Insight into postpartum depression; a situational analysis among women giving birth at Juba Teaching Hospital, South Sudan

Insight into postpartum depression; a situational analysis among women giving birth at Juba Teaching Hospital, South Sudan | Research Square window.SnipcartSettings = { analytics: { enabled: false } }; (function() { var accessVector = localStorage.getItem('access_vector') || ''; window.dataLayer = window.dataLayer || []; if (accessVector) { window.dataLayer.push({ user: { profile: { profileInfo: { snid: accessVector } } } }); } })(); (function(w,d,s,l,i){w[l]=w[l]||[];w[l].push({'gtm.start':new Date().getTime(),event:'gtm.js'});var f=d.getElementsByTagName(s)[0],j=d.createElement(s),dl=l!='dataLayer'?'&l='+l:'';j.async=true;j.src='https://www.googletagmanager.com/gtm.js?id='+i+dl;f.parentNode.insertBefore(j,f);})(window,document,'script','dataLayer','GTM-K279D39R'); Browse Preprints In Review Journals COVID-19 Preprints AJE Video Bytes Research Tools Research Promotion AJE Professional Editing AJE Rubriq About Preprint Platform In Review Editorial Policies Our Team Advisory Board Help Center Sign In Submit a Preprint Cite Share Download PDF Research Article Insight into postpartum depression; a situational analysis among women giving birth at Juba Teaching Hospital, South Sudan Zechariah J Malel, Garang Dakjur Lueth, Moses Maror Ayuel, Haram Mustafa Sebit, and 2 more This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-6386454/v1 This work is licensed under a CC BY 4.0 License Status: Under Review Version 1 posted 7 You are reading this latest preprint version Abstract Background Maternal mental health, particularly postpartum depression, remains one of the most overlooked health conditions globally. The study aimed to uncover the prevalence of women suffering from postpartum depression at Juba Teaching Hospital and to investigate the associations and predictors of this condition among mothers who gave birth in the Department of Obstetrics and Gynecology at Juba Teaching Hospital. Method This was a cross-sectional study conducted between January and June 2023 among postpartum women who gave birth at Juba Teaching Hospital. A total of 160 postpartum women were enrolled in the study using a randomized systematic method. Following delivery and prior to discharge, sociodemographic and obstetric data were collected. Then participants were requested to provide their phone contacts, which were used to contact them and organize a home visit to complete the interview six weeks from the time of the delivery. Chi- square was applied to suggest the associated factors, while regression was used to determine PPD predictors. To obtain PPD prevalence, questions on EPDS were coded at 13 points/below or above 13 points based on the answers provided by the study participants. Those who scored at 13 points or below on the EPDS scale were considered not to be suffering from PPD, in contrast to those above 13 points who were considered to have PPD. Results The majority of the postpartum women (54.4%) recruited for this study were aged between 25 and 45 years, and 81.9% were married and possessed at least a primary or secondary level of education. About 9% (14 out of 160) fell above the threshold of the Edinburgh Postnatal Depression Scale (EPDS), indicating the prevalence of postpartum depression among women in this study. Using a chi-square test, it was found that women below 18 years of age were significantly associated with PPD (X²=7.095, P = 0.029); also, single or cohabitant mothers (X²=12.772, P = 0.002); women with no formal education (X²=9.706, P = 0.008); and those with inadequate financial support, among others, were all associated with PPD. While maternal age, financial support, partner support, and preferences regarding pregnancy and infant sex are predictors of the likelihood of experiencing PPD. Conclusion The prevalence of PPD identified in this study (9%) highlights and raises concerns about the overlooked maternal mental health in South Sudan. Despite the challenging circumstances faced by many partners, offering emotional support to women during pregnancy and the postpartum period could help prevent unnecessary PPD from developing among postpartum women. The study recommends the necessity of scaling up maternal mental health support across the country, alongside empowering women through education and employment to alleviate their financial dependency. The study also recommends scaling up of the postpartum depression screening across the country using the EPDS tool, and subsequent establishment of clinical centers for mental support in the main state hospitals. Postpartum depression maternal mental health Edinburgh Postnatal Depression Scale (EPDS) Figures Figure 1 Introduction Maternal mental health concerns continue to be among the most underserved health issues in the globe. Approximately 17.2% of postpartum women develop mental health problems such as depression or anxiety ( 1 )( 2 ). According to a meta-analysis, 6.9–50.2% of women in Africa suffer from postpartum depression ( 3 ) with Sub-Saharan Africa alone accounting for 18.6 to 21.8% ( 4 )( 5 ). Postpartum mental health issues do not just affect postpartum women and their infants; they also have a detrimental impact on parental depression, family stress, poor family functioning, and instability ( 6 )( 7 ). Postpartum depression is considered as a public major health concern. It is defined as a mood disorder or disturbance that affect the mother after childbirth, last for weeks or months after birth ( 8 )( 9 ). Postpartum depression differs from postpartum blues and postpartum psychosis. Postpartum blues is a moderate and temporary condition that lasts no more than ten days and is characterized by rapid mood shifts in which the woman feels irritated, let down, and overly sensitive( 10 ). Postpartum blues is a self-limiting phenomenon that does not need major intervention apart from provision of the mother with emotional support and re-assurance( 11 ). Woman with postpartum depression presents with mood changes in the majority of days, for at least two weeks, where the woman feels losing interest or pleasure in engaging in anything ( 12 ). She also complains of exhaustion, restlessness, feelings of guilt or worthlessness, insomnia, loss of focus, and persistent thoughts of suicide or death. Furthermore, a woman with postpartum depression has anxiety about her newborn and the risk of developing psychotic thinking, such as hallucinations, which could lead to injuring her surroundings, such as children( 13 ) ( 14 )( 15 ).( 16 ). In a study conducted by O’Hara; Pearlstin in 2009, many women sufferings with mental health conditions are not usually diagnosed or receive proper medical attention. Numerous healthcare providers fail to recognize maternal depression during postpartum or pregnancy( 17 ). This is attributed to the lack of skillful personal to identify, treat and provide maternal psycho-social support to those in need( 18 ).( 19 ) There is a lack of statistics on the prevalence and trends of postpartum mental health disorders, as well as a general mental health program. A study conducted by Mwikali at Juma Kenyatta Tertiary Hospital revealed that 10.6% of women delivered at the facility during the time of study had postpartum depression,( 20 )which is lower than the 27.1% prevalence of postpartum depression in Mbrara in Western Uganda ( 21 ), and 33.8% in Southern Ethiopia( 22 ). Though no systematic studies were undertaken in South Sudan to determine factors related with postpartum depression, the country's socioeconomic challenges and political instability may in other ways contribute to the development of postpartum depression. Several studies have found that stressful life events, low financial income, low educational standing, and family problems all contribute to the development of postpartum depression. In studies conducted to determine the predictors of postpartum depression, women residing in a conflict dominated areas and have socioeconomic difficulties suffers from postpartum depression( 23 ) ( 24 ). Postpartum depression can affect all women of reproductive age. In a study done in Kenya, young age (18–24 years old) suffered from postpartum depression compared to woman with 40 years old( 25 ). Nonetheless, presence of birth defects and giving birth to unwanted sex child are also predictors to postpartum depression( 26 ) ( 27 ). Little or nothing is known about postpartum depression or maternal mental health in South Sudan. As a result, the purpose of this study was to present and analyze the situation, taking into account the general conditions in the country that are conducive to the development of postpartum mental health difficulties. A lack of previous similar studies in South Sudan, as well as a lack of postpartum mental health support in the nation, are a few of the contributing causes to poor documentation of the country's overall maternal mental health situation. Thus, the study exposed the unknown atmosphere of maternal mental health status in South Sudan with the objective of sharing the data with health policy makers to enable them in planning and designing a response strategy that bridges gaps related with the country's maternal mental health situation. Methodology Study design and population This was a prospective, cross-sectional study conducted among postpartum women who gave birth at the department of Obstetrics and gynecology, Juba Teaching Hospital between 1st January and June, 2023. Study population included all postpartum women of reproductive ages (15–45 years) who gave birth in the department during the study timeframe, and consented to participate in the study, with the exclusion of postpartum women known to have had mental disturbance prior to the time of the study or those who declined to take part in the study. Beside women with special needs such as women with hearing or sight impairments. Sample size The sample size was obtained through a proportion that calculate sample size N = Z2*P (1-p)/E2 Where N represents a sample size, Z is a percentage point of normal distribution corresponding to significant level of 95%. set for Z is equal to 1.96, E represent standard error degree of accuracy (0.05) while P represent proportion of women with postpartum depression. However, the calculated sample size was done in reference to study conducted in Kenyata National Hospital by Virgina Mwikali that found prevalence of postpartum to be 10.6%( 20 ) Hence, the calculated sample size became 160 women after calculating using the above formula and consideration of the 10% non-responding rate. Sampling procedure The study used a systematic randomized sampling technique to enroll the 160 postnatal women who fit the criteria. Those who consented to participate in the study and met the criteria were enrolled. Data collection and tool description Data were collected using a structured data collection tool adopted from the Edinburgh Postnatal Depression Scale (EPDS) that was developed by Cox and Holden in 1987. This is a screening instrument, and not diagnostic tool ( 28 ). The tool divides women into two groups according to their assessment results and consists of 10 questions with a maximum score of 30. According to the tool, women who score 13 points or higher are positive for postpartum depression, whereas those who score less than 13 points are deemed to have no postpartum depression( 29 ). The tool was divided into three sections for the study: section "A" includes the introduction and sociodemographic and economic data of the participants; section "B" records obstetric and reproductive details; and section "C" includes the Edinburgh Postnatal Depression Scale (EPDS) assessment questions. Women who gave birth and fulfilled the study's criteria were addressed within 24 hours of delivery or before being discharged home. The goal of the study was explained to them, and their consent to participate was acquired. Those who understood and agreed to participate in the study were given a consent form to sign, or they could sign with their thumbprint if they were unable to write or read. Those under the age of 18 provided consent through their grantors. A partial interview was conducted with participants who agreed to participate in the study by filling out social demographic, economic, obstetric, and reproductive health information. As they exited the facility, they were asked for their phone numbers and household addresses. Participants were called at six weeks after delivery using the phone number they supplied, and times for home visits were scheduled to complete the remainder of the questionnaire via EPDS assessment section. Data analysis Dada was checked for completeness; each questionnaire was be given a unique code. Complete questionnaire was entered into SPSS version 27 for analysis. Descriptive analysis was done through running frequencies and proportions. Relationship between outcome variable and exposure variables was established on chi square test(p)value, a value less than 0.05 was considered significant factors associated with postpartum depression. To determine the independent factors, associated with the postpartum depression, significant values of 0.05 or less on Chi square were run through multi-nominal logistic regression, and value less than 0.05 was considered a predictor factor for postpartum depression. To establish the PPD prevalences, responses obtained from the clients on the EPDS assessment were quantified based on the EPDS quantification system, before being transferred into SPSS, version 27 for frequencies and proportion analysis. Any assessed woman who fell below the EPDS 13 points scoring scale was considered not suffering of postnatal depression, contrary to those who scored above the 13-poins EPDS scoring system. Ethical issues and clearance Ethical clearance for the study was obtained from national ministry of health ethical committee board. However, there are no conflicts of interest or gain other than being instructive for health decision makers. Study participants were kept as anonymous and classified with numbers for confidentiality. The purpose for this study was explained to all participants, and everyone was granted the discretion to refuse or accept participating in the study. Those accepted to participate in the study were provided with a consent form to sign, which gave them the option of dropping out of the study or objecting to any question they felt uncomfortable answering. Participants less than 18 years provided consent through their guardians. Participants who couldn’t read or write were requested to sign using their thumbprints as per the ethical committee approval. Results Respondence rate during the follow phase All the 160 women who were recruited for the study and whom the interview was started with during the 24 hours postnatally were successfully reached during the follow up time that was meant after 6 weeks post delivery period, making the 100% respondence rate. Demographic information of women giving birth in the obstetrics and gynecology department, Juba Teaching Hospital. Table 1 Demographic information of women giving birth in the obstetrics and gynecology department, Juba Teaching Hospital Variable n % 95% Confidence Interval Lower Upper Age of the mother Less than 18 years 22 13.8 8.8 18.8 18–24 years 51 31.9 25 39.4 25–45 87 54.4 46.9 61.3 Marital status Married 131 81.9 75.6 87.5 Single 12 7.5 3.8 11.9 Co-habiting 17 10.6 6.3 15 Educational level No formal education 26 16.3 10.6 21.9 Primary to Secondary 104 65.0 58.1 72.5 University and above 30 18.8 13.1 25 Occupational level Not employed 108 67.5 60.6 75.6 Self employed 38 23.8 16.9 30.6 Employed 14 8.8 4.4 13.8 Table 1 displays the demographic profile of women giving birth at the Obstetrics and Gynecology Department of Juba Teaching Hospital. Regarding age distribution, a majority of the women (54.4%) were between 25 and 45 years old, with a confidence interval of 46.9–61.3%. Women aged 18 to 24 years constituted 31.9% of the sample (CI: 25–39.4%), while those under 18 years accounted for 13.8% (CI: 8.8–18.8%). Marital status data showed that most women (81.9%) were married (CI: 75.6–87.5%). A smaller proportion (10.6%) were cohabiting (CI: 6.3–15%), and 7.5% were single (CI: 3.8–11.9%). Educational attainment varied, with 65% of women having completed primary or secondary education (CI: 58.1–72.5%). Meanwhile, 18.8% had attained university-level education or higher (CI: 13.1–25%), whereas 16.3% had no formal education (CI: 10.6–21.9%). Occupational status indicated that the majority of the women (67.5%) were unemployed (CI: 60.6–75.6%). Self-employment was reported by 23.8% (CI: 16.9–30.6%), while 8.8% were formally employed (CI: 4.4–13.8%). Table 2 4.1Prevalence of postpartum depression among women giving birth in the obstetrics and gynecology department, Juba Teaching Hospital Postpartum Depression n % 95% Confidence Interval Lower Upper ≤ 12 points 146 91.3 86.9 95.6 ≥ 13 points 14 8.8 4.4 13.1 The prevalence of postpartum depression among women who gave birth in the obstetrics and gynecology department of Juba Teaching Hospital was assessed using a standardized scoring system. The majority of participants, 146 women (91.3%), had scores of 12 or lower, suggesting they were not experiencing substantial postpartum depression with 95% CI: 86.9% − 95.6%, demonstrating a high level of confidence in these results (Table 2 , Fig. 1 ). Nonetheless, a smaller proportion of women, 14 individuals (8.8%), had scores of 13 or higher, implying the presence of postpartum depression with 95% CI 4.4% − 13.1%, indicating some variability in the estimate but still highlighting a notable prevalence of postpartum depression in this population (Table 2 , Fig. 1 ). Determinants of postpartum depression among giving birth at the department of obstetrics and gynecology, Juba Teaching Hospital. Table 3 Factors associated with postpartum depression among giving birth at the department of obstetrics and gynecology, Juba Teaching Hospital Associated factors Postpartum Depression Total, n Chi-Square df p -value ≤ 12 points ≥ 13 points n % n % Age of the mother 7.095 2 0.029 Less than 18 years 18 12.3 4 28.6 22 18–24 years 44 30.1 7 50.0 51 25–45 84 57.5 3 21.4 87 Mother marital status 12.672 2 0.002 Married 124 84.9 7 50.0 131 Single 8 5.5 4 28.6 12 Co-habiting 14 9.6 3 21.4 17 Educational level 9.706 2 0.008 No formal education 20 13.7 6 42.9 26 Primay to Secondry 96 65.8 8 57.1 104 University and above 30 20.5 0 0.0 30 Occupational level 0.931 2 0.628 Not employed 100 68.5 8 57.1 108 Self employed 34 23.3 4 28.6 38 Employed 12 8.2 2 14.3 14 Husband‎ or partner financial support 11.631 2 0.003 No support 19 13.0 6 42.9 25 Yes, but not adequate 112 76.7 5 35.7 117 Yes, adequate 15 10.3 3 21.4 18 Husband or partner emotional support 8.446 2 0.015 No support 17 11.6 5 35.7 22 Sometimes supportive 80 54.8 3 21.4 83 Fully supportive 49 33.6 6 42.9 55 Parity of the mother 3.962 2 0.138 Para 1 17 11.6 3 21.4 20 Para 2–4 58 39.7 8 57.1 66 Para 5 or more 71 48.6 3 21.4 74 Was the pregnany wanted 14.845a 1 < 0.001 Not wanted 22 15.1 8 57.1 30 Yes,wanted 124 84.9 6 42.9 130 Sex of the infant 0.051 1 0.821 Female 100 68.5 10 71.4 110 Male 46 31.5 4 28.6 50 Was the infant sex wanted 11.567 2 0.003 No 14 9.6 5 35.7 19 Yes 22 15.1 4 28.6 26 Was not important whether a boy or girl 110 75.3 5 35.7 115 Was the baby born alive 3.638 1 0.056 No 10 6.8 3 21.4 13 Yes, Alive 136 93.2 11 78.6 147 What was the mode of the feeding planned for infant 0.194 1 0.659 Exclusive breast feeding 144 98.6 14 100.0 158 Others 2 1.4 0 0.0 2 Is the mother happy and accepted her infant sex 0.807 2 0.668 No 2 1.4 0 0.0 2 Yes 138 94.5 14 100.0 152 Somehow 6 4.1 0 0.0 6 Are there chronic physical maternal illnesses 0.293 1 0.588 Not present 143 97.9 14 100.0 157 Yes, present 3 2.1 0 0.0 3 Is infant congenital conditions 10.494 1 0.001 Not present 146 100.0 13 92.9 159 Present 0 0.0 1 7.1 1 Did the continue to get ill since the time of delivery 1.471 2 0.479 No 132 90.4 14 100.0 146 Yes 7 4.8 0 0.0 7 Somehow 7 4.8 0 0.0 7 Table 3 presents the factors associated with postpartum depression (PPD) among women who gave birth at the Department of Obstetrics and Gynecology at Juba Teaching Hospital. The chi-square test was used to assess the statistical significance of each factor. A significant relationship was found between age and postpartum depression (χ² = 7.095, p = 0.029). The highest percentage of women with PPD (28.6%) were under 18 years, while the lowest percentage was among those aged 25–45 years (21.4%). Marital status was significantly associated with postpartum depression (χ² = 12.672, p = 0.002). Women who were married had the lowest prevalence of PPD (50.), while those who were single or co-habiting experienced higher rates (28.6% and 21.4%, respectively) (Table 3 ) . Education was also found to have a significant association with postpartum depression (χ² = 9.706, p = 0.008). Women with no formal education had a higher percentage of PPD (42.9%), compared to those with secondary education (57.1%) or higher (). Employment status did not significantly correlate with PPD (χ² = 0.931, p = 0.628), suggesting that the type of employment (or lack thereof) does not have a major impact on postpartum depression. Financial support from a partner was significantly associated with postpartum depression (χ² = 11.631, p = 0.003). Women who received inadequate financial support had a higher percentage of PPD (42.9%), while those with no financial support had 42.9% as well. Adequate support was associated with a lower percentage of PPD (21.4%). Emotional support from a partner was found to be significantly associated with postpartum depression (χ² = 8.446, p = 0.015). Women who received no emotional support experienced a higher percentage of PPD (35.7%), compared to those who were sometimes or fully supported (21.4% and 42.9%, respectively) (Table 3 ) . There was no significant association between the number of previous pregnancies and postpartum depression (χ² = 3.962, p = 0.138), indicating that parity does not seem to play a major role in PPD risk. The pregnancy's desirability was significantly associated with postpartum depression (χ² = 14.845, p < 0.001). Women who reported that their pregnancy was not wanted had a much higher percentage of PPD (57.1%) compared to those who wanted the pregnancy (42.9%) (Table 3 ) . The sex of the infant did not significantly impact postpartum depression (χ² = 0.051, p = 0.821), as the incidence of PPD was almost identical between those with male and female infants. Whether the mother wanted the sex of the infant was significantly associated with PPD (χ² = 11.567, p = 0.003). Women who did not want the sex of their baby had a higher percentage of PPD (35.7%), compared to those who did not care about the sex of the infant (35.7%) or those who had a desired sex (28.6%) (Table 3 ) . The survival status of the infant was nearly significant (χ² = 3.638, p = 0.056), indicating that women whose infants were not alive were more likely to experience PPD (21.4%). There was no significant association between the planned mode of infant feeding and postpartum depression (χ² = 0.194, p = 0.659), with almost all women planning to exclusively breastfeed (Table 3 ) . Mother's emotional acceptance of the infant’s sex did not significantly correlate with postpartum depression (χ² = 0.807, p = 0.668), with most women being happy and accepting of their infant's sex. Chronic physical illnesses did not significantly affect postpartum depression (χ² = 0.293, p = 0.588), as all but three women did not have any chronic illnesses. The presence of congenital conditions in the infant was significantly associated with postpartum depression (χ² = 10.494, p = 0.001), with the only case of PPD among women whose infant had congenital conditions. There was no significant association between continuing illness since delivery and postpartum depression (χ² = 1.471, p = 0.479) (Table 3 ) . Table 4 Predictors of postpartum depression among giving birth at the department of obstetrics and gynecology, Juba Teaching Hospital Predictors B S.E. Wald df p - value OR 95% CI Lower Upper Age of the mother Less than 18 years 18–24 years 0.577 1.006 0.329 1 0.566 1.781 0.248 12.790 25–45 0.792 0.893 0.786 1 0.375 2.207 0.384 12.706 Husband‎ or partner financial support No support Yes, but not adequate 1.678 1.642 1.043 1 0.307 5.353 0.214 133.817 Yes, adequate -0.841 0.958 0.771 1 0.380 0.431 0.066 2.821 Husband or partner emotional support No support Sometimes supportive -1.801 1.569 1.318 1 0.251 0.165 0.008 3.574 Fully supportive -0.604 0.902 0.448 1 0.503 0.547 0.093 3.203 Was the pregnany wanted Not wanted Yes,wanted 1.579 0.827 3.648 1 0.056 4.849 0.959 24.510 Was the infant sex wanted No Yes 2.093 0.878 5.677 1 0.017 8.107 1.450 45.343 Was not important whether a boy or girl 0.767 0.948 0.655 1 0.418 2.154 0.336 13.810 Table 4 examines the predictors of postpartum depression among women giving birth at the Department of Obstetrics and Gynecology, Juba Teaching Hospital. The predictors such as maternal age, financial and emotional support from the partner, and pregnancy and infant sex preferences, influence the likelihood of experiencing postpartum depression. The odds ratio (OR) for postpartum depression is 1.781, though the p-value (0.566) is not statistically significant, suggesting that maternal age in this range does not significantly increase the risk of postpartum depression compared to those under 18 years. Similarly, OR is 2.207, with a p-value of 0.375, indicating no significant association between age in this category and postpartum depression risk (Table 4 ) . The odds ratio for inadequate financial support is 5.353 (p-value = 0.307), but the result is not statistically significant, suggesting that inadequate financial support is not a significant predictor of postpartum depression. In contrast, the odds ratio for adequate financial support is 0.431 (p-value = 0.380), which also shows no significant impact on postpartum depression risk, suggesting that adequate financial support does not significantly protect against postpartum depression in this sample (Table 4 ) . The odds ratio of 0.165 (p-value = 0.251) for women whose partners offer only occasional emotional support suggests a reduced likelihood of postpartum depression. However, this result is not statistically significant, meaning that the occasional emotional support does not significantly predict postpartum depression. Women whose partners are fully supportive have an OR of 0.547 (p-value = 0.503), indicating no significant effect of full emotional support on postpartum depression risk (Table 4 ) . The odds ratio of 4.849 (p-value = 0.056) suggests a trend toward a higher likelihood of postpartum depression when the pregnancy was wanted, though this result is only marginally significant. A p-value just above 0.05 implies that, while it’s not definitively conclusive, there may be an increased risk of postpartum depression for women who wanted their pregnancies (Table 4 ) . The odds ratio of 8.107 (p-value = 0.017) for women who wanted a specific infant sex shows a statistically significant increase in the likelihood of postpartum depression compared to those who had no preference. This indicates that women with a preference for the infant’s sex are more likely to encounter postpartum depression. The OR for women for whom infant sex was not important is 2.154 (p-value = 0.418), which is statistically insignificant, suggesting that the lack of preference for the infant's sex does not have a significant effect on the risk of postpartum depression (Table 4 ) . Discussion This study found that the prevalence of postpartum women who suffered from postpartum depression was 9%. This study found that the prevalence of postpartum women experiencing postpartum depression was 9%. Results from this study were found to be lower in comparison to a similar study conducted in Mizan Aman Town, Southern Ethiopia (22.4%)( 30 ), and comparable to another study carried out in two tertiary hospitals, Omdurman Maternity and Ibrahim Malik Teaching Hospitals in Sudan (9.2%)( 31 ). This is because South Sudan and Sudan share similar socio-political dynamics, and these results aligns with the current political and financial instability in South Sudan. In regard to the PPD association factors, this study revealed various factors that may contribute to the development of PPD among women who gave birth at Juba Teaching Hospital. These include age, marital status, partner or family support, and women's educational status. The study indicated that women below 18 years were seven times more likely to develop PPD compared to other age groups. These findings are also supported by evidence reported in this study, which suggests that single cohabiting women were likely to suffer from PPD. Reason for these findings could be linked to the fact that most of the women under 18 years found in this study were single, which means that they could have become pregnant outside of marital status. Thus, they find themselves being rejected by their families and also abandoned by their partners. This is a common practice among South Sudanese traditional communities, where they are considered a disgrace to the family and the community at large when they conceive without being married ( 32 , 33 ). Empowering women through education remains a crucial factor in fostering their self-resilience and ownership of decision-making. An educated woman can secure suitable employment, enabling her to be self-reliant and alleviating the economic and social challenges she may encounter, which can lead to stress( 34 , 35 ). This explanation could be supported by the findings revealed in this study, which indicated that 42.9% of women with no formal education were financially dependent on their partners to experience postpartum depression (PPD), in contrast to those who were educated or those receiving financial support from their partners. Another factor that was identified as being associated with PPD in this study was the absence of emotional support from one's partner. Similar investigations conducted inside the region supported the findings. According to a study conducted by Waled AM and his colleagues in Sudan, women who became pregnant outside of marriage were more likely to be rejected by their family and socially stigmatized, as well as abundant by their partners, due to local cultural norms that discouraged marriage to a woman who pregnant outside of marriage( 36 ). Other research conducted in Indonesia related psychological stress to underage females who were pregnant outside of marriage, which was associated with social stigma and a lack of emotional support from family and partners( 37 ). Planned pregnancies provide family joy and stability; they also contribute to both parties' psychological well-being, as opposed to unplanned pregnancies, which are rejected by either partner( 38 ). Male partners frequently blamed their female partners for unwanted births, which can result in neonatal denial and mother mental stress( 39 ). Such arguments could explain the study's findings, which revealed that 57.1% of women who did not want their pregnancy suffered from PPD, compared to 42.9% who did. In our study, women who did not want their newborn's sex were more likely to develop PPD than those who had no preferred sex for their infant or who received the infant sex of their choice. This could be due to societal African norms in which some sex births are valued over others, such as preferring male sex over female sex infants( 40 ). Or it could be attributed to some cultural beliefs that blame women for continuing to give birth to specific sex infants, such as female infants, putting the woman under mental stress as her family continues to blame her and requesting the male partner to find another partner who can give birth to a preferred infant sex( 41 ). It was also noted that women whose infants died were just as likely to have PPD as those whose infants were born with certain congenital abnormalities. These findings are consistent with another study conducted in Western Uganda, which found that mothers who had a stillbirth newborn were more likely to develop PPD than those who had live newborns( 42 ). Conclusion The prevalence of PPD identified in this study (9%) highlights and raises concerns about the overlooked maternal mental health in South Sudan. Despite the challenging circumstances faced by many partners, offering emotional support to women during pregnancy and the postpartum period could help prevent unnecessary PPD from developing among postpartum women. The study recommends the necessity of scaling up maternal mental health support across the country, alongside empowering women through education and employment to alleviate their financial dependency. The study also recommends scaling up of the postpartum depression screening across the country using the EPDS tool, and subsequent establishment of clinical centers for mental support in the main state hospitals. Abbreviations AGOSS Association of Gynecologists and Obstetricians of South Sudan EPDS Edinburgh Postnatal Depression Scale. PPD Postpartum depression SPSS Statistical package for social sciences Declarations Ethics approval and consent to participate This study followed the Declaration of Helsinki and received permission from the National South Sudan Ministry of Health's Research Ethical Committee. All participants were informed of the study's goal and had the option to participate or not. Participants in the study signed a consent form and had the option to withdraw or object to any questions they felt uncomfortable answering. Participants under 18 years supplied consent through their guardians. Participants who couldn't read or write were requested to sign using thumbprints, which was approved by the ethical committee. Consent for publication Not applicable. Availability of data and materials The data for this study are available with corresponding author AND can be provided on demand. Competing interests The authors declare no competing interests. Funding No funding was received for this study. Authors’ contributions All listed authors contributed significantly, directly, and intellectually to the work. ZJM designed and conceptualized the study. GDL reviewed the study proposal. MMA, HMS and JG provided inputs into manuscript, EW analysed the data and reviewed the manuscript. This submitted version was reviewed by all authors Acknowledgements Not applicable References Awini E, Agyepong IA, Owiredu D, Gyimah L, Ashinyo ME, Yevoo LL, et al. Burden of mental health problems among pregnant and postpartum women in sub-Saharan Africa: systematic review and meta-analysis protocol. BMJ Open. 2023 Jun 7;13(6):e069545. Wang Z, Liu J, Shuai H, Cai Z, Fu X, Liu Y, et al. Mapping global prevalence of depression among postpartum women. Vol. 11, Translational Psychiatry. Springer Nature; 2021. Atuhaire C, Brennaman L, Cumber SN, Rukundo GZ, Nambozi G. The magnitude of postpartum depression among mothers in africa: A literature review. Pan African Medical Journal. 