UCSF

Abstract

Coming Through it Together:

Narratives on the Relational Aspects of Maternal Postpartum Depression and Parenting Practices

Alyssa J. Abraham O’Brien

Depression that occurs in new mothers during the postpartum period is the most common complication of childbirth with an etiology and course similar to depression that occurs in women during other life events. However, postpartum depression (PPD) deserves dedicated research and clinical focus because of the critical role this period plays in the development of a family. The partner relationship is a well-known support for women during this time, yet little is understood about the associations between PPD and this relationship. The aim of this interpretive phenomenological study, conducted using the narrative and thematic interviewing style and analysis methods of Benner (1994), was to examine the experiences of couples as they made the transition to parenthood within the context of a maternal PPD diagnosis. Ten couples were interviewed within three years of the mother’s PPD diagnosis. Findings indicate that couples experienced a range of responses to maternal PPD, including the processes of dismissal, acknowledgment and accommodation. These processes influenced their experience of their transition to parenthood, and their interpersonal relationship, and the functioning of their household. Multiple patterns of interaction and coping that varied by relationship style, were also identified and impacted daily habits and practices in the home. Three relationship styles were identified: 1) an equally supportive relationship style; 2) a relationship style that consisted of differing perspectives, but was still supportive; and 3) a discordant relationship style that created significant dysfunction in all aspects of the relationship. Relationship and parenting experiences were impacted differently depending on the couple’s style of interaction and the quality of the support they reported. Finally, results highlighted ways that parenting practices were influenced by a mother’s PPD and how couples worked together, even through disagreements in the attempt to shelter their children from a mother’s depression and their relationship conflicts. These findings suggest a need for perinatal nurses and health professionals to develop family centered postpartum assessments and interventions when the mother is diagnosed with PPD.