A Qualitative Exploration of a Peer-Support Intervention for Postpartum Depression in First-Time Mothers, Khayelitsha, 2020

**Abstract** Postpartum depression is a significant public health concern, with first-time mothers being particularly vulnerable. In low-resource settings such as Khayelitsha, Cape Town, access to formal mental health support is often limited. This qualitative study explored the experiences and perceptions of first-time mothers with postpartum depression regarding a structured peer-support group intervention, to understand its role in alleviating depressive symptoms. A descriptive, qualitative design was employed. In-depth, semi-structured interviews were conducted with a purposive sample of 18 first-time mothers, all diagnosed with postpartum depression and having completed the peer-support programme. Interviews were audio-recorded, transcribed verbatim, and analysed using reflexive thematic analysis. Four primary themes were constructed: the reduction of isolation through shared experience; the development of practical coping strategies; increased maternal self-efficacy; and the value of culturally congruent support. A salient finding was that 14 of the 18 participants explicitly described a perceived reduction in their depressive symptoms, attributing this change directly to the group's normalising environment and mutual aid. The findings suggest that this peer-support intervention was perceived by participants as a valuable and effective component of managing postpartum depression, addressing key psychosocial factors like isolation and self-doubt. Peer-support groups should be considered for integration into maternal mental health programmes in comparable low-resource settings. Further research should investigate the long-term sustainability of benefits and optimal models for training peer supporters.