2020 Sep 1;37:1–11. 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Kale DP, Tambawala ZY, Rajput NM. Postpartum depression prevalence in a tertiary care hospital in Mumbai, Maharashtra, India. Journal of SAFOG. 2019 Jul 1;11(4):239–42. Suplee PD, Janke J. Awhonn compendium of postpartum care. Manurung S, Setyowati S. Development and validation of the maternal blues scale through bonding attachments in predicting postpartum blues. Malaysian Family Physician. 2021;16(1). Postpartum-Depression. Johansson M, Benderix Y, Svensson I. Mothers’ and fathers’ lived experiences of postpartum depression and parental stress after childbirth: a qualitative study. Int J Qual Stud Health Well-being. 2020 Jan 1;15(1). Patel M, Bailey RK, Jabeen S, Ali S, Barker NC, Osiezagha K. Postpartum depression: A review. J Health Care Poor Underserved. 2012 May;23(2):534–42. Hapgood CC, Elkind GS, Wright JJ. Maternity blues: Phenomena and relationship to later post partum depression. Australasian Psychiatry. 1988;22(3):299–306. Zakeri MA, Khoram S, Bazmandegan G, Ghaedi-Heidari F, Talebi B, Ramezani N, et al. Postpartum depression and its correlates: a cross-sectional study in southeast Iran. BMC Womens Health. 2022 Dec 1;22(1). O’Hara MW, Mc Cabe JE. Postpartum depression: Current status and future directions. Vol. 9, Annual Review of Clinical Psychology. 2013. p. 379–407. Rai S, Pathak A, Sharma I. Postpartum psychiatric disorders: Early diagnosis and management. Vol. 57, Indian Journal of Psychiatry. Wolters Kluwer Medknow Publications; 2015. p. 216–21. Good Practice No. 14 Management of Women with Mental Health Issues during Pregnancy and the Postnatal Period [Internet]. 2011. Available from: www.mhra.gov.uk PREVALENCE OF POSTPARTUM DEPRESSION AMONG WOMEN DELIVERING AT KENYATTA NATIONAL HOSPITAL DISSERTATION IN PARTIAL FULFILMENT FOR THE DEGREE OF MASTERS OF MEDICINE IN OBSTETRICS AND GYNECOLOGY, UNIVERSITY OF NAIROBI 2013 SUBMITTED BY Mwikali Musau MBChB V. Atuhaire C, Rukundo GZ, Nambozi G, Ngonzi J, Atwine D, Cumber SN, et al. Prevalence of postpartum depression and associated factors among women in Mbarara and Rwampara districts of south-western Uganda. BMC Pregnancy Childbirth. 2021 Dec 1;21(1). Tolossa T, Fetensa G, Yilma MT, Abadiga M, Wakuma B, Besho M, et al. Postpartum depression and associated factors among postpartum women in Ethiopia: A systematic review and meta-analysis, 2020. Vol. 41, Public Health Reviews. BioMed Central Ltd; 2020. Gloria M, Njoku C. CAUSES AND CONSEQUENCES OF POSTPARTUM DEPRESSION AMONG WOMEN. Gunst A, Sundén M, Korja R, Boddy AM, Kotler J, Paavonen EJ, et al. Postpartum depression and mother-offspring conflict over maternal investment. Evol Med Public Health. 2021;9(1):11–23. Kariuki EW, Kuria MW, Were FN, Ndetei DM. Predictors of postnatal depression in the slums Nairobi, Kenya: a cross-sectional study. BMC Psychiatry. 2022 Dec 1;22(1). Chalise A, Bhandari TR. Postpartum Depression and its Associated Factors: A Community-based Study in Nepal. J Nepal Health Res Counc. 2019 Aug 4;17(2):200–5. Yu J, Zhang Z, Deng Y, Zhang L, He C, Wu Y, et al. Risk factors for the development of postpartum depression in individuals who screened positive for antenatal depression. BMC Psychiatry [Internet]. 2023 Aug 1;23(1):557. Available from: https://bmcpsychiatry.biomedcentral.com/articles/10.1186/s12888-023-05030-1 ABOUT THE EPDS. Edinburgh Postnatal Depression Scale 1 (EPDS) [Internet]. Available from: www.depressionafterdelivery.com Toru T, Chemir F, Anand S. Magnitude of postpartum depression and associated factors among women in Mizan Aman town, Bench Maji zone, Southwest Ethiopia. BMC Pregnancy Childbirth. 2018 Nov 14;18(1). Khalifa DS, Glavin K, Bjertness E, Lien L. Postnatal depression among Sudanese women: Prevalence and validation of the Edinburgh Postnatal depression scale at 3 months postpartum. Int J Womens Health. 2015 Jul 8;7:677–84. Howe K, Stites E, Moran M, Marshak A, Hammada A, Sulaiman S, et al. Circumscribed Lives: Separated, Divorced, and Widowed Female Youth in South Sudan and the Kurdistan Region of Iraq Feinstein International Center Circumscribed Lives: Separated, Divorced, and Widowed Female Youth in South Sudan and the Kurdistan Region of Iraq [Internet]. 2022. Available from: https://reporting.unhcr.org/document/1799. Atem Deng S. Fitting the Jigsaw: South Sudanese Family Dynamics and Parenting Practices in Australia. 2016. Basak R. ROLE OF EDUCATION ON WOMEN EMPOWERMENT IN THE SOCIETY [Internet]. Available from: https://www.researchgate.net/publication/370818401 Magaji RJ. THE ROLE OF WOMEN EDUCATION IN THE EMPOWERMENT OF WOMEN FOR NATIONAL DEVELOPMENT. Mohamed AAA, Babiker EAA, Godat SM, Doalbet SMG, Ahmed AAF, Ali MHM, et al. Out-of-Wedlock Pregnancy Among Single Mothers in Khartoum, Sudan: Sociodemographic Characteristics, Causes, and Consequences. Sudan Journal of Medical Sciences. 2023;18(3):377–90. Sundari E, Retnowati A. Marrying Unwanted Pregnant Girl Phenomenon in Indonesia: Is it in the Child’s Best Interests? KnE Social Sciences. 2024 Jan 5; Su JH. Unexpectedly Expecting: Pregnancy Intentions and Parental Well-being. 2011. Beumer WY, Koot MH, Vrijkotte T, Roseboom TJ, van Ditzhuijzen J. Long-term effects of unintended pregnancy on children: Findings from the Dutch perspective birth-cohort Amsterdam born children and their development study. Soc Sci Med. 2024 Sep 1;357. Rossi P, Rouanet L. Gender Preferences in Africa: A Comparative Analysis of Fertility Choices [Internet]. 2015. Available from: https://shs.hal.science/halshs-01074934v2 Baloyi ME, Manala MJ. Reflections on challenges of preferring the male child in an African marriage – a practical theological observation. Verbum et Ecclesia. 2019;40(1). Bekkhus M, Oftedal A, Braithwaite E, Haugen G, Kaasen A. Paternal Psychological Stress After Detection of Fetal Anomaly During Pregnancy. A Prospective Longitudinal Observational Study. Front Psychol. 2020 Jul 29;11. Additional Declarations No competing interests reported. Cite Share Download PDF Status: Under Review Version 1 posted Reviews received at journal 23 May, 2025 Reviewers agreed at journal 18 May, 2025 Reviewers invited by journal 06 May, 2025 Editor invited by journal 11 Apr, 2025 Editor assigned by journal 11 Apr, 2025 Submission checks completed at journal 11 Apr, 2025 First submitted to journal 06 Apr, 2025 You are reading this latest preprint version Research Square lets you share your work early, gain feedback from the community, and start making changes to your manuscript prior to peer review in a journal. As a division of Research Square Company, we’re committed to making research communication faster, fairer, and more useful. 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Also discoverable on Platform About Our Team In Review Editorial Policies Advisory Board Help Center Resources Author Services Accessibility API Access RSS feed Manage Cookie Preferences © Research Square 2026 | ISSN 2693-5015 (online) Privacy Policy Terms of Service Do Not Sell My Personal Information {"props":{"pageProps":{"initialData":{"identity":"rs-6386454","acceptedTermsAndConditions":true,"allowDirectSubmit":false,"archivedVersions":[],"articleType":"Research Article","associatedPublications":[],"authors":[{"id":453621103,"identity":"7148bae5-e1ce-45ff-9d38-1e1412cb6f54","order_by":0,"name":"Zechariah J Malel","email":"data:image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAZAAAAAyAQMAAABI0h/eAAAABlBMVEX///8AAABVwtN+AAAACXBIWXMAAA7EAAAOxAGVKw4bAAAA+ElEQVRIiWNgGAWjYBAC+wYGAwbGBgYZNvbmgw8+AEXY2AloYYRq4eHjOZZsOAOkhZlYLXISOWbSPCAhQlqYxQ5vfPBzhw0PG88ZA2mbX9vk+ZgZGD98zMGthU06rdiw90waDxt7W4Fxbt9twzZmBmbJmdtwa+GRBrqHse0w0JbDG5Jze24zArWwMfPi0SIhnWP+G6xFIsHgsGXPbXuCWgyAtjBDtKQYNjP8uJ1IhJa0YsneNqBfgIHM2NtwO7mNmbEZr1/sZydv/PCzzUZOvr35+I8ff27bzm9vPvjhIx4tqICxDUw2EKseBP6QongUjIJRMApGCgAAn6tM+d+453kAAAAASUVORK5CYII=","orcid":"","institution":"University of Juba","correspondingAuthor":true,"prefix":"","firstName":"Zechariah","middleName":"J","lastName":"Malel","suffix":""},{"id":453621105,"identity":"b700f8c3-d72f-47b9-84d8-33440ef2822d","order_by":1,"name":"Garang Dakjur Lueth","email":"","orcid":"","institution":"University of Juba","correspondingAuthor":false,"prefix":"","firstName":"Garang","middleName":"Dakjur","lastName":"Lueth","suffix":""},{"id":453621108,"identity":"c8e75474-dcd3-4039-b493-668976c94b85","order_by":2,"name":"Moses Maror Ayuel","email":"","orcid":"","institution":"University of Juba","correspondingAuthor":false,"prefix":"","firstName":"Moses","middleName":"Maror","lastName":"Ayuel","suffix":""},{"id":453621109,"identity":"ae57d907-2a29-439e-a240-73060b0bd1c7","order_by":3,"name":"Haram Mustafa Sebit","email":"","orcid":"","institution":"University of Juba","correspondingAuthor":false,"prefix":"","firstName":"Haram","middleName":"Mustafa","lastName":"Sebit","suffix":""},{"id":453621112,"identity":"46aa30b4-70df-4a81-a3c3-61fed608f0cf","order_by":4,"name":"Ezbon Wapary","email":"","orcid":"","institution":"University of Juba","correspondingAuthor":false,"prefix":"","firstName":"Ezbon","middleName":"","lastName":"Wapary","suffix":""},{"id":453621113,"identity":"c8ef5217-ecb1-4984-aecf-541968dfd691","order_by":5,"name":"Jock Gang","email":"","orcid":"","institution":"Upper Nile University","correspondingAuthor":false,"prefix":"","firstName":"Jock","middleName":"","lastName":"Gang","suffix":""}],"badges":[],"createdAt":"2025-04-06 11:53:12","currentVersionCode":1,"declarations":"","doi":"10.21203/rs.3.rs-6386454/v1","doiUrl":"https://doi.org/10.21203/rs.3.rs-6386454/v1","draftVersion":[],"editorialEvents":[],"editorialNote":"","failedWorkflow":false,"files":[{"id":82374806,"identity":"70f158f2-435a-45de-b072-daa921b985cf","added_by":"auto","created_at":"2025-05-09 14:25:48","extension":"jpg","order_by":1,"title":"Figure 1","display":"","copyAsset":false,"role":"figure","size":13250,"visible":true,"origin":"","legend":"\u003cp\u003ePrevalence of postpartum depression among women giving birth in the obstetrics and gynecology department, Juba Teaching Hospital\u003c/p\u003e","description":"","filename":"1.jpg","url":"https://assets-eu.researchsquare.com/files/rs-6386454/v1/016d250b51b47e7a68b0d39c.jpg"},{"id":82376783,"identity":"1aec4314-faf6-4d85-9377-370068bffb42","added_by":"auto","created_at":"2025-05-09 14:41:48","extension":"pdf","order_by":0,"title":"","display":"","copyAsset":false,"role":"manuscript-pdf","size":1363276,"visible":true,"origin":"","legend":"","description":"","filename":"manuscript.pdf","url":"https://assets-eu.researchsquare.com/files/rs-6386454/v1/a6d5ea13-1c70-4be1-abfc-07cf4c8d2b83.pdf"}],"financialInterests":"No competing interests reported.","formattedTitle":"Insight into postpartum depression; a situational analysis among women giving birth at Juba Teaching Hospital, South Sudan","fulltext":[{"header":"Introduction","content":"\u003cp\u003eMaternal mental health concerns continue to be among the most underserved health issues in the globe. Approximately 17.2% of postpartum women develop mental health problems such as depression or anxiety (\u003cspan citationid=\"CR1\" class=\"CitationRef\"\u003e1\u003c/span\u003e)(\u003cspan citationid=\"CR2\" class=\"CitationRef\"\u003e2\u003c/span\u003e). According to a meta-analysis, 6.9–50.2% of women in Africa suffer from postpartum depression (\u003cspan citationid=\"CR3\" class=\"CitationRef\"\u003e3\u003c/span\u003e) with Sub-Saharan Africa alone accounting for 18.6 to 21.8% (\u003cspan citationid=\"CR4\" class=\"CitationRef\"\u003e4\u003c/span\u003e)(\u003cspan citationid=\"CR5\" class=\"CitationRef\"\u003e5\u003c/span\u003e).\u003c/p\u003e \u003cp\u003ePostpartum mental health issues do not just affect postpartum women and their infants; they also have a detrimental impact on parental depression, family stress, poor family functioning, and instability (\u003cspan citationid=\"CR6\" class=\"CitationRef\"\u003e6\u003c/span\u003e)(\u003cspan citationid=\"CR7\" class=\"CitationRef\"\u003e7\u003c/span\u003e).\u003c/p\u003e \u003cp\u003ePostpartum depression is considered as a public major health concern. It is defined as a mood disorder or disturbance that affect the mother after childbirth, last for weeks or months after birth (\u003cspan citationid=\"CR8\" class=\"CitationRef\"\u003e8\u003c/span\u003e)(\u003cspan citationid=\"CR9\" class=\"CitationRef\"\u003e9\u003c/span\u003e).\u003c/p\u003e \u003cp\u003ePostpartum depression differs from postpartum blues and postpartum psychosis. Postpartum blues is a moderate and temporary condition that lasts no more than ten days and is characterized by rapid mood shifts in which the woman feels irritated, let down, and overly sensitive(\u003cspan citationid=\"CR10\" class=\"CitationRef\"\u003e10\u003c/span\u003e). Postpartum blues is a self-limiting phenomenon that does not need major intervention apart from provision of the mother with emotional support and re-assurance(\u003cspan citationid=\"CR11\" class=\"CitationRef\"\u003e11\u003c/span\u003e). Woman with postpartum depression presents with mood changes in the majority of days, for at least two weeks, where the woman feels losing interest or pleasure in engaging in anything (\u003cspan citationid=\"CR12\" class=\"CitationRef\"\u003e12\u003c/span\u003e). She also complains of exhaustion, restlessness, feelings of guilt or worthlessness, insomnia, loss of focus, and persistent thoughts of suicide or death. Furthermore, a woman with postpartum depression has anxiety about her newborn and the risk of developing psychotic thinking, such as hallucinations, which could lead to injuring her surroundings, such as children(\u003cspan citationid=\"CR13\" class=\"CitationRef\"\u003e13\u003c/span\u003e) (\u003cspan citationid=\"CR14\" class=\"CitationRef\"\u003e14\u003c/span\u003e)(\u003cspan citationid=\"CR15\" class=\"CitationRef\"\u003e15\u003c/span\u003e).(\u003cspan citationid=\"CR16\" class=\"CitationRef\"\u003e16\u003c/span\u003e).