transferred through close physical contact.

P3 (normal delivery) stated “I have heard some people arguing that it is a contagious disease…that if you intact closely with individuals having it, then you are also likely to suffer”.

P12 (C-section delivery) expressed “I believe it’s more difficult to understand because it’s all related to depression…and it’s challenging to attempt to comprehend that it’s not caused by another diseases”.

Think of PPD as indolence

As the fourth theme, women talked about their opinion on PPD as being indolence, which gave rise to a subtheme known as unfavorable social perception. PPD was seen to be a blame game for those who are scared of taking on the responsibility of raising their babies.

The responder (P4, normal delivery) expressed that “I was told that is just an excuse to avoid taking care of the baby when the mother feels tired and not wanting responsibilities”.

P2 (C-section delivery) noted “In many ways, it is difficult…Although I feel terrible for my baby…I might get frustrated at times when I have to care for [him] alone without my husband’s help…I feel this way even though I know it’s wrong”.

P10 (C-section delivery) stated “I couldn’t take care of my child and do my housework at the same time after giving birth…I become depressed when I see how messy and dirty the house is”.

P13 (C-section delivery) also said “People who were close to me saw that I wasn’t feeling well when I lost all ability to care for my child and became exhausted and depressed”.

4. Discussion

This study is the first to explore Jordanian women’s sociocultural perceptions and misconceptions about PPD. Ten themes and subthemes were identified, and they were grouped into four major topics: (i) general perceptions of PPD; (ii) perceived causes; (iii) cultural and community beliefs; and (iv) accuracy and misconceptions.

4.1. General Perceptions of PPD

Women stated they could not tell the difference between PPD and baby blues, and they assumed PPD was only the latter. Maternity blues, sometimes referred to as baby blues, can appear in the initial days following delivery and include mild depression and poor mood [40]. PPD and baby blues were confused; nevertheless, possibly because PPD is thought to be an expected side effect of stress-induced childbirth [41]. Psychotherapy is often the first line of treatment when PPD develops. The use of antidepressants during pregnancy and after giving birth should be carefully considered, even though they may be required [42]. Women were given false information regarding perinatal mental health care symptoms, which they mistakenly believed to be the baby blues, according to a qualitative study conducted in Canada [43]. Further supporting the misconception between PPD and baby blues is the belief among the women in this study that PPD is simply a type of depression and low mood that all new mothers may experience.

4.2. Perceived Causes

Spiritual and religious tendencies influenced women’s opinions regarding the causes of PPD. A prior study found that both spirituality and religiosity predicted fewer depression symptoms within the first year after giving birth. Optimism, self-esteem, and mastery were thought to be psychological resources that explain how spirituality and religion affect women’s mental health after giving birth [44]. Women in this study believed that PPD exclusively affects women who are spiritually depressed or have poor faith, viewing it as a sign of personal weakness rather than a diagnosable mental health illness. Notably, Bharadwaj et al. [45] revealed that women perceive PPD as a matter of personal and religious deficiency, indicating that such views are not exclusive to Jordanian women. In one qualitative study, Latina and African American mothers who practiced spirituality and remained true to their faith reported changing how they viewed a variety of life stressors that are known to cause PPD, such as tense family relationships and negative thoughts and feelings. This, in turn, caused them to make positive changes in their lives [46]. In another study, US women with PPD reported that spirituality was important to their emotional recovery, describing prayer as a source of strength and seeing it as a means of connecting with their spirituality. Additionally, women mentioned feeling stressed out because they were under pressure to practice their religion in a way that was frequently different from how they now did it. The guilt indicated above that women connected with religion appeared to be a major factor in this experience and the anguish it caused [47].

