PURPOSE This article examines postpartum depression (PPD) using autoethnography to explore the stigmatization of depression and cultural expectations of motherhood. Because the personal experiences of living with PPD are often absent from primary care literature, this article uses first-person narrative and analysis of intensive mothering to explore the barriers to seeking PPD treatment, the need for increasing physician confidence and comfort using screening tools, and the impact PPD stigma has on patients and their health care.METHODS Autoethnography, as a relatively unfamiliar methodology in primary care, is used to illuminate individual experiences of living with PPD. The author details a series of encounters as wife, mother, and patient by narrating what it means to live with the disease. A thematic analysis of the series of first-person narratives was employed to further understand the culture of motherhood and shed light on the stigmatization of PPD.RESULTS Four themes emerged from the analysis revealing the pressures surrounding the cultural ideologies of intensive mothering and the stigma of mental illness: essentialism, failure, shame, and avoidance.DISCUSSION There is a need to reframe cultural perceptions of motherhood and PPD to positively impact familial interactions and health care encounters for those who live with the illness. The article calls for providing broader diagnostic efforts, more comprehensive care, and engagement with patients in shared decision making around the diagnosis and treatment of PPD.
THE STORY1:47 PM. I feel his feet slide out. I remember it clearly. He is placed on my belly, screaming, as though he needs to prove he exists, this alien sound coming from this tiny being we had created. I hold him and cry, tears of relief that the pain of birth is over, that my son is screaming on my belly. My husband cuts the cord, severing the connection. My son is weighed, printed, wrapped up. They take him to the nursery and wheel me to the floor to recover, ice over my most private parts, now swollen and sewn back together, forever changed by bringing my son into this world.We brought home a happy, healthy baby boy. My husband was overjoyed, but he was soon back to work as an internal medicine intern with long hours and already limited sleep. I was alone with my son most of the time, surrounded by bottles, breast pump equipment, and dirty diapers.Months pass. The late afternoon sunshine streams into the hallway from our bedroom while outside the window it dances across yellows and oranges and reds of falling leaves. My back presses against a cold, white door. From behind the door loud wails from deep within my son, as if he were searching for love and a feeling of belonging he had yet to find in my arms. Earlier, we had done the dance-he was fed, his diaper was dry, he had been burped, he had napped. All afternoon we had rocked, walked, I held him close to me, taking in the softness of his skin and hair, the smell that babies have of freshness and powder and milk, and none of i...