\u003c/p\u003e \u003cp\u003eIn a study conducted by O’Hara; Pearlstin in 2009, many women sufferings with mental health conditions are not usually diagnosed or receive proper medical attention. Numerous healthcare providers fail to recognize maternal depression during postpartum or pregnancy(\u003cspan citationid=\"CR17\" class=\"CitationRef\"\u003e17\u003c/span\u003e). This is attributed to the lack of skillful personal to identify, treat and provide maternal psycho-social support to those in need(\u003cspan citationid=\"CR18\" class=\"CitationRef\"\u003e18\u003c/span\u003e).(\u003cspan citationid=\"CR19\" class=\"CitationRef\"\u003e19\u003c/span\u003e)\u003c/p\u003e \u003cp\u003eThere is a lack of statistics on the prevalence and trends of postpartum mental health disorders, as well as a general mental health program.\u003c/p\u003e \u003cp\u003eA study conducted by Mwikali at Juma Kenyatta Tertiary Hospital revealed that 10.6% of women delivered at the facility during the time of study had postpartum depression,(\u003cspan citationid=\"CR20\" class=\"CitationRef\"\u003e20\u003c/span\u003e)which is lower than the 27.1% prevalence of postpartum depression in Mbrara in Western Uganda (\u003cspan citationid=\"CR21\" class=\"CitationRef\"\u003e21\u003c/span\u003e), and 33.8% in Southern Ethiopia(\u003cspan citationid=\"CR22\" class=\"CitationRef\"\u003e22\u003c/span\u003e).\u003c/p\u003e \u003cp\u003eThough no systematic studies were undertaken in South Sudan to determine factors related with postpartum depression, the country's socioeconomic challenges and political instability may in other ways contribute to the development of postpartum depression. Several studies have found that stressful life events, low financial income, low educational standing, and family problems all contribute to the development of postpartum depression.\u003c/p\u003e \u003cp\u003eIn studies conducted to determine the predictors of postpartum depression, women residing in a conflict dominated areas and have socioeconomic difficulties suffers from postpartum depression(\u003cspan citationid=\"CR23\" class=\"CitationRef\"\u003e23\u003c/span\u003e) (\u003cspan citationid=\"CR24\" class=\"CitationRef\"\u003e24\u003c/span\u003e). Postpartum depression can affect all women of reproductive age. In a study done in Kenya, young age (18–24 years old) suffered from postpartum depression compared to woman with 40 years old(\u003cspan citationid=\"CR25\" class=\"CitationRef\"\u003e25\u003c/span\u003e). Nonetheless, presence of birth defects and giving birth to unwanted sex child are also predictors to postpartum depression(\u003cspan citationid=\"CR26\" class=\"CitationRef\"\u003e26\u003c/span\u003e) (\u003cspan citationid=\"CR27\" class=\"CitationRef\"\u003e27\u003c/span\u003e).\u003c/p\u003e \u003cp\u003eLittle or nothing is known about postpartum depression or maternal mental health in South Sudan. As a result, the purpose of this study was to present and analyze the situation, taking into account the general conditions in the country that are conducive to the development of postpartum mental health difficulties. A lack of previous similar studies in South Sudan, as well as a lack of postpartum mental health support in the nation, are a few of the contributing causes to poor documentation of the country's overall maternal mental health situation. Thus, the study exposed the unknown atmosphere of maternal mental health status in South Sudan with the objective of sharing the data with health policy makers to enable them in planning and designing a response strategy that bridges gaps related with the country's maternal mental health situation.\u003c/p\u003e "},{"header":"Methodology","content":"\u003cp\u003eStudy design and population\u003c/p\u003e\u003cp\u003eThis was a prospective, cross-sectional study conducted among postpartum women who gave birth at the department of Obstetrics and gynecology, Juba Teaching Hospital between 1st January and June, 2023. Study population included all postpartum women of reproductive ages (15–45 years) who gave birth in the department during the study timeframe, and consented to participate in the study, with the exclusion of postpartum women known to have had mental disturbance prior to the time of the study or those who declined to take part in the study. Beside women with special needs such as women with hearing or sight impairments.\u003c/p\u003e\u003cp\u003eSample size\u003c/p\u003e\u003cp\u003eThe sample size was obtained through a proportion that calculate sample size N = Z2*P (1-p)/E2\u003c/p\u003e\u003cp\u003eWhere N represents a sample size, Z is a percentage point of normal distribution corresponding to significant level of 95%. set for Z is equal to 1.96, E represent standard error degree of accuracy (0.05) while P represent proportion of women with postpartum depression. However, the calculated sample size was done in reference to study conducted in Kenyata National Hospital by Virgina Mwikali that found prevalence of postpartum to be 10.6%(\u003cspan citationid=\"CR20\" class=\"CitationRef\"\u003e20\u003c/span\u003e) Hence, the calculated sample size became 160 women after calculating using the above formula and consideration of the 10% non-responding rate.\u003c/p\u003e\u003cp\u003eSampling procedure\u003c/p\u003e\u003cp\u003eThe study used a systematic randomized sampling technique to enroll the 160 postnatal women who fit the criteria. Those who consented to participate in the study and met the criteria were enrolled.\u003c/p\u003e\u003cp\u003eData collection and tool description\u003c/p\u003e\u003cp\u003eData were collected using a structured data collection tool adopted from the Edinburgh Postnatal Depression Scale (EPDS) that was developed by Cox and Holden in 1987. This is a screening instrument, and not diagnostic tool (\u003cspan citationid=\"CR28\" class=\"CitationRef\"\u003e28\u003c/span\u003e). The tool divides women into two groups according to their assessment results and consists of 10 questions with a maximum score of 30. According to the tool, women who score 13 points or higher are positive for postpartum depression, whereas those who score less than 13 points are deemed to have no postpartum depression(\u003cspan citationid=\"CR29\" class=\"CitationRef\"\u003e29\u003c/span\u003e). The tool was divided into three sections for the study: section \"A\" includes the introduction and sociodemographic and economic data of the participants; section \"B\" records obstetric and reproductive details; and section \"C\" includes the Edinburgh Postnatal Depression Scale (EPDS) assessment questions.\u003c/p\u003e\u003cp\u003eWomen who gave birth and fulfilled the study's criteria were addressed within 24 hours of delivery or before being discharged home. The goal of the study was explained to them, and their consent to participate was acquired. Those who understood and agreed to participate in the study were given a consent form to sign, or they could sign with their thumbprint if they were unable to write or read. Those under the age of 18 provided consent through their grantors. A partial interview was conducted with participants who agreed to participate in the study by filling out social demographic, economic, obstetric, and reproductive health information. As they exited the facility, they were asked for their phone numbers and household addresses. Participants were called at six weeks after delivery using the phone number they supplied, and times for home visits were scheduled to complete the remainder of the questionnaire via EPDS assessment section.\u003c/p\u003e\u003ch2\u003eData analysis\u003c/h2\u003e\u003cp\u003eDada was checked for completeness; each questionnaire was be given a unique code. Complete questionnaire was entered into SPSS version 27 for analysis. Descriptive analysis was done through running frequencies and proportions. Relationship between outcome variable and exposure variables was established on chi square test(p)value, a value less than 0.05 was considered significant factors associated with postpartum depression. To determine the independent factors, associated with the postpartum depression, significant values of 0.05 or less on Chi square were run through multi-nominal logistic regression, and value less than 0.05 was considered a predictor factor for postpartum depression. To establish the PPD prevalences, responses obtained from the clients on the EPDS assessment were quantified based on the EPDS quantification system, before being transferred into SPSS, version 27 for frequencies and proportion analysis. Any assessed woman who fell below the EPDS 13 points scoring scale was considered not suffering of postnatal depression, contrary to those who scored above the 13-poins EPDS scoring system.\u003c/p\u003e\u003cp\u003eEthical issues and clearance\u003c/p\u003e\u003cp\u003e Ethical clearance for the study was obtained from national ministry of health ethical committee board. However, there are no conflicts of interest or gain other than being instructive for health decision makers.\u003c/p\u003e\u003cp\u003eStudy participants were kept as anonymous and classified with numbers for confidentiality. The purpose for this study was explained to all participants, and everyone was granted the discretion to refuse or accept participating in the study. Those accepted to participate in the study were provided with a consent form to sign, which gave them the option of dropping out of the study or objecting to any question they felt uncomfortable answering. Participants less than 18 years provided consent through their guardians. Participants who couldn’t read or write were requested to sign using their thumbprints as per the ethical committee approval.\u003c/p\u003e"},{"header":"Results","content":"\u003cdiv id=\"Sec4\" class=\"Section2\"\u003e \u003ch2\u003eRespondence rate during the follow phase\u003c/h2\u003e \u003cp\u003eAll the 160 women who were recruited for the study and whom the interview was started with during the 24 hours postnatally were successfully reached during the follow up time that was meant after 6 weeks post delivery period, making the 100% respondence rate.\u003cdiv class=\"BlockQuote\"\u003e\u003cp\u003e \u003cem\u003eDemographic information of women giving birth in the obstetrics and gynecology department, Juba Teaching Hospital.\u003c/em\u003e \u003c/p\u003e\u003c/div\u003e\u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab1\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 1\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003eDemographic information of women giving birth in the obstetrics and gynecology department, Juba Teaching Hospital\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"5\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c5\" colnum=\"5\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003eVariable\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c2\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003en\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003e%\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colspan=\"2\" nameend=\"c5\" namest=\"c4\"\u003e \u003cp\u003e95% Confidence Interval\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c4\"\u003e \u003cp\u003eLower\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c5\"\u003e \u003cp\u003eUpper\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\"\u003e \u003cp\u003eAge of the mother\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/th\u003e \u003cth align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/th\u003e \u003cth align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eLess than 18 years\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e22\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e13.8\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e8.8\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e18.8\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e18\u0026ndash;24 years\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e51\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e31.9\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e25\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e39.4\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e25\u0026ndash;45\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e87\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e54.4\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e46.9\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e61.3\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eMarital status\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eMarried\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e131\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e81.9\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e75.6\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e87.5\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eSingle\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e12\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e7.5\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e3.8\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e11.9\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eCo-habiting\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e17\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e10.6\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e6.3\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e15\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eEducational level\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eNo formal education\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e26\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e16.3\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e10.6\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e21.9\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003ePrimary to Secondary\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e104\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e65.0\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e58.1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e72.5\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eUniversity and above\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e30\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e18.8\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e13.1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e25\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eOccupational level\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eNot employed\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e108\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e67.5\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e60.6\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e75.6\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eSelf employed\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e38\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e23.8\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e16.9\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e30.6\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eEmployed\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e14\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e8.8\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e4.4\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e13.8\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003cp\u003eTable\u0026nbsp;\u003cspan refid=\"Tab1\" class=\"InternalRef\"\u003e1\u003c/span\u003e displays the demographic profile of women giving birth at the Obstetrics and Gynecology Department of Juba Teaching Hospital. Regarding age distribution, a majority of the women (54.4%) were between 25 and 45 years old, with a confidence interval of 46.9\u0026ndash;61.3%. Women aged 18 to 24 years constituted 31.9% of the sample (CI: 25\u0026ndash;39.4%), while those under 18 years accounted for 13.8% (CI: 8.8\u0026ndash;18.8%).\u003c/p\u003e \u003cp\u003eMarital status data showed that most women (81.9%) were married (CI: 75.6\u0026ndash;87.5%). A smaller proportion (10.6%) were cohabiting (CI: 6.3\u0026ndash;15%), and 7.5% were single (CI: 3.8\u0026ndash;11.9%).\u003c/p\u003e \u003cp\u003eEducational attainment varied, with 65% of women having completed primary or secondary education (CI: 58.1\u0026ndash;72.5%). Meanwhile, 18.8% had attained university-level education or higher (CI: 13.1\u0026ndash;25%), whereas 16.3% had no formal education (CI: 10.6\u0026ndash;21.9%).