Table 2.

Themes arising from data analysis.

Illustrative quotations from women	Unit of meaning	Emerging themes
“When I first became pregnant, I was scared; during the pregnancy it was quite difficult for me because I was sick all the time. It was really hard.”	Sick all through pregnancy; anxiety about job loss and discontinuation of education	Responses to pregnancy
“This was my first baby, I was afraid and also I don't have family here… and was crying all the time and very lonely.”  “So I realise it was the pregnancy, it was a mixed feelings I'm very happy, I'm very healthy but not so happy as there are all other stuff going on in my mind, such as not being with the father or married to him only empty promises, happy but sad.”	Crying a lot; sadness; lonely; unexpected expectation	Emotional feelings before birth of baby
“OK. For the first one, after I had the baby, I didn't have much help for the first one, and I felt really isolated, and even though I had people around, but they were not helping me, I was doing things for them, even though they should have been doing things for me because pregnancy is difficult… I mean having a baby is difficult but I did all the cooking, my in-laws were around, I was frustrated, nobody helped me do anything for six months, I changed the baby's diapers all the time, nobody helped me once. I was cooking, I was going to the market, there was no help for me. I cried a lot, felt rejected by my husband.”	Very tired/baby cried all the time; mixed feelings; isolated; rejected by husband; depressed	Emotional feelings after the birth of the baby
“OK. I'm Ghanaian, I will go straight to the question which is my emotional feelings. When I first realised I was pregnant, it was a mixture of excitement and sadness because of my own situation that I was going through. So I suppose I was happy to become a mum, emotionally I was sad, and I……… but I had sessions of uncontrolled cries and could not explain why.”	In-laws causing rift
“When I found out I was pregnant, I was really happy because we'd been trying for some years, and I was actually in the process of finding out if there was something wrong, and then I went to the Chinese man for my hay-fever, so we're always like… we'll never know whether it was nature or if it was the herbs, and we were really happy.”
“… pregnancy is difficult… I mean having a baby is difficult but I did all the cooking, my in-laws were around, I was frustrated, nobody helped me do anything for six months, I changed the baby's diapers all the time, nobody helped me once. I got pregnant the second time, I wasn't looking forward to having the baby, I was………”	In-laws' interference when pregnancy not forthcoming, Husband left	Social support or the lack of it
“… And those, all those things, all the culture and all the things that happen, make the afterbirth very difficult, something that a bright person, very vibrant and passionate, all of a sudden you're just like demoted…”
“Well for me, being pregnant is always an exciting experience for a mum, you know, knowing that you're going to bring forth someone, a child, that can change the course of the world, so I was excited.”	Source of joy; happy; long-awaited surprise	Expected pregnancy
“It's something nobody else can help you with. Like someone can help you with the baby and help you with other things, but the way that you're feeling, you don't get help for that.”
“That I'm going mad, mentally and sometimes I'd be crying… the baby and I will be crying, and sometimes I feel like throwing the baby out, but I can't.”	To express feelings is a sign of weakness	Being alone with feelings
“I don't know. Maybe it's my culture, I don't know. It could be cultural. I can't imagine myself going to my mum, or my mother-in-law… probably I can say to my mum, but I still didn't, I just couldn't imagine saying to somebody, “Oh do you know what? I'm really struggling, I'm really down…” It just sounds odd. It's just not… it's not something that you do, you just… Everybody expects you to get on with it and you get on with it.”
“I felt that (health authority) spend a lot of money on teaching you to breastfeed in the hospital, but the people who were trying to teach me I don't think were very good and I felt like they were pressuring me a bit as well, but they didn't really give me some of the other information that as a new mother I would have found really useful, without me having to look on the internet or buy a book. And speaking to some people doesn't help because they just make you feel like it's just your baby crying…”	Not enough information of what to expect as a first-time mother	Lack of information
“I'm not that After my first baby I think my depression was caused by… because after the first child I wanted to get a job and to start working maybe.” “Money, yeah, but I'm trying my best, you know, to do all I can do, you know. type of person that I want to wait for my husband to put the money on the table all the time, you know, whatever I think I can do I do to get extra money…”	Hardship experienced in terms of finance, shopping and working/extra income	Poverty
“That I'm going mad, mentally and sometimes I'd be crying… the baby and I will be crying, and sometimes I feel like throwing the baby out, but I can't.”  “It was like a torture. I mean I was screaming at the midwife so I was just screaming, I cried, postnatal depression, so I said No, I want to go home.”	Failing to admit that they are depressed as it is taboo to admit to such	Signs of postnatal depression
“Very tired/baby cried all the time.”
“Mixed feelings—happy at times and sad sometimes.”	Crying at times but only in secret as cannot be seen to be failing	Not coping
“Feeling isolated/rejected by husband.”