Suffering in Silence: A Qualitative Meta‐Data‐Analysis of Postpartum Depression

Abstract

In this article, we apply a relational lens to a grounded theory meta-data-analysis of qualitative studies on postpartum depression (PPD) conducted between 1999 and 2005. Women in all studies report feeling that they have failed to live up to cultural standards for a "good mother." Central to this experience is a sense that these negative feelings could not be spoken. The analysis shows how constructions of motherhood and the reactions of others combine with feelings of incompetence to precipitate isolation from others. Women survive depression through support that validates their experience and promotes eventual reconnection with others. Conclusions emphasize the need for persons trained to facilitate relational connection to develop interventions that address the interpersonal contexts of PPD.

Transitioning From Caregiving to Widowhood

“…One strategy employed by the women was downward social comparisons which can enhance well-being and has been documented in breast cancer patients (25,26). Conversely, 'suffering in silence' outside the context of religion, has been linked to feelings of isolation despite presence of supportive family in women with postpartum depression (27).…”

Constructions of motherhood and fatherhood in newspaper articles on maternal and paternal postpartum depression

“…A significant concern for feminist theorists is the societal expectations with respect to new motherhood (e.g., Barnes, 2006;Knudson-Martin & Silverstein, 2009;Nicolson, 1990;Whiffen, 2004). According to the feminist perspective of MPPD, a mother's distress in the postpartum period comes from a conflict between her expectations of what it takes to be a good mother (which are influenced by her society and culture, Burr 1995;Fairclough, 1995Fairclough, /2010Willig, 2001) and the reality of her situation (Abrams & Curran, 2007;Barnes, 2006;Beck, 2002;Biehle & Mickelson, 2012;Choi et al, 2005;Whiffen, 2004).…”

“…More often, these women felt that a lack of preparedness for motherhood (Choi, Henshaw, Baker, & Tree, 2005;Homewood, Tweed, Cree, & Crossley, 2009;Zelkowitz & Milet, 1997), lack of support (also in Zelkowitz & Milet, 1997), fatigue and difficulties in breastfeeding (also in Haga, Lynne, Slinning, & Kraft, 2012) and delivery were the major contributors to their PPD. Other possible contributing factors could be high levels of stress (including work and financial; Zelkowitz & Milet, 1997), low self-esteem and loneliness, as well as feelings of incompetence, loss of self, an inability to cope (Letourneau et al, 2010), and isolation (Knudson-Martin & Silverstein, 2009). …”

“…Rather than PPD being medicalized and constructed as something is wrong with a mother, Nicolson (1990Nicolson ( , 1999 argued that it should be viewed as a normal reaction to grieving the loss of the stability and familiarity of a mother's "old life," and indicative of the transition and growth into a new one. Women's experiences need to be validated, not just normalized (Knudson-Martin & Silverstein, 2009). …”

“…The most common statistic reported for MPPD is approximately 10-15% (e.g., American Psychological Association, 2007;Bina, 2008;CPA, 2009;Posmontier & Horowitz, 2004;Rychnovksy & Beck, 2006) and 10% for PPPD (e.g., Paulson & Bazemore, 2010). The following is a compiled list of symptoms from a number of sources (e.g., APA, 2000; Knudson-Martin & Silverstein, 2009;Letourneau et al, 2010;Nicolson, 1990;Roehrich, 2008;Suda et al, 2008;Whiffen, 1992) that fathers and mothers may experience after childbirth: mood swings, guilt, shame, suicidal ideation, energy loss, loss of interest, agitation, motor retardation, anxiety, irritability, and/or insomnia.…”