\u003c/p\u003e \u003cp\u003eOccupational status indicated that the majority of the women (67.5%) were unemployed (CI: 60.6\u0026ndash;75.6%). Self-employment was reported by 23.8% (CI: 16.9\u0026ndash;30.6%), while 8.8% were formally employed (CI: 4.4\u0026ndash;13.8%).\u003cdiv class=\"BlockQuote\"\u003e\u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab2\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 2\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003e4.1Prevalence of postpartum depression among women giving birth in the obstetrics and gynecology department, Juba Teaching Hospital\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"5\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c5\" colnum=\"5\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003ePostpartum Depression\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c2\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003en\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003e%\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colspan=\"2\" nameend=\"c5\" namest=\"c4\"\u003e \u003cp\u003e95% Confidence Interval\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c4\"\u003e \u003cp\u003eLower\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c5\"\u003e \u003cp\u003eUpper\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u0026le;\u0026thinsp;12 points\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e146\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e91.3\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e86.9\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e95.6\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u0026ge;\u0026thinsp;13 points\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e14\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e8.8\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e4.4\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e13.1\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003cp\u003eThe prevalence of postpartum depression among women who gave birth in the obstetrics and gynecology department of Juba Teaching Hospital was assessed using a standardized scoring system. The majority of participants, 146 women (91.3%), had scores of 12 or lower, suggesting they were not experiencing substantial postpartum depression with 95% CI: 86.9% \u0026minus;\u0026thinsp;95.6%, demonstrating a high level of confidence in these results (Table\u0026nbsp;\u003cspan refid=\"Tab2\" class=\"InternalRef\"\u003e2\u003c/span\u003e, Fig.\u0026nbsp;\u003cspan refid=\"Fig1\" class=\"InternalRef\"\u003e1\u003c/span\u003e).\u003c/p\u003e \u003cp\u003eNonetheless, a smaller proportion of women, 14 individuals (8.8%), had scores of 13 or higher, implying the presence of postpartum depression with 95% CI 4.4% \u0026minus;\u0026thinsp;13.1%, indicating some variability in the estimate but still highlighting a notable prevalence of postpartum depression in this population (Table\u0026nbsp;\u003cspan refid=\"Tab2\" class=\"InternalRef\"\u003e2\u003c/span\u003e, Fig.\u0026nbsp;\u003cspan refid=\"Fig1\" class=\"InternalRef\"\u003e1\u003c/span\u003e).\u003cdiv class=\"BlockQuote\"\u003e\u003cp\u003e \u003cem\u003eDeterminants of postpartum depression among giving birth at the department of obstetrics and gynecology, Juba Teaching Hospital.\u003c/em\u003e \u003c/p\u003e\u003c/div\u003e\u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab3\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 3\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003eFactors associated with postpartum depression among giving birth at the department of obstetrics and gynecology, Juba Teaching Hospital\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"9\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c5\" colnum=\"5\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c6\" colnum=\"6\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c7\" colnum=\"7\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c8\" colnum=\"8\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c9\" colnum=\"9\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\" morerows=\"2\" rowspan=\"3\"\u003e \u003cp\u003eAssociated factors\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colspan=\"4\" nameend=\"c5\" namest=\"c2\"\u003e \u003cp\u003ePostpartum Depression\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c6\" morerows=\"2\" rowspan=\"3\"\u003e \u003cp\u003eTotal, n\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c7\" morerows=\"2\" rowspan=\"3\"\u003e \u003cp\u003eChi-Square\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c8\" morerows=\"2\" rowspan=\"3\"\u003e \u003cp\u003edf\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c9\" morerows=\"2\" rowspan=\"3\"\u003e \u003cp\u003ep -value\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003ctr\u003e \u003cth align=\"left\" colspan=\"2\" nameend=\"c3\" namest=\"c2\"\u003e \u003cp\u003e\u0026le;\u0026thinsp;12 points\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colspan=\"2\" nameend=\"c5\" namest=\"c4\"\u003e \u003cp\u003e\u0026ge;\u0026thinsp;13 points\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003en\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003e%\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c4\"\u003e \u003cp\u003en\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c5\"\u003e \u003cp\u003e%\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eAge of the mother\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e7.095\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e2\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e0.029\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eLess than 18 years\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e18\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e12.3\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e4\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e28.6\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e22\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e18\u0026ndash;24 years\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e44\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e30.1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e7\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e50.0\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e51\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e25\u0026ndash;45\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e84\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e57.5\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e3\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e21.4\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e87\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eMother marital status\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e12.672\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e2\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e0.002\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eMarried\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e124\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e84.9\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e7\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e50.0\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e131\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eSingle\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e8\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e5.5\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e4\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e28.6\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e12\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eCo-habiting\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e14\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e9.6\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e3\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e21.4\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e17\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eEducational level\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e9.706\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e2\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e0.008\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eNo formal education\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e20\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e13.7\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e6\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e42.9\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e26\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003ePrimay to Secondry\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e96\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e65.8\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e8\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e57.1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e104\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eUniversity and above\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e30\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e20.5\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e0.0\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e30\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eOccupational level\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e0.931\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e2\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e0.628\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eNot employed\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e100\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e68.5\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e8\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e57.1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e108\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eSelf employed\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e34\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e23.3\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e4\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e28.6\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e38\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eEmployed\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e12\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e8.2\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e2\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e14.3\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e14\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c2\" namest=\"c1\"\u003e \u003cp\u003e\u003cb\u003eHusband\u0026lrm; or partner financial support\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e11.631\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e2\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e0.003\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eNo support\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e19\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e13.0\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e6\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e42.9\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e25\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eYes, but not adequate\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e112\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e76.7\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e5\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e35.7\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e117\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eYes, adequate\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e15\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e10.3\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e3\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e21.4\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e18\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c2\" namest=\"c1\"\u003e \u003cp\u003e\u003cb\u003eHusband or partner emotional support\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e8.446\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e2\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e0.015\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eNo support\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e17\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e11.6\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e5\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e35.7\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e22\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eSometimes supportive\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e80\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e54.8\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e3\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e21.4\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e83\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eFully supportive\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e49\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e33.6\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e6\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e42.9\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e55\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eParity of the mother\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e3.962\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e2\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e0.138\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003ePara 1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e17\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e11.6\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e3\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e21.4\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e20\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003ePara 2\u0026ndash;4\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e58\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e39.7\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e8\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e57.1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e66\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003ePara 5 or more\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e71\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e48.6\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e3\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e21.4\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e74\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eWas the pregnany wanted\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e14.845a\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;0.001\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eNot wanted\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e22\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e15.1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e8\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e57.1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e30\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eYes,wanted\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e124\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e84.9\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e6\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e42.9\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e130\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eSex of the infant\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e0.051\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e0.821\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eFemale\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e100\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e68.5\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e10\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e71.4\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e110\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eMale\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e46\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e31.5\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e4\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e28.6\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e50\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eWas