Editing Postpartum depression (section)

=== Cultural beliefs ===
Postpartum depression can be influenced by sociocultural factors.<ref name="Halbreich_2006" /> There are many examples of particular cultures and societies that hold specific beliefs about PPD.

[[Malay culture]] holds a belief in Hantu Meroyan; a spirit that resides in the placenta and amniotic fluid.<ref>{{cite book| vauthors = Laderman C |title=Wives and midwives: childbirth and nutrition in rural Malaysia|date=1987|publisher=University of California Press|isbn=978-0-520-06036-4|edition=1st pbk.|location=Berkeley|page=202}}</ref> When this spirit is unsatisfied and venting resentment, it causes the mother to experience frequent crying, loss of appetite, and trouble sleeping, known collectively as "sakit meroyan". The mother can be cured with the help of a [[shaman]], who performs a [[séance]] to force the spirits to leave.<ref name="-20092">{{cite book|title=Medical Anthropology in Ecological Perspective|year=2009|isbn=978-0-7867-2740-7| veditors = McElroy A, Townsend PK |pages=217–66|chapter=Culture, Ecology, and Reproduction }}</ref>

Some cultures believe that the symptoms of postpartum depression or similar illnesses can be avoided through protective rituals in the period after birth. These may include offering structures of organized support, hygiene care, diet, rest, infant care, and breastfeeding instruction.<ref name="Dennis_2007"/> The rituals appear to be most effective when the support is welcomed by the mother.<ref name="Grigoriadis_2009"/>

Some Chinese women [[Postpartum confinement|participate in a ritual]] that is known as "doing the month" (confinement) in which they spend the first 30 days after giving birth resting in bed, while the mother or mother-in-law takes care of domestic duties and childcare. In addition, the new mother is not allowed to bathe or shower, wash her hair, clean her teeth, leave the house, or be blown by the wind.<ref name="-2009032">{{cite journal | vauthors = Klainin P, Arthur DG | title = Postpartum depression in Asian cultures: a literature review | journal = International Journal of Nursing Studies | volume = 46 | issue = 10 | pages = 1355–1373 | date = October 2009 | pmid = 19327773 | doi = 10.1016/j.ijnurstu.2009.02.012 | s2cid = 19493163 }}</ref>

The relationship with the [[Parent-in-law|mother-in-law]] has been identified as a significant risk factor for postpartum depression in many Arab regions. Based on cultural beliefs that place importance on mothers, mothers-in-law have significant influences on daughters-in-law and grandchildren's lives in such societies as the husbands frequently have close relationships with their family of origin, including living together.<ref name="Haque_2015" />

Furthermore, cultural factors influence how [[Middle East]]ern women are screened for PPD. The traditional [[Edinburgh Postnatal Depression Scale]], or EPDS, has come under criticism for emphasizing depression symptoms that may not be consistent with [[Muslims|Muslim]] cultural standards. Thoughts of self-harm are strictly prohibited in [[Islam]], yet it is a major symptom within the EPDS. Words like "depression screen" or "mental health" are considered disrespectful to some [[Arabs|Arab]] cultures. Furthermore, women may under report symptoms to put the needs of the family before their own because these countries have [[Collectivism|collectivist]] cultures.<ref name="Haque_2015" />

Additionally, research showed that mothers of female babies had a considerably higher risk of PPD, ranging from 2-4 times higher than those of mothers of male babies, due to the value certain cultures in the Middle East place on female babies compared to male babies.<ref name="Ayoub_2020" />