Causes of postnatal depression : perceptions of recovered women
Investigations into the causes of postnatal depression are, with few exceptions, quantitative in nature. Although there are psychological, interpersonal and sociocultural perspectives on postnatal depression, the medical one dominates in terms of academic, professional and lay understandings of aetiology. The medical model has produced a plethora of investigations into the causes of postnatal depression but has paid little attention to the insights of women who have experienced the condition. This study sought to redress this by exploring the causes of post-natal depression from a women-centred perspective. A feminist approach to postnatal depression was adopted. This approach has evolved largely as a critique of the medical model and is grounded in a more qualitative tradition. Semi-structured, in-depth interviews were conducted with twenty women who had recovered from postnatal depression. Transcribed data from the interviews were thematically analysed to uncover the participants' attributed causes for their post-natal depression. A number of common themes emerged and could be broadly grouped under ""interpersonal factors"" (such as the impact of the woman's relationship with her own mother); ""psychological factors"" (such as the impact of unresolved issues and feelings of loss on the new mother) and ""biological factors"" (such as hormonal factors). The dominant theme that emerged from this study was that of ""motherhood"". Included under this heading were all those factors specifically associated with being a mother that were regarded by the women as being the cause of their postnatal depression (such as the experience of childbirth, breastfeeding and lack of sleep). At the core of this theme lay the realisation that motherhood was not what they had expected it to be. Their disappointment in not meeting their own expectations of motherhood contributed significantly to their postnatal depression. An interesting finding was that while many of the respondents located feelings of failure to live up to the ""ideal image"" of motherhood as a cause of their depression, few questioned the validity of the social construction of this ideal. This paper also examined the extent to which women's aetiological explanations resonate with existing models of post-natal depression. Their explanations were found to reflect some of the existing aetiological models of postnatal depression but no single model of explanation could be identified as the cause of their postnatal depression. Rather, women's attributions of cause were multi-layered and complex. They all attributed their depression following childbirth to a number of factors and they differed markedly from one another in their attributions. According to this research, postnatal depression results from a myriad of inter-related factors which interact with one another in different ways to produce a largely different picture for each and every woman. The limitations and contributions of this study are discussed.
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