the infant sex wanted\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e11.567\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e2\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e0.003\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eNo\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e14\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e9.6\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e5\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e35.7\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e19\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eYes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e22\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e15.1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e4\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e28.6\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e26\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eWas not important whether a boy or girl\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e110\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e75.3\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e5\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e35.7\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e115\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eWas the baby born alive\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e3.638\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e0.056\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eNo\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e10\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e6.8\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e3\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e21.4\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e13\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eYes, Alive\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e136\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e93.2\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e11\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e78.6\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e147\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"3\" nameend=\"c3\" namest=\"c1\"\u003e \u003cp\u003e\u003cb\u003eWhat was the mode of the feeding planned for infant\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e0.194\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e0.659\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eExclusive breast feeding\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e144\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e98.6\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e14\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e100.0\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e158\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eOthers\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e2\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e1.4\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e0.0\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e2\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"3\" nameend=\"c3\" namest=\"c1\"\u003e \u003cp\u003e\u003cb\u003eIs the mother happy and accepted her infant sex\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e0.807\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e2\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e0.668\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eNo\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e2\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e1.4\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e0.0\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e2\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eYes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e138\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e94.5\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e14\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e100.0\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e152\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eSomehow\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e6\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e4.1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e0.0\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e6\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"3\" nameend=\"c3\" namest=\"c1\"\u003e \u003cp\u003e\u003cb\u003eAre there chronic physical maternal illnesses\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e0.293\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e0.588\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eNot present\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e143\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e97.9\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e14\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e100.0\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e157\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eYes, present\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e3\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e2.1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e0.0\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e3\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eIs infant congenital conditions\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e10.494\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e0.001\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eNot present\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e146\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e100.0\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e13\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e92.9\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e159\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003ePresent\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e0\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e0.0\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e7.1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"3\" nameend=\"c3\" namest=\"c1\"\u003e \u003cp\u003e\u003cb\u003eDid the continue to get ill since the time of delivery\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e1.471\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e2\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e0.479\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eNo\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e132\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e90.4\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e14\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e100.0\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e146\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eYes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e7\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e4.8\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e0.0\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e7\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eSomehow\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e7\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e4.8\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e0.0\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e7\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003cp\u003eTable\u0026nbsp;\u003cspan refid=\"Tab3\" class=\"InternalRef\"\u003e3\u003c/span\u003e presents the factors associated with postpartum depression (PPD) among women who gave birth at the Department of Obstetrics and Gynecology at Juba Teaching Hospital. The chi-square test was used to assess the statistical significance of each factor.\u003c/p\u003e \u003cp\u003eA significant relationship was found between age and postpartum depression (χ\u0026sup2; = 7.095, p\u0026thinsp;=\u0026thinsp;0.029). The highest percentage of women with PPD (28.6%) were under 18 years, while the lowest percentage was among those aged 25\u0026ndash;45 years (21.4%). Marital status was significantly associated with postpartum depression (χ\u0026sup2; = 12.672, p\u0026thinsp;=\u0026thinsp;0.002). Women who were married had the lowest prevalence of PPD (50.), while those who were single or co-habiting experienced higher rates (28.6% and 21.4%, respectively) (Table\u0026nbsp;\u003cspan refid=\"Tab3\" class=\"InternalRef\"\u003e3\u003c/span\u003e\u003cb\u003e)\u003c/b\u003e.\u003c/p\u003e \u003cp\u003eEducation was also found to have a significant association with postpartum depression (χ\u0026sup2; = 9.706, p\u0026thinsp;=\u0026thinsp;0.008). Women with no formal education had a higher percentage of PPD (42.9%), compared to those with secondary education (57.1%) or higher (). Employment status did not significantly correlate with PPD (χ\u0026sup2; = 0.931, p\u0026thinsp;=\u0026thinsp;0.628), suggesting that the type of employment (or lack thereof) does not have a major impact on postpartum depression.\u003c/p\u003e \u003cp\u003eFinancial support from a partner was significantly associated with postpartum depression (χ\u0026sup2; = 11.631, p\u0026thinsp;=\u0026thinsp;0.003). Women who received inadequate financial support had a higher percentage of PPD (42.9%), while those with no financial support had 42.9% as well. Adequate support was associated with a lower percentage of PPD (21.4%). Emotional support from a partner was found to be significantly associated with postpartum depression (χ\u0026sup2; = 8.446, p\u0026thinsp;=\u0026thinsp;0.015). Women who received no emotional support experienced a higher percentage of PPD (35.7%), compared to those who were sometimes or fully supported (21.4% and 42.9%, respectively) (Table\u0026nbsp;\u003cspan refid=\"Tab3\" class=\"InternalRef\"\u003e3\u003c/span\u003e\u003cb\u003e)\u003c/b\u003e.\u003c/p\u003e \u003cp\u003eThere was no significant association between the number of previous pregnancies and postpartum depression (χ\u0026sup2; = 3.962, p\u0026thinsp;=\u0026thinsp;0.138), indicating that parity does not seem to play a major role in PPD risk. The pregnancy's desirability was significantly associated with postpartum depression (χ\u0026sup2; = 14.845, p\u0026thinsp;\u0026lt;\u0026thinsp;0.001). Women who reported that their pregnancy was not wanted had a much higher percentage of PPD (57.1%) compared to those who wanted the pregnancy (42.9%) (Table\u0026nbsp;\u003cspan refid=\"Tab3\" class=\"InternalRef\"\u003e3\u003c/span\u003e\u003cb\u003e)\u003c/b\u003e.\u003c/p\u003e \u003cp\u003eThe sex of the infant did not significantly impact postpartum depression (χ\u0026sup2; = 0.051, p\u0026thinsp;=\u0026thinsp;0.821), as the incidence of PPD was almost identical between those with male and female infants. Whether the mother wanted the sex of the infant was significantly associated with PPD (χ\u0026sup2; = 11.567, p\u0026thinsp;=\u0026thinsp;0.003). Women who did not want the sex of their baby had a higher percentage of PPD (35.7%), compared to those who did not care about the sex of the infant (35.7%) or those who had a desired sex (28.6%) (Table\u0026nbsp;\u003cspan refid=\"Tab3\" class=\"InternalRef\"\u003e3\u003c/span\u003e\u003cb\u003e)\u003c/b\u003e.\u003c/p\u003e \u003cp\u003eThe survival status of the infant was nearly significant (χ\u0026sup2; = 3.638, p\u0026thinsp;=\u0026thinsp;0.056), indicating that women whose infants were not alive were more likely to experience PPD (21.4%). There was no significant association between the planned mode of infant feeding and postpartum depression (χ\u0026sup2; = 0.194, p\u0026thinsp;=\u0026thinsp;0.659), with almost all women planning to exclusively breastfeed (Table\u0026nbsp;\u003cspan refid=\"Tab3\" class=\"InternalRef\"\u003e3\u003c/span\u003e\u003cb\u003e)\u003c/b\u003e.\u003c/p\u003e \u003cp\u003eMother's emotional acceptance of the infant\u0026rsquo;s sex did not significantly correlate with postpartum depression (χ\u0026sup2; = 0.807, p\u0026thinsp;=\u0026thinsp;0.668), with most women being happy and accepting of their infant's sex. Chronic physical illnesses did not significantly affect postpartum depression (χ\u0026sup2; = 0.293, p\u0026thinsp;=\u0026thinsp;0.588), as all but three women did not have any chronic illnesses. The presence of congenital conditions in the infant was significantly associated with postpartum depression (χ\u0026sup2; = 10.494, p\u0026thinsp;=\u0026thinsp;0.001), with the only case of PPD among women whose infant had congenital conditions. There was no significant association between continuing illness since delivery and postpartum depression (χ\u0026sup2; = 1.471, p\u0026thinsp;=\u0026thinsp;0.479) (Table\u0026nbsp;\u003cspan refid=\"Tab3\" class=\"InternalRef\"\u003e3\u003c/span\u003e\u003cb\u003e)\u003c/b\u003e.\u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab4\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 4\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003ePredictors of postpartum depression among giving birth at the department of obstetrics and gynecology, Juba Teaching Hospital\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"9\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c5\" colnum=\"5\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c6\" colnum=\"6\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c7\" colnum=\"7\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c8\" colnum=\"8\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c9\" colnum=\"9\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003ePredictors\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c2\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003eB\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003eS.E.\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c4\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003eWald\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c5\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003edf\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c6\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003e\u003cem\u003ep - value\u003c/em\u003e\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c7\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003eOR\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colspan=\"2\" nameend=\"c9\" namest=\"c8\"\u003e \u003cp\u003e95% CI\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c8\"\u003e \u003cp\u003eLower\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c9\"\u003e \u003cp\u003eUpper\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\"\u003e \u003cp\u003eAge of the mother\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/th\u003e \u003cth align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/th\u003e \u003cth align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/th\u003e \u003cth align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/th\u003e \u003cth align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/th\u003e \u003cth align=\"left\" colname=\"c8\"\u003e\u0026nbsp;\u003c/th\u003e \u003cth align=\"left\" colname=\"c9\"\u003e\u0026nbsp;\u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eLess than 18 years\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e18\u0026ndash;24 years\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e0.577\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e1.006\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0.329\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e0.566\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e1.781\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c8\"\u003e \u003cp\u003e0.248\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c9\"\u003e \u003cp\u003e12.790\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e25\u0026ndash;45\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e0.792\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e0.893\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0.786\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e0.375\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e2.207\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c8\"\u003e \u003cp\u003e0.384\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c9\"\u003e \u003cp\u003e12.706\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eHusband\u0026lrm; or