Puerperal psychosis – a qualitative study of women’s experiences

Abstract

Objective: This study explored women's experience of puerperal psychosis (PP) and their perceptions of its cause, in order to contribute to an increased understanding of PP and promote consideration of new management perspectives. Background: Out of every 1000 live births, approximately one to two women will develop PP. The numbers are relatively small, yet the consequences can be devastating. Key theoretical explanations for the aetiology of PP are genetic, biochemical and endocrine. A small and relatively tenuous evidence base considers PP from a psychological perspective, despite acknowledgement of the need for broader understanding. A stress-vulnerability model has offered a contemporary explanation of psychotic symptoms in other contexts and non-clinical populations and may offer useful insight in relation to a psychobiological model of PP. Methods: In a qualitative study, seven women who had been diagnosed with PP previously were interviewed and the data subjected to an inductive thematic analysis. Trustworthiness and rigour of the study was assured by careful monitoring of the research process and data checking. Results: Four themes were identified -The path to PP; Unspeakable thoughts and unacceptable self; 'Snap out of it'; and Perceived causes. While women attributed their PP to the physiological changes associated with childbirth, their accounts of PP began before and during pregnancy. Women highlighted stressful pregnancies characterised by significant challenges and emotions, difficult births and unsupportive family relationships postnatally. The experience of PP was extremely distressing. Conclusion: Findings add to the debate about a more multifaceted explanation of PP and potentially offer a psychobiological model of understanding.

A qualitative investigation in the role of the baby in recovery from postpartum psychosis

“…Early qualitative research in this area indicates that mothers experienced postpartum psychosis as a particular type of mental health difficulty that is distinct to and precipitated by the experience of childbirth (Stewart et al, 2003). During the course of postpartum psychosis, mothers often experience negative thoughts about the baby (Glover, Jomeen, Urquhart, & Martin, 2014), accompanied by feelings of shame and guilt over not being able to care or respond appropriately to her infant (Engqvist, Ferszt, Ahlin, & Nilsson, 2011;Engqvist & Nilsson, 2013). Mothers often reported that family members cannot cope or understand the illness and that this was detrimental to their recovery (Glover et al, 2014).…”

Historical perspectives: a snapshot of women admitted to psychiatric facilities with psychosis or mania after childbirth in the late Victorian and inter‐war periods

“…, Glover et al . ). It appears that time away from the responsibilities of her home life and a good diet contributed to her recovery.…”

“…, Posmontier , Oates & Cantwell , Glover et al . ). It is treated with antipsychotic and mood stabilizers; however, admission is often required to prevent harm to the woman or to any other person, including the child (Doucet et al .…”

Qualitative exploration of the effect of a television soap opera storyline on women with experience of postpartum psychosis

“…The widened perspective of research findings, provided by the significant heterogeneity in age and time since first postpartum psychosis episode between participants, offers novel insight previously unexplored by other recent qualitative research in this population, which rarely seeks the perspective of women 20 years or further into their recovery from postpartum psychosis. 9 – 13 However, important and distinct experiences may be elicited by interviewing a more narrowly focused age range or those with more recent experience of postpartum psychosis.…”