Loss, happiness and postpartum depression: The ultimate paradox.

AbstractThis paper describes a British-based longitudinal qualitative study of postpartum depression over the transition to motherhood. Twenty-four women were interviewed during pregnancy and one, three and six months after the birth. The data were transcribed verbatim and analyzed from a symbolic interactionist perspective to identify themes surrounding the meaning of motherhood and experiences of depression during this time.The findings presented here demonstrate an important paradox in women's experiences: they are happy to be mothers to their children, while unhappy at the losses that early motherhood inflicts upon their lives - losses of autonomy and time, appearance, femininity and sexuality, and occupational identity. It is argued that if these losses were taken seriously and the women encouraged to grieve that postpartum depression would be seen by the women and their partners, family and friends as a potentially healthy process towards psychological re-integration and personal growth rather than as a pathological response to a "happy event."Motherhood remains central to female identity even though it is no longer motherhood alone that dictates the way women spend their daily lives (Church & Sommerfield, 1995). However the notion of motherhood is fraught with contradictions.Motherhood certainly changes women's lives, socially, emotionally and economically (see, for example, Gittins, 1993). The evidence suggests that many low income, poorly educated young women see it as their means of liberation from dreary paid employment (Sharpe, 1994), or their entry into adulthood with its accompanying regard (Thomas & Nicolson, 1996). The reality is not so clear cut and motherhood (or parenthood) is more likely to increase both poverty and the stress for young people from low socio-economic groups.While motherhood itself still carries the popular image as a mythical, magical and powerful role (Apter, 1993), the documented reality of many women's lives as mothers (Gavron, 1966/77; Friedan, 1963; Oakley, 1976; Boulton, 1983; Richardson, 1993) indicates otherwise. Women experience the pleasure and the pain of caring for others, giving and receiving love alongside social isolation and the resentment that they are no longer able (or even sometimes willing) to put themselves first (Rich, 1984; Friedan, 1963; Parker, 1995). Motherhood as an institution includes certain responsibilities and duties, but women's power is limited. Women's power in both the public and private/domestic spheres is subject to the rule of men -- both as individuals and as represented by patriarchy. Psychologists have traditionally claimed priority for mothers' power over children, through emphasizing the importance of mother-child relationships (Apter, 1993) and through the debate on mothers' responsibilities to their children (Tizard, 1991). However, legal and traditional power over women and children is held by men (Segal, 1990).Despite this evidence, becoming a mother is routinely expected to be a "happy event" in family life. That significant numbers of women become depressed in the first months following childbirth (Lee, 1997) is frequently portrayed in the scientific literature as an objective psychological problem, i.e., postpartum depression, in that the woman herself who gets depressed in the early months of motherhood is not psychologically normal (see Ussher, 1989, 1991; Nicolson, 1998). The meaning that the women themselves might seek to place upon their experiences has been curiously absent until a very few years ago (Ussher, 1989; Nicolson, 1998; Lewis & Nicolson, 1998; Stoppard, 1998).WHAT IS POSTPARTUM DEPRESSION?Postpartum depression is still seen by many experts and lay people as distinct both from the social context of childbirth and motherhood and from any other kind of depression (WHO, 1992). It is frequently described as an irrational, inevitable, response to the hormone fluctuations following childbirth (e. …