“Smile through It!” Keeping up the Facade While Suffering from Postnatal Depressive Symptoms and Feelings of Loss: Findings of a Qualitative Study

Kari Vik, Marit Hafting

Department for Child and Adolescent Mental Health, Sorlandet Hospital, Kristiansand, Norway.
Department for Child and Adolescent Mental Health, Voss Hospital, Voss, Norway.

DOI: 10.4236/psych.2012.329123                

Abstract

This qualitative study describes a research project in Norway comprising 15 mothers with postnatal depression and/or depressive symptoms and their experiences of loss in the early period following childbirth. During in-depth interviews, the mothers provided detailed descriptions of various loss subjects. Qualitative analysis revealed three global themes: loss of former identity, loss of self-reliance and lack of capacity for self-care. The analysis and discussions include perspectives from medicine and sociology. The descriptions may be valuable for health professionals’ understanding and assessment of postnatal depressive symptoms in mothers. The findings may also help to bridge the gap between medicine and sociology; furthermore, the results demonstrate the importance of an interdisciplinary approach to this multifaceted and complex phenomenon.

Keywords

Postnatal Depression; Loss; In-Depth Interviews; Qualitative Study; Primary Health Care Services; Interdisciplinary

Conflicts of Interest

The authors declare no conflicts of interest.

