Experiences of Peripartum Depression among Middle-class Chinese Mothers in Urban China and the Netherlands

Abstract

This research is grounded in (digital) ethnographic fieldwork, offering an in-depth exploration into the dynamics of contemporary motherhood, particularly women’s experiences of peripartum depression. The study places an emphasis on a frequently understudied group: highly educated and seemingly privileged middle-class Chinese mothers residing in urban China, as well as those who have chosen to migrate to the Netherlands. It also examines of the quality of the maternity care provider-woman relationship within the interactions involving midwives and maternity care assistants with middle-class Chinese migrant women in the Netherlands. Chapter 1 aims to define the vulnerability to developing postpartum depression of middle-class migrant women as an intersubjective phenomenon undergoing transformation due to individual's social, cultural, and intergenerational interactions within transnational families. This article specifically focuses on middle-class Chinese migrant women, representing an often-overlooked subgroup within the burgeoning global middle-class migrant populations. Notably, it provides insights the pressures induced by the dominant public discourse of “good” mothering and explores how women who feel compelled to meet the standards of a "good" mother often exhibit lower levels of maternal self-efficacy, leading to heightened stress and anxiety. Chapter 2 is grounded in semi-structured, in-depth interviews with 43 Chinese mothers residing in urban China. This study examines the prevailing mothering paradigm embraced by the majority of middle-class Chinese mothers—termed "scientific mothering" (kexue yu’er). This conceptual framework places a premium on the authority and accountability of modern science, particularly drawing from the perspective of developmental psychology. Implicit in the notion of scientific mothering is the expectation for women to self-sacrifice their individual needs and pursuits for the purpose of fostering high-achieving children. A growing number of middle-class Chinese women find themselves in a dilemma, navigating the tension between self-sacrifice for intensive mothering and asserting autonomy as a new generation of women. This dichotomy limits their freedom to raise children according to their own desires. Despite the fact that many of them emotionally struggled with the loss of their autonomous self in the process of navigating first-time motherhood, a noteworthy development is the gradual learning process among these individuals. Most importantly, they have gradually learned to prioritize self-nurturing through practices of self-care. Chapter 3 addresses the multifaceted psychosocial challenges encountered by Chinese migrant women during the peripartum period, specifically within their relationships with intimate partners, mothers, and mothers-in-law. Many participating women with peripartum depressive symptoms in the study faced challenges in the transition into motherhood due to the unmet self-expectations regarding the pursuit of a good quality of life and a happy motherhood. Also, tension and conflict arose during interactions with women's mothers and mothers-in-law, contributing to the accumulation of stress and anxiety, particularly in the context of adopting the postpartum ritual such “doing the month”. Drawing upon interviews conducted with 46 middle-class Chinese migrant women, 13 midwives, and 12 maternity care assistants in the Netherlands, Chapter 4 employs three key concepts: interpersonal trust, culturally sensitive health care, and women's autonomy in shared decision-making. Through these lenses, this study offers insights into the formation and functioning of interpersonal relationships in the context of maternity care. The finding highlights the general trend of medicalization of surrounding pregnancy and childbirth in urban China and its impact on the expectations of care among Chinese women. The discrepancy between the inclination of Chinese migrant women towards more medicalized care and the Dutch midwives' emphasis on promoting the natural course of pregnancy and birth often lead to the suppression of women's concerns and anxieties.