1. An Exploration of Postnatal Depression in Central Vietnam Linda Murray, PhD Candidate, QUT Supervisors: Professor Michael Dunne, QUT School of Public Health Professor Cao Ngoc Thanh, Hue University of Medicine and Pharmacy Dr Nigar Khawaja, QUT School of Psychology and Counselling

11. Statements in Clusters Cluster Statements 1. Economics 2 Worry about losing employment (applies to professionals) 11 Lost opportunities for promotion (e.g after third child) 1 Economic difficulty 9 Loss of income post delivery 10 Sufficient financial resources 4 Less time for social activities 2. Family Aspects 25 Informational support from relatives and family 44 Happy/harmonious family 21 Supportive husband 22 Gender of the baby is the one they desired 3. Society and Friendship 26 Support from the reproductive health program 40 Good atmosphere 43 Help of the neighbourhood 46 Support from mother’s friends 4. Mother’s Emotions and Worry 34 Single mother 31 Husband very concerned about the gender of the baby 5 Gender of the baby the parents don’t want 33 Gender of the baby the mother didn’t want 39 Disappointment because the gender is different to the ultrasound 10 Lack of confidence about their place in the community (e.g after third child) 3 Worry about physical appearance after delivery

12. Statements in Clusters Cont… 5. Negative Stressors 14 Husband isn’t loyal 38 Grandparents don’t accept the baby and send it to an orphanage 30 Husband is rude, drinks, and goes out a lot 13 Lack of care, concern and help from relatives 35 A family member has recently died 45 The family observes traditional customs the mother doesn’t want to follow 6. Baby’s Health 6 Stillbirth 15 The baby has a congenital disability 18 Poor health of the baby 32 Baby difficult to nurse 17 Worry about enough milk for the baby 42 Healthy baby 24 The baby is feeding well 7. Mother’s Health 19 The mother has a history of mental illness 8 Obstetric complications (e.g postpartum haemorrhage) 37 Caesarean wound infection 12 Other physical disease during pregnancy and delivery 36 Pain and fatigue after delivery 7 Pain during delivery 8. Protective Factors 16 Sleeplessness due to the baby 28 Regular diet 29 Sufficient relaxation, wakes up late 27 Physical activity for avoiding stress 41 Mother doesn’t smoke or drink coffee or alcohol 23 The mother has enough time to take care of the baby

13. Concept Map 1. Economics 2. Family Aspects 3. Society and Friendship 4. Mother's Emotions and Worry 5. Negative Stressors 6. Baby's Health 7. Mother's Health 8. Protective Factors 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34 35 36 37 38 39 40 41 42 43 44 45 46

14. Most Likely to Cause PND 1. Economics 2. Family Aspects 3. Society and Friendship 4. Mother's Emotions and Worry 5. Negative Stressors 6. Baby's Health 7. Mother's Health 8. Protective Factors Cluster Legend Layer Value 1 1.73 to 2.23 2 2.23 to 2.73 3 2.73 to 3.23 4 3.23 to 3.73 5 3.73 to 4.24 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34 35 36 37 38 39 40 41 42 43 44 45 46

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