The Helpful and Hindering Actions of Others as Women Recover from Postpartum Depression

Purpose:

This study was conducted to describe and understand the experience of recovery in women who have recovered from PPD.  Many women, as many as 15% or more in some studies, experience a perinatal mood disorder of varying severity.  Understanding the experiences of women who recover from PPD may shed light on the behaviors, feelings of thoughts associated with the recovery timeframe.  This presentation will focus on the facilitators and barriers to recovery from PPD as learned by listening to women describe their experience of recovery.

Methods:

Naturalistic inquiry paradigm with qualitative descriptive design.

 Interviews of nine participants took place anywhere the participant felt comfortable to freely express herself with the majority taking place in the participant’s home, other settings used were a university, hospital, diner, or over the telephone.

Prior to data colleaction, IRB approval was obtained.  A convenience sample of nine women were recruited, one from a doctor’s office and eight by the snowball method with acquaintances and colleagues.  Inclusion criteria were that a participant be over 18 years old, that she had been diagnosed with PPD by her doctor, and felt through self-reflection that she was recovered.  The participants were predominantly Caucasian, between the ages of 28 and 54, and married or living with a committed partner.  The time in recovery spanned from less than one year to 24 years.

Participants were called prior to the interview to explain the study and determine their suitability.  Each participant was interviewed one time, this interview was digitally recorded and transcribed by the researcher.  The participant was asked to describe the facilitators and barriers to recovery with minimal comment or input from the researcher to allow for consistency and a range of responses.  Analysis to uncover the presence of themes followed the method suggested by Ryan & Bernard (2003).  This method focuses on repetitions of topics, analogies, similar shifts in the content of the interviews, similarities or differences in topics, topics avoided, and linguistic connectors of topics. 

Results:

Facilitators - Two themes emerged from the descriptions expressed by these nine women.  First, support from their husbands, family members and friends as expressed in their caring relationships.  Second, their own positive attitudes and confidence also helped them endure PPD through to recovery.  Help given by their healthcare providers also accounted for easier access to care and guidance for their self-care.  These women talked without hesitation and their expressions revealed the intense work involved in recovery.  Their baby had to come first in their life which left little time or energy to care for themselves or their family.  The helping actions of others were key to their recovery.

Barriers - Three themes were revealed within the descriptions of the participants.  First, what hindered their recovery was a lack of support from others, second, a negative attitude toward themselves, and third, limitations in their ability to function.   Their inability to function during the experience of postpartum depression was further hampered by the lack of cooperation and caring from people around them.  The negative aspects of the care they received from their healthcare providers involved barriers to care and a perceived lack of concern for their welfare.  Many conflicting demands  from their family and their own needs had to be managed and sometimes they know they did not cope as well as they would have liked.  They have great lessons for other mothers, families, and all health care providers that inform all of us how to anticipate and recognize the needs of women recovering from PPD.

Conclusion:

Health care providers have an important role in recovery by supporting the woman and removing barriers to care.  Individualizing the care given to meet the needs of each woman is an essential part of care.  At times health care providers were seen as barriers by preventing direct communication with the care giver or not initially assessing the severity of the PPD.  Informing every woman as well as her family and friends on the characteristics of PPD will emphasize the importance of support and understanding.   Improving the understanding of the woman's experience with PPD by her health care provider is essential for each newly delivered mother.