``Struggling with life'': Narratives from women with signs of postpartum depression

Abstract

Aim: The aim of this study was to explore and describe how Swedish women with signs of postpartum depression two months postpartum experience the first months with their child. Method: A grounded theory approach was chosen. Twenty-two women who showed signs of depression, i.e. scored 10 or more on the Edinburgh Postnatal Depression Scale (EPDS), were interviewed at an average of 80 days after the delivery. Results: The new mothers were struggling with life related to the self, the child, and the partner. They expressed feelings of loss of who they are, felt overwhelmed by the responsibility for the child, and were struggling with feelings of abandonment, worries, and breastfeeding problems. They often felt like ``bad mothers'' but they never blamed the child. Most mothers were reluctant to speak about their feelings and they assigned their depressed mood to personal weakness rather than illness. In relationship to the partner the mothers were struggling to keep their equality in the new situation and to get him involved in childcare. Conclusions: The findings suggest that depressed feelings postpartum may be explained in terms of losses and changes. However, postpartum depressive symptoms remain hidden and it is important to understand the complexity of postpartum depressive mood, described here as struggling with life related to three different dimensions: the self, the child, and the partner.

Keywords

EPDS experiences grounded theory Postpartum depressive symptoms postnatal depressive symptoms

Get full access to this article

View all access options for this article.

References

Pitt B. ``Atypical'' depression following childbirth. Br J Psychiat 1968;122:431—3.

Mauthner NS ``Feeling low and feeling really bad about feeling low'': Women's experiences of motherhood and postpartum depression . Can Psychol 1999;40:143—61.

O'Hara MW , Swain AM Rates and risk of postpartum depression — a meta-analysis. Int Rev Psychiat 1996;8:37—54.

Small R. , Brown S. , Lumley J. , Astbury J. Missing voices: What women say and do about depression after childbirth . J Reprod Infant Psychol 1994;12:89—103.

Beck CT The lived experience of postpartum depression: A phenomenological study. Nurs Res 1992;41:166—70.

Beck CT Teetering on the edge: A substantive theory of postpartum depression . Nurs Res 1993;41:66—170.

McIntosh J. The experience of motherhood and the development of depression in the postnatal period. J Clin Nurs 1993;2:243—9.

Romito P. Postpartum depression and the experience of motherhood. Acta Obstet Gynecol Scand 1990;69(154, Suppl):7—37.

Oakley A. Women confined: Towards a sociology of childbirth. Oxford : Martin Robertson, 1980.

10.

Nicolson P. Understanding postnatal depression: A mother-centred approach. J Adv Nurs 1990;15:689—95.

11.

Nicolson P. Post-natal depression: psychology, science and the transition to motherhood . London: Routledge, 1998.

12.

Beck CT Postpartum depression: A metasynthesis. Qual Health Res 2002;12:453—72.

13.

Schreiber RS The ``how to'' of grounded theory: Avoiding pitfalls. In: Screiber RS , Stern PN , editors. Using grounded theory in nursing. New York: Springer , 2001: 55—82.

14.

Charon JM Symbolic interactionism: An introduction, an interpretation, an integration . Englewood Cliffs, NJ: Prentice-Hall , 1995.

15.

Blumer H. Symbolic interactionism: Perspective and method. Los Angeles : University of California Press, 1969.

16.

Glaser BG Theoretical sensitivity: Advances in the methodology of grounded theory . Mill Valley, CA: Sociology Press , 1978.

17.

Glaser BG , Strauss AL The discovery of grounded theory: Strategies for qualitative research . New York: Aldine de Gruyter, 1999 [original work published 1967].

18.

Cox JL , Holden JM , Sagovsky R. Detection of postnatal depression: Development of the 10-item Edinburgh Postnatal Depression Scale. Br J Psychiatry 1987;150:782—6.

19.

Birbrajer A. , Glas Kullbratt M. Motherhood, a struggle against the wind. Women's experience of postpartum depression: A phenomenological study. Psykisk hälsa 2003;3:187—204 [in Swedish].

20.

Rogan F. , Shmied V. , Barclay L. , Everitt L. , Wyllie A. ``Becoming a mother'' — developing a new theory of early motherhood . J Adv Nurs 1997;5:877—85.

21.

Poslusny SM Street music or the blues? The lived experience and social environment of depression. Public Health Nurs 2000;17:292—9.

22.

Andersson AM Factors influencing the father—infant relationship. J Fam Nurs 1996;2:306—24.

23.

Parke RD Fatherhood. London: Harvard University Press, 1996.

24.

Brown S. , Small R. , Lumley J. Being a ``good Mother''. J Reprod Infant Psychol 1997;15:185—200.

25.

Wollett A. , Parr M. Psychological tasks for women and men in the postpartum. J Reprod Infant Psychol 1997;15: 159—83.

26.

Oates MR , et al. Postnatal depression across countries and cultures: a qualitative study. Br J Psychiatr 2004;184(Suppl. 46):10—16.

27.

Field T. , Hernandez-Reif M. , Feijo L. Breastfeeding in depressed mother—infant dyads. Early Child Dev Care 2002;172:539—46.