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Maternal Understandings of Postnatal Depression
[Thesis]. Manchester, UK: The University of Manchester; 2011.
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Abstract
Paper one is a systematic literature review of qualitative studies examining postnatal depression in immigrant mothers using a metasynthesis approach. This review involved three phases: a systematic literature search of qualitative studies reporting on postnatal depression among immigrant mothers, critical appraisal of the studies from the literature search, and the metasynthesis of these studies. Fifteen studies met the inclusion, exclusion and quality criteria. The synthesis of the studies demonstrated that immigrant mothers are subjected to two overarching factors of migration and cultural influences that interact and give rise to psychosocial understandings of postnatal depression, healthcare barriers and views of potential remedies lying within the psychosocial domain. Mothers use self-help coping strategies in line with this. Social support appears to play an integral and mediating role for these immigrant mothers removed from their sociocultural context.A grounded theory approach was taken in the second paper to explore illness beliefs in mothers with postnatal depression. Eleven participants were interviewed using a semi-structured interview schedule and data was analysed in line with a grounded theory methodology. A theory of illness beliefs in PND was developed encompassing six core categories: ‘unmet expectations’, ‘identifying stressors in their life context’, ‘conflict over label’, ‘antidepressants: the lesser of two evils’, ‘loss of time’ and ‘uncertain futures.’ It was concluded that participants made multiple appraisals of their PND in light of their initial difficulties, following service involvement, their improvements, their consequences and the future. Participants’ narratives were conflicting and uncertain with internal struggles evident as mothers were torn between their desire to be good mothers and their perceptions that PND meant that they were not good enough mothers. The final paper is a critical appraisal that outlines my personal journey through a grounded theory methodology in exploring illness beliefs in postnatal depression. This appraisal first discusses why a qualitative design was chosen and more specifically a grounded theory approach. The difficulties attached to using grounded theory are then considered. Finally in keeping with the need for transparency within the methodology, there is a reflective account of the challenges encountered, the knowledge and skills gained throughout the process and how this has been important for my learning and progression towards becoming a qualified Clinical Psychologist.