partner financial support\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eNo support\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eYes, but not adequate\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e1.678\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e1.642\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e1.043\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e0.307\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e5.353\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c8\"\u003e \u003cp\u003e0.214\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c9\"\u003e \u003cp\u003e133.817\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eYes, adequate\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e-0.841\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e0.958\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0.771\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e0.380\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e0.431\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c8\"\u003e \u003cp\u003e0.066\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c9\"\u003e \u003cp\u003e2.821\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eHusband or partner emotional support\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eNo support\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eSometimes supportive\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e-1.801\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e1.569\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e1.318\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e0.251\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e0.165\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c8\"\u003e \u003cp\u003e0.008\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c9\"\u003e \u003cp\u003e3.574\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eFully supportive\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e-0.604\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e0.902\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0.448\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e0.503\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e0.547\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c8\"\u003e \u003cp\u003e0.093\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c9\"\u003e \u003cp\u003e3.203\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eWas the pregnany wanted\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eNot wanted\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eYes,wanted\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e1.579\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e0.827\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e3.648\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e0.056\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e4.849\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c8\"\u003e \u003cp\u003e0.959\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c9\"\u003e \u003cp\u003e24.510\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eWas the infant sex wanted\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eNo\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eYes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e2.093\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e0.878\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e5.677\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e0.017\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e8.107\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c8\"\u003e \u003cp\u003e1.450\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c9\"\u003e \u003cp\u003e45.343\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eWas not important whether a boy or girl\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e0.767\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e0.948\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0.655\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e0.418\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e2.154\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c8\"\u003e \u003cp\u003e0.336\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c9\"\u003e \u003cp\u003e13.810\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003cp\u003eTable\u0026nbsp;\u003cspan refid=\"Tab4\" class=\"InternalRef\"\u003e4\u003c/span\u003e examines the predictors of postpartum depression among women giving birth at the Department of Obstetrics and Gynecology, Juba Teaching Hospital. The predictors such as maternal age, financial and emotional support from the partner, and pregnancy and infant sex preferences, influence the likelihood of experiencing postpartum depression.\u003c/p\u003e \u003cp\u003eThe odds ratio (OR) for postpartum depression is 1.781, though the p-value (0.566) is not statistically significant, suggesting that maternal age in this range does not significantly increase the risk of postpartum depression compared to those under 18 years. Similarly, OR is 2.207, with a p-value of 0.375, indicating no significant association between age in this category and postpartum depression risk (Table\u0026nbsp;\u003cspan refid=\"Tab4\" class=\"InternalRef\"\u003e4\u003c/span\u003e\u003cb\u003e)\u003c/b\u003e.\u003c/p\u003e \u003cp\u003eThe odds ratio for inadequate financial support is 5.353 (p-value\u0026thinsp;=\u0026thinsp;0.307), but the result is not statistically significant, suggesting that inadequate financial support is not a significant predictor of postpartum depression. In contrast, the odds ratio for adequate financial support is 0.431 (p-value\u0026thinsp;=\u0026thinsp;0.380), which also shows no significant impact on postpartum depression risk, suggesting that adequate financial support does not significantly protect against postpartum depression in this sample (Table\u0026nbsp;\u003cspan refid=\"Tab4\" class=\"InternalRef\"\u003e4\u003c/span\u003e\u003cb\u003e)\u003c/b\u003e.\u003c/p\u003e \u003cp\u003eThe odds ratio of 0.165 (p-value\u0026thinsp;=\u0026thinsp;0.251) for women whose partners offer only occasional emotional support suggests a reduced likelihood of postpartum depression. However, this result is not statistically significant, meaning that the occasional emotional support does not significantly predict postpartum depression. Women whose partners are fully supportive have an OR of 0.547 (p-value\u0026thinsp;=\u0026thinsp;0.503), indicating no significant effect of full emotional support on postpartum depression risk (Table\u0026nbsp;\u003cspan refid=\"Tab4\" class=\"InternalRef\"\u003e4\u003c/span\u003e\u003cb\u003e)\u003c/b\u003e.\u003c/p\u003e \u003cp\u003eThe odds ratio of 4.849 (p-value\u0026thinsp;=\u0026thinsp;0.056) suggests a trend toward a higher likelihood of postpartum depression when the pregnancy was wanted, though this result is only marginally significant. A p-value just above 0.05 implies that, while it\u0026rsquo;s not definitively conclusive, there may be an increased risk of postpartum depression for women who wanted their pregnancies (Table\u0026nbsp;\u003cspan refid=\"Tab4\" class=\"InternalRef\"\u003e4\u003c/span\u003e\u003cb\u003e)\u003c/b\u003e.\u003c/p\u003e \u003cp\u003eThe odds ratio of 8.107 (p-value\u0026thinsp;=\u0026thinsp;0.017) for women who wanted a specific infant sex shows a statistically significant increase in the likelihood of postpartum depression compared to those who had no preference. This indicates that women with a preference for the infant\u0026rsquo;s sex are more likely to encounter postpartum depression. The OR for women for whom infant sex was not important is 2.154 (p-value\u0026thinsp;=\u0026thinsp;0.418), which is statistically insignificant, suggesting that the lack of preference for the infant's sex does not have a significant effect on the risk of postpartum depression (Table\u0026nbsp;\u003cspan refid=\"Tab4\" class=\"InternalRef\"\u003e4\u003c/span\u003e\u003cb\u003e)\u003c/b\u003e.\u003c/p\u003e \u003c/div\u003e"},{"header":"Discussion","content":"\u003cp\u003eThis study found that the prevalence of postpartum women who suffered from postpartum depression was 9%. This study found that the prevalence of postpartum women experiencing postpartum depression was 9%. Results from this study were found to be lower in comparison to a similar study conducted in Mizan Aman Town, Southern Ethiopia (22.4%)(\u003cspan citationid=\"CR30\" class=\"CitationRef\"\u003e30\u003c/span\u003e), and comparable to another study carried out in two tertiary hospitals, Omdurman Maternity and Ibrahim Malik Teaching Hospitals in Sudan (9.2%)(\u003cspan citationid=\"CR31\" class=\"CitationRef\"\u003e31\u003c/span\u003e). This is because South Sudan and Sudan share similar socio-political dynamics, and these results aligns with the current political and financial instability in South Sudan.\u003c/p\u003e \u003cp\u003eIn regard to the PPD association factors, this study revealed various factors that may contribute to the development of PPD among women who gave birth at Juba Teaching Hospital. These include age, marital status, partner or family support, and women's educational status. The study indicated that women below 18 years were seven times more likely to develop PPD compared to other age groups. These findings are also supported by evidence reported in this study, which suggests that single cohabiting women were likely to suffer from PPD. Reason for these findings could be linked to the fact that most of the women under 18 years found in this study were single, which means that they could have become pregnant outside of marital status. Thus, they find themselves being rejected by their families and also abandoned by their partners. This is a common practice among South Sudanese traditional communities, where they are considered a disgrace to the family and the community at large when they conceive without being married (\u003cspan citationid=\"CR32\" class=\"CitationRef\"\u003e32\u003c/span\u003e, \u003cspan citationid=\"CR33\" class=\"CitationRef\"\u003e33\u003c/span\u003e).\u003c/p\u003e \u003cp\u003eEmpowering women through education remains a crucial factor in fostering their self-resilience and ownership of decision-making. An educated woman can secure suitable employment, enabling her to be self-reliant and alleviating the economic and social challenges she may encounter, which can lead to stress(\u003cspan citationid=\"CR34\" class=\"CitationRef\"\u003e34\u003c/span\u003e, \u003cspan citationid=\"CR35\" class=\"CitationRef\"\u003e35\u003c/span\u003e). This explanation could be supported by the findings revealed in this study, which indicated that 42.9% of women with no formal education were financially dependent on their partners to experience postpartum depression (PPD), in contrast to those who were educated or those receiving financial support from their partners.\u003c/p\u003e \u003cp\u003eAnother factor that was identified as being associated with PPD in this study was the absence of emotional support from one's partner. Similar investigations conducted inside the region supported the findings. According to a study conducted by Waled AM and his colleagues in Sudan, women who became pregnant outside of marriage were more likely to be rejected by their family and socially stigmatized, as well as abundant by their partners, due to local cultural norms that discouraged marriage to a woman who pregnant outside of marriage(\u003cspan citationid=\"CR36\" class=\"CitationRef\"\u003e36\u003c/span\u003e). Other research conducted in Indonesia related psychological stress to underage females who were pregnant outside of marriage, which was associated with social stigma and a lack of emotional support from family and partners(\u003cspan citationid=\"CR37\" class=\"CitationRef\"\u003e37\u003c/span\u003e).\u003c/p\u003e \u003cp\u003ePlanned pregnancies provide family joy and stability; they also contribute to both parties' psychological well-being, as opposed to unplanned pregnancies, which are rejected by either partner(\u003cspan citationid=\"CR38\" class=\"CitationRef\"\u003e38\u003c/span\u003e). Male partners frequently blamed their female partners for unwanted births, which can result in neonatal denial and mother mental stress(\u003cspan citationid=\"CR39\" class=\"CitationRef\"\u003e39\u003c/span\u003e). Such arguments could explain the study's findings, which revealed that 57.1% of women who did not want their pregnancy suffered from PPD, compared to 42.9% who did. In our study, women who did not want their newborn's sex were more likely to develop PPD than those who had no preferred sex for their infant or who received the infant sex of their choice.\u003c/p\u003e \u003cp\u003eThis could be due to societal African norms in which some sex births are valued over others, such as preferring male sex over female sex infants(\u003cspan citationid=\"CR40\" class=\"CitationRef\"\u003e40\u003c/span\u003e). Or it could be attributed to some cultural beliefs that blame women for continuing to give birth to specific sex infants, such as female infants, putting the woman under mental stress as her family continues to blame her and requesting the male partner to find another partner who can give birth to a preferred infant sex(\u003cspan citationid=\"CR41\" class=\"CitationRef\"\u003e41\u003c/span\u003e).\u003c/p\u003e \u003cp\u003eIt was also noted that women whose infants died were just as likely to have PPD as those whose infants were born with certain congenital abnormalities. These findings are consistent with another study conducted in Western Uganda, which found that mothers who had a stillbirth newborn were more likely to develop PPD than those who had live newborns(\u003cspan citationid=\"CR42\" class=\"CitationRef\"\u003e42\u003c/span\u003e).\u003c/p\u003e"},{"header":"Conclusion","content":"\u003cp\u003eThe prevalence of PPD identified in this study (9%) highlights and raises concerns about the overlooked maternal mental health in South Sudan. Despite the challenging circumstances faced by many partners, offering emotional support to women during pregnancy and the postpartum period could help prevent unnecessary PPD from developing among postpartum women. The study recommends the necessity of scaling up maternal mental health support across the country, alongside empowering women through education and employment to alleviate their financial dependency. The study also recommends scaling up of the postpartum depression screening across the country using the EPDS tool, and subsequent establishment of clinical centers for mental support in the main state hospitals.\u003c/p\u003e"},{"header":"Abbreviations","content":"\u003cp\u003eAGOSS \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp;Association of Gynecologists and Obstetricians of South Sudan\u003c/p\u003e\n\u003cp\u003eEPDS \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; Edinburgh Postnatal Depression Scale.\u003c/p\u003e\n\u003cp\u003ePPD \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; Postpartum depression\u003c/p\u003e\n\u003cp\u003eSPSS \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; Statistical package for social sciences\u0026nbsp;\u003c/p\u003e"},{"header":"Declarations","content":"\u003cp\u003eEthics approval and consent to participate\u003c/p\u003e\n\u003cp\u003eThis study followed the Declaration of Helsinki and received permission from the National South Sudan Ministry of Health's Research Ethical Committee. All participants were informed of the study's goal and had the option to participate or not. Participants in the study signed a consent form and had the option to withdraw or object to any questions they felt uncomfortable answering. Participants under 18 years supplied consent through their guardians. Participants who couldn't read or write were requested to sign using thumbprints, which was approved by the ethical committee.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eConsent for publication\u003c/p\u003e\n\u003cp\u003eNot applicable.\u003c/p\u003e\n\u003cp\u003eAvailability of data and materials\u003c/p\u003e\n\u003cp\u003eThe data for this study are available with corresponding author AND can be provided on demand.\u003c/p\u003e\n\u003cp\u003eCompeting interests\u003c/p\u003e\n\u003cp\u003eThe authors declare no competing interests.