PPD is a psychological disorder and is just a myth about what causes it in women who intentionally choose to experience distressing situations, like being helpless, engaging in negative self-talk, and watching depressing films or short videos on their phones. While it is true that repeated exposure to stressful situations can lead to postpartum mood disorders, the Jordanian women’s belief appears to oversimplify the issue because they failed to consider other important factors, such as biological and socioeconomic influences. A qualitative study conducted in Russia revealed that pregnant women viewed PPD as a combination of psychological and physical symptoms, and they also pointed out a gap between what they expected from pregnancy and what parenthood actually entailed [48]. According to another study, women in the UK frequently felt defeated since their birth was not the typical, unassisted birthing experience and frequently felt guilty about having a bad birth experience [49]. Australian women with PPD reported that their screen time was influenced by feelings of social isolation and loneliness, and that using a smartphone served as their connection to the outside world when they felt alone at home with their baby [50]. Jordanian women with PPD may benefit most from intervention strategies that focus primarily on psychological and social factors. The development of focused psychosocial, physical activity, and screen time therapies for these women may be aided by these findings.

4.3. Cultural and Community Beliefs

According to this study, women with PPD are experiencing a wave of stigma that makes them feel ashamed and unfit for society. They have also been called insane and abnormal by other women. UK Women feel stigmatized and dread being perceived as incapable of handling their new baby, according to a prior qualitative study. This was because they were worried about being viewed as a “bad mother,” which is a more general social construct [51]. Iranian women with PPD reported that the stigma prevents them from getting better mental health care [52]. The stigma is seen by Latina women since it can affect a whole family, making them feel ill and socially burdened [53]. Cultural perspectives of PPD and its treatment options transcend regional boundaries, as suggested by Palestinian mothers’ views on the medical model of PPD, which highlights the importance of addressing the stigma attached to medicine as a therapeutic option [54]. This study suggests that interventions that could benefit women with PPD might focus on eliminating stigma and providing peer and professional support that is culturally relevant.

Women are reluctant to seek any assistance from medical professionals because they mistrust them. Guy et al. [55] have also noted this observation, stating that American women with PPD were afraid to disclose their conditions to doctors for fear of being poorly assessed by their peers. In a similar vein, Sampson et al. [53] observed that even if minority women with PPD sought care, they would ultimately provide medical professionals with insufficient information. Because they believed that hospitals did not provide them with adequate official support, Chinese women with PPD felt ignored and uncared for by medical professionals [56]. The failure of healthcare providers to give support and insurance reimbursement for services was cited by Iranian women with PPD as the most difficult aspect of their lives [52]. Thus, in order to offer women with PPD high-quality services, it could be important to enhance postnatal social support services through interdisciplinary collaboration.

4.4. Accuracy and Misconceptions

It is believed that PPD affects women who do not have a strong bond with their babies. This finding aligns with a US study that found mothers with PPD expressed feelings of guilt and shame around their alleged abnormal emotional condition. They talked about her expecting an immediate bond with her child and how she felt guilty and ashamed when she didn’t experience it right away [57]. In a different study, mothers in the UK reported that their experience with PPD didn’t begin the way they had intended. Many women justified their sense of remoteness by citing unpleasant birth experiences, which they frequently held themselves responsible for, and a new baby’s challenging care [49]. In another Iranian study, women’s emotional discomfort and affection for their spouse took the place of their love for their baby during PPD [58]. This study implies that PPD may cause mothers to lose control over their personal lives, which can lead to psychological distress and a decrease in their affection for their children.

According to the respondents, PPD solely has an impact on the West and has no place in the Asian or Arabic populations. This is a type of cultural distancing that is not exclusive to this study. Bharadwaj et al. [45] proposed that mental health disorders are frequently perceived as a Western issue. Concerns regarding the use of Western-standardized research instruments are further supported by a previous qualitative study that found that women in 10 European countries and one African country reported morbid unhappiness following childbirth that was comparable to PPD [59]. Thus, in order to effectively connect the Jordanian and Western cultures and combat PPD, this study highlights the necessity for culturally validated screening instruments.

