Abstract Aim. The aim of this study was to provide a deeper insight into the life world of women who have lived through postnatal depression (PND). Objectives. Gain insight into women’s lived experiences’ of PND and describe the meaning of the illness from the perspective of the people who have had experience of the illness. Method. A phenomenological, hermeneutical approach was used to describe women’s experiences of PND. A purposeful sample of seven women agreed to participate in the study. In-depth unstructured interviews were audiotaped and transcribed verbatim with consent from the participants. Transcriptions were processed using the hermeneutic circle: dialogue, fusions of horizons and metaphors to understand the meaning of the experience adapted from Dicklemann et al, (1989) and the participants confirmed the transcript interpretations. Findings/results. The findings were presented under the four existential lifeworlds – lived space, lived body, lived relations and lived time (Van Manen, 1990). All of the women experienced a loss of their former self after they went through a process of being a known person in a known world to an unknown person in an unknown world (Rubin, 1984). The women vividly described their brokenness and sorrow as they struggled to come to terms with their new image and their new role as a mother. It was after they had experienced a cycle of grief that they were able to accept their new self and new role as a mother. These women came to accept their experiences as normal. They felt they had to experience death of their former self before giving birth to their new persona. Implications. This perception of normal experience challenges midwives and mental health workers to redefine the meaning of normal and to review the consequences of labelling women as suffering from PND. The study calls for a review of current antenatal preparation for parenthood and challenges midwives to review commonly accepted beliefs that almost every woman naturally adjusts to the role of motherhood when their baby is born. New approaches are required in order to prepare women for the possible event of experiencing this sometimes ‘natural’ metamorphic state after giving birth.
|Journal||Evidence Based Midwifery|
|Publication status||Published - 2003|
Bibliographical noteReference text: References
Baker C, Wuest J, Noerager Stern P. (1992) Medical slurring: the ground-
ed theory/phenomenology example. Journal of Advanced Nursing 25:
Baker P. (2001) The tidal model: developing an empowering, person
centred approach to recovery within psychiatric and mental health
nursing. Journal of Psychiatric and Mental Health Nursing 8: 233-
Chilton H. (1940) In: Mothers: an illustrated treasury.(1993) Royle
Bowlby J. (1980) Loss (Attachment and Loss: volume 3).Hogarth Press:
Davidson L, Strauss JS. (1992) Sense of self in recovery from severe
mental illness. British Journal of Medical Psychology 65: 131-45.
Davidson L, Strauss JS. (1995) Beyond the psychosocial model: integrat-
ing disorder, health and recovery. Psychiatry 58: 44-55.
Diekelmann M, Allen D, Tanner C. (1989) The National League for
Nursing criteria for appraisal of baccalaureate programs: a critical
hermeneutic analysis.The National League for Nursing Press: New
Engel GC. (1961) Is grief a disease? A challenge for medical research.
Psychosomatic Medicine 23: 18-22.
Forrest S. (1993) Toward understanding the self. Nursing Forum 28(2):
Fry AJ, Nguyen T. ( 1996) Culture and the self: implications for the
perception of depression by Australian and Vietnamese nursing
students. Journal of Advanced Nursing 23: 1147-54.
Jones A. (1989) Managing the invisible grief. Senior Nurse 9(5): 26-7.
Keane C. (1995).Mercier Press: Dublin.
Koch T. (1994) Establishing rigour in qualitative research: the decision
trial. Journal of Advanced Nursing 19(5): 976-86.
Koch T. (1995) Interpretive approaches in nursing research. Journal of
Advanced Nursing 21: 827-36.
Koch T. (1996) Implementation of a hermeneutic inquiry in nursing:
philosophy, riquor and representation. Journal of Advanced Nursing
Kubler-Ross E. (1978) On death and dying.Tavistock Publication: London.
Mander R. (1994) Loss and bereavement in childbearing.Blackwell
Scientific Publications: Oxford.
Markus HR, Kitayama S. (1991) Culture and the self: implications for
cognition, emotion and motivation. Psychological Review 98: 224-53.
Murphy-Lawless J, Kennedy P. (2002) The maternity care needs of
refugee and asylum-seeking women: a research study conducted for
the Women’s Health Unit Northern Area Health Board.University
College Dublin: Dublin.
Nochi M. (1998) Loss of self in the narratives of people with traumatic
brain injuries: a qualitative analysis. Social Science Medicine 46(7):
Parkes CM. (1985) Bereavement: studies of grief in adult life. (2nd
edition) Penguin Books: Harmondsworth.
Parkes CM, Weiss RS. (1985) Recovery from bereavement.Basic Books:
Parkes CM, Stevenson-Hinde J, Marris P. (1991) Attachment across the
life cycle.Routledge: London.
Rose K. (1994) Unstructured and semi-structured interviewing. Nurse
Researcher 3: 23-32.
Rubin R. (1984) Maternal identity and maternal experience. Springer
Publishing: New York: 52.
Sadala MLA, de Camargo Ferreira Adorno R. (2002) Phenomenology
as a method to investigate the experience lived: a perspective from
Husserl and Merleau Ponty’s thought. Journal of Advanced Nursing
Small R, Lumley J, Donohue L, Potter A, Waldenstrom U. (2000)
Randomized controlled trial of midwife-led debriefing to reduce
maternal depression after operative childbirth. British Medical Journal
Van Manen M. (1990) Researching lived experience: human science
for an action sensitive pedagogy. State University of New York
Press: New York.
Walsh, M.P. (1995) Living after a death: a guidebook for the journey of
bereavement. The Columbia Press: Dublin.
- Hermeneutical phenomenology
- postnatal depression