References

[1]	Attride-Stirling, J. (2001). Thematic networks: An analytic tool for qualitative research. Qualitative Research, 1, 385-405. doi:10.1177/146879410100100307
[2]	Beck, C. T. (2002). Postpartum depression: A metasynthesis. Qualitative Health Research, 12, 453-472. doi:10.1177/104973202129120016
[3]	Beck, U. (1992). Risk society: Towards a new modernity. London: Sage.
[4]	Berle, J. O., Aarre, T. F., Mykletun, A., Dahl, A. A., & Holsten, F. (2003). Screening for postnatal depression. Validation of the Norwegian version of the Edinburgh Postnatal Depression Scale, and assessment of risk factors for postnatal depression. Journal of Affective Disorders, 76, 151-156. doi:10.1016/S0165-0327(02)00082-4
[5]	Borkan, J. (1999). Immersion/crystallization. In B. F. Crabtree, & W. L. Miller (Eds.), Doing qualitative research (pp. 179-194). Thousand Oaks, CA: Sage.
[6]	Brudal, L. (2000). Mental reactions in connection with pregnancy, birth and the post partum period. Bergen: Fagbokforlaget.
[7]	Cox, J. L., Holden, J. M., & Sagovsky, R. (1987). Detection of postnatal depression. Development of the 10-item Edinburgh Postnatal De- pression Scale. British Journal of Psychiatry, 150, 782-786. doi:10.1192/bjp.150.6.782
[8]	Davies, B., & Welch, D. (1986). Motherhood and feminism: Are they compatible? The ambivalence of mothering. Australian and New Zealand Journal of Sociology, 22, 411-426. doi:10.1177/144078338602200305
[9]	Eberhard-Gran, M., Eskild, A., Tambs, K., Schei, B., & Opjordsmoen, S. (2001). The Edinburgh Postnatal Depression Scale: Validation in a Norwegian community sample. Nordic Journal of Psychiatry, 55, 113-117. doi:10.1080/08039480151108525
[10]	Eberhard-Gran, M., Nordhagen, R., Heiberg, E., Bergsjo, P., & Eskild, A. (2003). Postnatal care in a cross-cultural and historical perspective. Tidsskrift for Norsk Laegeforening, 123, 3553-3556.
[11]	Edhborg, M., Friberg, M., Lundh, W., & Widstrom, A. M. (2005). “Struggling with life”: Narratives from women with signs of post- partum depression. Scandinatian Journal of Public Health, 33, 261- 267. doi:10.1080/14034940510005725
[12]	Fisher, C., Hauck, Y., & Fenwick, J. (2006). How social context impacts on women’s fears of childbirth: A Western Australian example. Social Science and Medicine, 63, 64-75. doi:10.1016/j.socscimed.2005.11.065
[13]	Giddens, A. (1991). Modernity and self-identity: Self and society in the late modern age. Cambridge: Polity Press.
[14]	Giddens, A. (1992). The transformation of intimacy: Sexuality, love and eroticism. Oxford: Polity Press.
[15]	Gilligan, C. (1982). In a different voice: psychological theory and wo- men’s development. London: Harvard University Press.
[16]	Hall, P. L., & Wittkowski, A. (2006). An exploration of negative thoughts as a normal phenomenon after childbirth. Journal of Mid-wifery and Women’s Health, 51, 321-330. doi:10.1016/j.jmwh.2006.03.007
[17]	Hammersley, M., & Atkinson, P. (1983). Ethnography: Principles in practice. London: Tavistock.
[18]	Harris, T. (2003). Review of Postnatal depression: Facing the paradox of loss, happiness and motherhood. Journal of Child Psychology and Psychiatry, 44, 930-931. doi:10.1111/1469-7610.00176_10
[19]	Hedenbro, M. (2006). The family triad: The interaction between the child, its mother, and father from birth to the age of 4 years old. Ph.D. Thesis, Stockholm: Karolinska Institutet.
[20]	James, K. (1998). The depressed mother: A practical guide to treatment and support. London: Cassell.
[21]	Kurth, E., Spichiger, E., Zemp, S. E., Biedermann, J., Hosli, I., & Kennedy, H. P. (2010). Crying babies, tired mothers—Challenges of the postnatal hospital stay: An interpretive phenomenological study. BMC Pregnancy and Childbirth, 10, 21. doi:10.1186/1471-2393-10-21
[22]	Lee, C. (1997). Social context, depression, and the transition to motherhood. British Journal of Health Psychology, 2, 93-108. doi:10.1111/j.2044-8287.1997.tb00527.x
[23]	Lewis, S. E., & Nicolson, P. (1998). Talking about early motherhood: Recognizing loss and reconstructing depression. Journal of Reproductive and Infant Psychology, 16, 177-197. doi:10.1080/02646839808404567
[24]	Lloyd, B., & Hawe, P. (2003). Solutions forgone? How health professionals frame the problem of postnatal depression. Social Science and Medicine, 57, 1783-1795. doi:10.1016/S0277-9536(03)00061-3
[25]	Morgan, M., Matthey, S., Barnett, B., & Richardson, C. (1997). A group programme for postnatally distressed women and their partners. Journal of Advanced Nursing, 26, 913-920. doi:10.1046/j.1365-2648.1997.00433.x
[26]	Nicolson, P. (1999). Loss, happiness and postpartum depression: The ultimate paradox. Canadian Psychology/Psychologie Canadienne, 40, 162-178.
[27]	O'Hara, M. W., & Swain, A. M. (1996). Rates and risk of postpartum depression—A meta-analysis. International Review of Psychiatry, 8, 23-54.
[28]	Oakley, A. (1985). Doctors, maternity patients and social scientists. Birth: Issues in Perinatal Care and Education, 12, 161-166.
[29]	Orange, D. M. (1995). Emotional understanding: studies in psychoanalytic epistemology. New York: Guilford Press.
[30]	Sethi, S. (1995). The dialectic in becoming a mother: Experiencing a postpartum phenomenon. Scandinavian Journal of Caring Sciences, 9, 235-244.
[31]	Smith, J. A. (1999). Identity development during the transition to motherhood: An interpretive phenomenological analysis. Journal of Reproductive and Infant Psychology, 17, 281-299. doi:10.1080/02646839908404595
[32]	Sokolowski, R. (2000). Introduction to phenomenology. Cambridge: Cambridge University Press.
[33]	Stern, D. N. (2004). The motherhood constellation: Therapeutic approaches to early relational problems. In A. J. Sameroff, S. C. Mc- Donough, & K. L. Rosenblum (Eds.), Treating parent-infant relationship problems: Strategies for intervention (pp. 29-42). New York: Guilford Press.
[34]	Thio, I. M., Oakley Browne, M. A., Coverdale, J. H., & Argyle, N. (2006). Postnatal depressive symptoms go largely untreated: A probability study in urban New Zealand. Social Psychiatry and Psychiatric Epidemiology, 41, 814-818. doi:10.1007/s00127-006-0095-6
[35]	Thurtle, V. (1995). Post-natal depression: The relevance of sociological approaches. Journal of Advanced Nursing, 22, 416-424. doi:10.1046/j.1365-2648.1995.22030416.x
[36]	Vik, K. (2010). “From the outside looking in”: A phenomenological study of postnatal depression, mother-infant interaction and video guidance. Ph.D. Thesis, Unipub., Oslo: University of Oslo.
[37]	Wood, A. F., Thomas, S. P., Droppleman, P. G., & Meighan, M. (1997). The downward spiral of postpartum depression. American Journal of Maternal Child Nursing, 22, 308-316. doi:10.1097/00005721-199711000-00007