Women even held the belief that PPD is communicable and may be transmitted through physical contact. Nechaeva et al. [48] claimed that the community was afraid to socialize with those who had mental health issues for fear of getting the disease. Additionally, PPD was not seen by women as a medical condition but rather as a personal defect. The women were only perceived by them as being lethargic and unwilling to care for their children. Therefore, these women trivialized the symptoms, which is similar to what Mattar et al. [54] had reported. The women’s emotional problems were minimized and even disregarded in a prior study as transient situations with no real medical basis [55].

5. Limitations of the Study

This study may not have as generalizable results as it could because it only examined a limited number of women in Northern Jordan. In addition to the fact that just five women who had cesarean deliveries diagnosed with PPD, it is difficult to pinpoint the exact experiences of PPD. The diagnosis of PPD in women depends on self-reported data, which are subject to recall bias and underreporting.

The short interview period may limit the breadth and depth of the data collected by preventing women from discussing their experiences and/or perceptions in great detail. Nevertheless, using saturation as a guiding concept ensured that enough information had been collected to understand the primary themes and sub-themes, even if some interviews were brief.

Although employing tape recordings in this study may be a useful approach to data collection, doing so as a single method may not be particularly ideal or more reliable. When working directly from the recording, it could be more challenging to interpret the data. This method has disadvantages, including inaccurate transcripts, time commitment, and the difficulty of translating some information into text [36]. In contrast, this study employed field notes and semi-structured interviews, which are efficient techniques for obtaining detailed and descriptive information about lived experiences. Combining these approaches could help validate results and provide a more thorough understanding of the lived experience by capturing the interview’s context, and result in a more robust and trustworthy description of the phenomena [37].

The fact that women were not given the chance to examine the field notes and transcript, as well as the analysis that followed, to evaluate their perspectives on PPD, is another limitation. Given that the women were selected from the general public, the findings regarding their perceptions of PPD may be even more peculiar.

6. Conclusions

This study employed a descriptive phenomenological design and found that ten themes/subthemes summed up the sociocultural perceptions and misconceptions about PPD perceptions among Jordanian women. Women reported that they believed PPD to be just baby blues and that they were unable to distinguish between the two. PPD was perceived by women as a sign of personal weakness rather than a diagnosable mental health disorder, and they thought it only affected women who were spiritually dejected or had low faith. Women falsely believed that PPD was a psychological condition, and they purposefully decided to participate in painful behaviors like feeling powerless, talking negatively about themselves, and watching dismal movies or short videos.

Women were feeling ashamed and unfit for society as a result of the stigma they are facing. Other women have likewise referred to them as odd and insane. Additionally, women stated that they distrust medical experts and are hesitant to seek any help from them.

PPD is thought to affect women who don’t have a close connection to their kids. Women thought that PPD originated in the West and had no place in the populations of Asia or the Arab world. Women even believed that PPD could be spread through physical touch and was contagious. Women also viewed PPD as a personal flaw rather than a medical condition.

7. Recommendations

It is necessary to address health literacy interventions in order to dispel misconceptions regarding PPD and impart accurate medical knowledge. In-depth community education initiatives are required to provide women with PPD with accurate information about the disorder and to motivate them to seek appropriate medical care rather than depending solely on conventional therapies. The cure for PPD can be communicated by qualified healthcare professionals in a way that is more acceptable and consistent with community values.

To confirm and build upon these findings, more research in this field is obviously required. Future research recommends spending adequate time with women and permitting longer interviews to foster rapport and increase transparency. Additional research is required to confirm whether tape recordings, when combined with field notes and transcripts, are reliable tools for exploring the lived experiences of women with PPD. Member checking would be used in future research, in which the researchers asked women for input to confirm the findings’ accuracy and reliability. It’s possible that focus-group interviews would have given a more comprehensive picture of women’s perceptions of PPD misconceptions. More research could better comprehend women’s perceptions of PPD misconceptions by using mixed-method approaches.