\u003c/p\u003e\n\u003cp\u003eFunding\u003c/p\u003e\n\u003cp\u003eNo funding was received for this study.\u003c/p\u003e\n\u003cp\u003eAuthors’ contributions\u003c/p\u003e\n\u003cp\u003eAll listed authors contributed significantly, directly, and intellectually to the work.\u003cbr\u003e\u0026nbsp;ZJM designed and conceptualized the study. GDL reviewed the study\u003c/p\u003e\n\u003cp\u003eproposal. MMA, HMS and JG provided inputs into manuscript, EW analysed the data and reviewed the manuscript.\u003c/p\u003e\n\u003cp\u003eThis submitted version was reviewed by all authors\u003c/p\u003e\n\u003cp\u003eAcknowledgements\u003c/p\u003e\n\u003cp\u003eNot applicable\u003c/p\u003e"},{"header":"References","content":"\u003col\u003e\n\u003cli\u003eAwini E, Agyepong IA, Owiredu D, Gyimah L, Ashinyo ME, Yevoo LL, et al. Burden of mental health problems among pregnant and postpartum women in sub-Saharan Africa: systematic review and meta-analysis protocol. BMJ Open. 2023 Jun 7;13(6):e069545.\u003c/li\u003e\n\u003cli\u003eWang Z, Liu J, Shuai H, Cai Z, Fu X, Liu Y, et al. Mapping global prevalence of depression among postpartum women. Vol. 11, Translational Psychiatry. Springer Nature; 2021.\u003c/li\u003e\n\u003cli\u003eAtuhaire C, Brennaman L, Cumber SN, Rukundo GZ, Nambozi G. The magnitude of postpartum depression among mothers in africa: A literature review. Pan African Medical Journal. 2020 Sep 1;37:1\u0026ndash;11.\u003c/li\u003e\n\u003cli\u003eWoldeyohannes Handiso D, Tekalegn Ifa Y, Sahiledengle Sahiledengle B, Ermias Makango D, Ejajo Wontamo T, Mwanri Mwanri L. Effect of Postpartum Depression on Exclusive Breast-Feeding Practices in Sub-Saharan Africa Countries: Systematic Review and Meta-analysis. Available from: https://doi.org/10.21203/rs.3.rs-86191/v1\u003c/li\u003e\n\u003cli\u003eAbdollahi F, Zarghami M. Effect of postpartum depression on women\u0026rsquo;s mental and physical health four years after childbirth. Eastern Mediterranean Health Journal. 2018 Oct 1;24(10):1002\u0026ndash;9.\u003c/li\u003e\n\u003cli\u003eMoline ML, Kahn DA, Ross RW, Altshuler LL, Cohen LS. POSTPARTUM DEPRESSION: A Guide for Patients and Families [Internet]. Available from: www.womensmentalhealth.org\u003c/li\u003e\n\u003cli\u003eRobertson P, Curtis R, Lasher R, Jacques S, Tom SJ. Experiences of Postpartum Mood Disorders of Women With More Than One Child. The Family Journal. 2013;21(4):435\u0026ndash;42.\u003c/li\u003e\n\u003cli\u003eWisner KL, Moses-Kolko EL, Sit DKY. Postpartum depression: A disorder in search of a definition. Vol. 13, Archives of Women\u0026rsquo;s Mental Health. 2010. p. 37\u0026ndash;40.\u003c/li\u003e\n\u003cli\u003eKale DP, Tambawala ZY, Rajput NM. Postpartum depression prevalence in a tertiary care hospital in Mumbai, Maharashtra, India. Journal of SAFOG. 2019 Jul 1;11(4):239\u0026ndash;42.\u003c/li\u003e\n\u003cli\u003eSuplee PD, Janke J. Awhonn compendium of postpartum care.\u003c/li\u003e\n\u003cli\u003eManurung S, Setyowati S. Development and validation of the maternal blues scale through bonding attachments in predicting postpartum blues. Malaysian Family Physician. 2021;16(1).\u003c/li\u003e\n\u003cli\u003ePostpartum-Depression.\u003c/li\u003e\n\u003cli\u003eJohansson M, Benderix Y, Svensson I. Mothers\u0026rsquo; and fathers\u0026rsquo; lived experiences of postpartum depression and parental stress after childbirth: a qualitative study. Int J Qual Stud Health Well-being. 2020 Jan 1;15(1).\u003c/li\u003e\n\u003cli\u003ePatel M, Bailey RK, Jabeen S, Ali S, Barker NC, Osiezagha K. Postpartum depression: A review. J Health Care Poor Underserved. 2012 May;23(2):534\u0026ndash;42.\u003c/li\u003e\n\u003cli\u003eHapgood CC, Elkind GS, Wright JJ. Maternity blues: Phenomena and relationship to later post partum depression. Australasian Psychiatry. 1988;22(3):299\u0026ndash;306.\u003c/li\u003e\n\u003cli\u003eZakeri MA, Khoram S, Bazmandegan G, Ghaedi-Heidari F, Talebi B, Ramezani N, et al. Postpartum depression and its correlates: a cross-sectional study in southeast Iran. BMC Womens Health. 2022 Dec 1;22(1).\u003c/li\u003e\n\u003cli\u003eO\u0026rsquo;Hara MW, Mc Cabe JE. Postpartum depression: Current status and future directions. Vol. 9, Annual Review of Clinical Psychology. 2013. p. 379\u0026ndash;407.\u003c/li\u003e\n\u003cli\u003eRai S, Pathak A, Sharma I. Postpartum psychiatric disorders: Early diagnosis and management. Vol. 57, Indian Journal of Psychiatry. Wolters Kluwer Medknow Publications; 2015. p. 216\u0026ndash;21.\u003c/li\u003e\n\u003cli\u003eGood Practice No. 14 Management of Women with Mental Health Issues during Pregnancy and the Postnatal Period [Internet]. 2011. Available from: www.mhra.gov.uk\u003c/li\u003e\n\u003cli\u003ePREVALENCE OF POSTPARTUM DEPRESSION AMONG WOMEN DELIVERING AT KENYATTA NATIONAL HOSPITAL DISSERTATION IN PARTIAL FULFILMENT FOR THE DEGREE OF MASTERS OF MEDICINE IN OBSTETRICS AND GYNECOLOGY, UNIVERSITY OF NAIROBI 2013 SUBMITTED BY Mwikali Musau MBChB V.\u003c/li\u003e\n\u003cli\u003eAtuhaire C, Rukundo GZ, Nambozi G, Ngonzi J, Atwine D, Cumber SN, et al. Prevalence of postpartum depression and associated factors among women in Mbarara and Rwampara districts of south-western Uganda. BMC Pregnancy Childbirth. 2021 Dec 1;21(1).\u003c/li\u003e\n\u003cli\u003eTolossa T, Fetensa G, Yilma MT, Abadiga M, Wakuma B, Besho M, et al. Postpartum depression and associated factors among postpartum women in Ethiopia: A systematic review and meta-analysis, 2020. Vol. 41, Public Health Reviews. BioMed Central Ltd; 2020.\u003c/li\u003e\n\u003cli\u003eGloria M, Njoku C. CAUSES AND CONSEQUENCES OF POSTPARTUM DEPRESSION AMONG WOMEN.\u003c/li\u003e\n\u003cli\u003eGunst A, Sund\u0026eacute;n M, Korja R, Boddy AM, Kotler J, Paavonen EJ, et al. Postpartum depression and mother-offspring conflict over maternal investment. Evol Med Public Health. 2021;9(1):11\u0026ndash;23.\u003c/li\u003e\n\u003cli\u003eKariuki EW, Kuria MW, Were FN, Ndetei DM. Predictors of postnatal depression in the slums Nairobi, Kenya: a cross-sectional study. BMC Psychiatry. 2022 Dec 1;22(1).\u003c/li\u003e\n\u003cli\u003eChalise A, Bhandari TR. Postpartum Depression and its Associated Factors: A Community-based Study in Nepal. J Nepal Health Res Counc. 2019 Aug 4;17(2):200\u0026ndash;5.\u003c/li\u003e\n\u003cli\u003eYu J, Zhang Z, Deng Y, Zhang L, He C, Wu Y, et al. Risk factors for the development of postpartum depression in individuals who screened positive for antenatal depression. BMC Psychiatry [Internet]. 2023 Aug 1;23(1):557. Available from: https://bmcpsychiatry.biomedcentral.com/articles/10.1186/s12888-023-05030-1\u003c/li\u003e\n\u003cli\u003eABOUT THE EPDS.\u003c/li\u003e\n\u003cli\u003eEdinburgh Postnatal Depression Scale 1 (EPDS) [Internet]. Available from: www.depressionafterdelivery.com\u003c/li\u003e\n\u003cli\u003eToru T, Chemir F, Anand S. Magnitude of postpartum depression and associated factors among women in Mizan Aman town, Bench Maji zone, Southwest Ethiopia. BMC Pregnancy Childbirth. 2018 Nov 14;18(1).\u003c/li\u003e\n\u003cli\u003eKhalifa DS, Glavin K, Bjertness E, Lien L. Postnatal depression among Sudanese women: Prevalence and validation of the Edinburgh Postnatal depression scale at 3 months postpartum. Int J Womens Health. 2015 Jul 8;7:677\u0026ndash;84.\u003c/li\u003e\n\u003cli\u003eHowe K, Stites E, Moran M, Marshak A, Hammada A, Sulaiman S, et al. Circumscribed Lives: Separated, Divorced, and Widowed Female Youth in South Sudan and the Kurdistan Region of Iraq Feinstein International Center Circumscribed Lives: Separated, Divorced, and Widowed Female Youth in South Sudan and the Kurdistan Region of Iraq [Internet]. 2022. Available from: https://reporting.unhcr.org/document/1799.\u003c/li\u003e\n\u003cli\u003eAtem Deng S. Fitting the Jigsaw: South Sudanese Family Dynamics and Parenting Practices in Australia. 2016.\u003c/li\u003e\n\u003cli\u003eBasak R. ROLE OF EDUCATION ON WOMEN EMPOWERMENT IN THE SOCIETY [Internet]. Available from: https://www.researchgate.net/publication/370818401\u003c/li\u003e\n\u003cli\u003eMagaji RJ. THE ROLE OF WOMEN EDUCATION IN THE EMPOWERMENT OF WOMEN FOR NATIONAL DEVELOPMENT.\u003c/li\u003e\n\u003cli\u003eMohamed AAA, Babiker EAA, Godat SM, Doalbet SMG, Ahmed AAF, Ali MHM, et al. Out-of-Wedlock Pregnancy Among Single Mothers in Khartoum, Sudan: Sociodemographic Characteristics, Causes, and Consequences. Sudan Journal of Medical Sciences. 2023;18(3):377\u0026ndash;90.\u003c/li\u003e\n\u003cli\u003eSundari E, Retnowati A. Marrying Unwanted Pregnant Girl Phenomenon in Indonesia: Is it in the Child\u0026rsquo;s Best Interests? KnE Social Sciences. 2024 Jan 5;\u003c/li\u003e\n\u003cli\u003eSu JH. Unexpectedly Expecting: Pregnancy Intentions and Parental Well-being. 2011.\u003c/li\u003e\n\u003cli\u003eBeumer WY, Koot MH, Vrijkotte T, Roseboom TJ, van Ditzhuijzen J. Long-term effects of unintended pregnancy on children: Findings from the Dutch perspective birth-cohort Amsterdam born children and their development study. Soc Sci Med. 2024 Sep 1;357.\u003c/li\u003e\n\u003cli\u003eRossi P, Rouanet L. Gender Preferences in Africa: A Comparative Analysis of Fertility Choices [Internet]. 2015. Available from: https://shs.hal.science/halshs-01074934v2\u003c/li\u003e\n\u003cli\u003eBaloyi ME, Manala MJ. Reflections on challenges of preferring the male child in an African marriage \u0026ndash; a practical theological observation. Verbum et Ecclesia. 2019;40(1).\u003c/li\u003e\n\u003cli\u003eBekkhus M, Oftedal A, Braithwaite E, Haugen G, Kaasen A. Paternal Psychological Stress After Detection of Fetal Anomaly During Pregnancy. A Prospective Longitudinal Observational Study. Front Psychol. 2020 Jul 29;11.\u003c/li\u003e\n\u003c/ol\u003e"}],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":true,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":false,"hideJournal":false,"highlight":"","institution":"","isAcceptedByJournal":false,"isAuthorSuppliedPdf":false,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":false,"isPdf":false,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"bmc-pregnancy-and-childbirth","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":false,"externalIdentity":"prch","sideBox":"Learn more about [BMC Pregnancy and Childbirth](http://bmcpregnancychildbirth.biomedcentral.com/)","snPcode":"","submissionUrl":"https://www.editorialmanager.com/prch/default.aspx","title":"BMC Pregnancy and Childbirth","twitterHandle":"@BMC_series","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"em","reportingPortfolio":"BMC Series","inReviewEnabled":true,"inReviewRevisionsEnabled":true},"keywords":"Postpartum depression, maternal mental health, Edinburgh Postnatal Depression Scale (EPDS)","lastPublishedDoi":"10.21203/rs.3.rs-6386454/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-6386454/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003ch2\u003eBackground\u003c/h2\u003e \u003cp\u003eMaternal mental health, particularly postpartum depression, remains one of the most overlooked health conditions globally. The study aimed to uncover the prevalence of women suffering from postpartum depression at Juba Teaching Hospital and to investigate the associations and predictors of this condition among mothers who gave birth in the Department of Obstetrics and Gynecology at Juba Teaching Hospital.\u003c/p\u003e\u003ch2\u003eMethod\u003c/h2\u003e \u003cp\u003eThis was a cross-sectional study conducted between January and June 2023 among postpartum women who gave birth at Juba Teaching Hospital. A total of 160 postpartum women were enrolled in the study using a randomized systematic method. Following delivery and prior to discharge, sociodemographic and obstetric data were collected. Then participants were requested to provide their phone contacts, which were used to contact them and organize a home visit to complete the interview six weeks from the time of the delivery. Chi- square was applied to suggest the associated factors, while regression was used to determine PPD predictors. To obtain PPD prevalence, questions on EPDS were coded at 13 points/below or above 13 points based on the answers provided by the study participants. Those who scored at 13 points or below on the EPDS scale were considered not to be suffering from PPD, in contrast to those above 13 points who were considered to have PPD.\u003c/p\u003e\u003ch2\u003eResults\u003c/h2\u003e \u003cp\u003eThe majority of the postpartum women (54.4%) recruited for this study were aged between 25 and 45 years, and 81.9% were married and possessed at least a primary or secondary level of education. About 9% (14 out of 160) fell above the threshold of the Edinburgh Postnatal Depression Scale (EPDS), indicating the prevalence of postpartum depression among women in this study. Using a chi-square test, it was found that women below 18 years of age were significantly associated with PPD (X\u0026sup2;=7.095, P\u0026thinsp;=\u0026thinsp;0.029); also, single or cohabitant mothers (X\u0026sup2;=12.772, P\u0026thinsp;=\u0026thinsp;0.002); women with no formal education (X\u0026sup2;=9.706, P\u0026thinsp;=\u0026thinsp;0.008); and those with inadequate financial support, among others, were all associated with PPD. While maternal age, financial support, partner support, and preferences regarding pregnancy and infant sex are predictors of the likelihood of experiencing PPD.\u003c/p\u003e\u003ch2\u003eConclusion\u003c/h2\u003e \u003cp\u003eThe prevalence of PPD identified in this study (9%) highlights and raises concerns about the overlooked maternal mental health in South Sudan. Despite the challenging circumstances faced by many partners, offering emotional support to women during pregnancy and the postpartum period could help prevent unnecessary PPD from developing among postpartum women. The study recommends the necessity of scaling up maternal mental health support across the country, alongside empowering women through education and employment to alleviate their financial dependency. The study also recommends scaling up of the postpartum depression screening across the country using the EPDS tool, and subsequent establishment of clinical centers for mental support in the main state hospitals.\u003c/p\u003e","manuscriptTitle":"Insight into postpartum depression; a situational analysis among women giving birth at Juba Teaching Hospital, South Sudan","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2025-05-09 14:25:43","doi":"10.21203/rs.3.rs-6386454/v1","editorialEvents":[{"type":"communityComments","content":0},{"type":"editorInvitedReview","content":"","date":"2025-05-24T02:46:37+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"122681937986519600654545377946632202270","date":"2025-05-19T00:20:15+00:00","index":"hide","fulltext":""},{"type":"reviewersInvited","content":"","date":"2025-05-06T05:03:49+00:00","index":"","fulltext":""},{"type":"editorInvited","content":"","date":"2025-04-11T20:35:44+00:00","index":"","fulltext":""},{"type":"editorAssigned","content":"","date":"2025-04-11T09:11:51+00:00","index":"","fulltext":""},{"type":"checksComplete","content":"","date":"2025-04-11T09:09:38+00:00","index":"","fulltext":""},{"type":"submitted","content":"BMC Pregnancy and Childbirth","date":"2025-04-06T11:44:14+00:00","index":"","fulltext":""}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"bmc-pregnancy-and-childbirth","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":false,"externalIdentity":"prch","sideBox":"Learn more about [BMC Pregnancy and Childbirth](http://bmcpregnancychildbirth.biomedcentral.com/)","snPcode":"","submissionUrl":"https://www.editorialmanager.com/prch/default.aspx","title":"BMC Pregnancy and Childbirth","twitterHandle":"@BMC_series","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"em","reportingPortfolio":"BMC Series","inReviewEnabled":true,"inReviewRevisionsEnabled":true}}],"origin":"","ownerIdentity":"e77d6a82-b6d3-452e-ba7b-adf912d241c6","owner":[],"postedDate":"May 9th, 2025","published":true,"recentEditorialEvents":[],"rejectedJournal":[],"revision":"","amendment":"","status":"under-review","subjectAreas":[],"tags":[],"updatedAt":"2025-05-09T14:25:44+00:00","versionOfRecord":[],"versionCreatedAt":"2025-05-09 14:25:43","video":"","vorDoi":"","vorDoiUrl":"","workflowStages":[]},"version":"v1","identity":"rs-6386454","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-6386454","identity":"rs-6386454","version":["v1"]},"buildId":"8U1c8b4HqxoKbykW_rLl7","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}