Pregnancy and Depression Seeking Support – Part 5

Posted by: Kevin Flatt

Pregnancy and Depression Seeking Support. Management and treatment of their depression. Support from husbands, parents, siblings and friends?

Intervening condition that influenced becoming the best mom that I can.

The condition that intervened and influenced becoming the best mom that I can was the type and degree of support that women perceived to be available to them. Most women in this study were in stable marital relationships and described their husbands as providing (in the main) practical and emotional support.

Their husbands accompanied them, on at least one occasion, to the psychiatrist, and participated in discussions about treatment strategies.

However, being seen by their husbands as “not having a grip on things” was upsetting and embarrassing for the women. Some women were not entirely convinced that their husbands, as supportive as they were, were totally aware of the depth of their emotional problems.


He boosts me up, but at the same time, sometimes I feel like he’s
really missing the point sometimes, or do you really know that I
am really struggling here to keep it together.


Three women perceived their partners to be unsupportive. Those women actively excluded their partners from participation in, or discussion of, the management and treatment of their depression.

Few women described seeking support from parents or siblings. The majority delayed telling their families about their depression until after they had sought professional care; some women did not want to be a “burden”, others were “ashamed”. A number of women, who described their parents as being very ill or their families of origin as “dysfunctional”, delayed, avoided, or simply were unable to discuss their concerns.

None of the women sought support from friends. Many were embarrassed about how they were feeling, convinced that they would not be understood, and feared that they would be “judged”:

I mean it felt like a failure to me. I felt if I told my friends, I felt
like I might be judged by it.

We’re pretty judgmental about mothers; I mean mothers are the
worse culprits, mothers judging other mothers. Then non-mothers
judging non-mothers, and sometimes I think women are
harder on each other than men are.

Unable to talk to others, the women’s sense of loneliness and their sense of “being the only one” was intensified.

Strategies for becoming the best mom that I can – Confronting and confining the threat.

In the presence of the contextual and the intervening conditions, the women began the process of confronting and confining the threat. For the women in this study, that process involved seeking care from a psychiatrist experienced in the field of reproductive mental health and consisted of three stages: Overcoming barriers, Gaining knowledge, and Taking control. Each stage was composed of several properties.

Stage 1. Overcoming barriers

Facing personal obstacles
Women who had not experienced depression prior to pregnancy struggled to understand what was happening and challenged themselves saying, “there is no reason – there is no physical reason why I couldn’t do more”. (#20) They were ashamed and concerned that they would be viewed by others as being “incredibly lazy”, or “wanting attention”, and that what they were feeling would not be seen as “real”. The act of asking for help was seen to be an admission of failure:


So, just swallowing my pride and going outside of the home, was
a big step. Once I committed to saying that I have to tell someone, it was easier. (#16)
(Note: As mentioned in Part 1, confidentiality was maintained by assigning each participant a code number).


For some women, feelings of shame continued unabated throughout the period of their treatment. One woman explained how she felt when attending her scheduled appointments with the psychiatrist as:


Even when I was going to the psychiatrist in the hospital, I was
worried that I would run into somebody. (#10)


Navigating the healthcare system
Having committed to telling someone the women approached their obstetric care provider or their family physician for help. For many, this resulted in being referred directly to a mental healthcare professional. One woman, who had been under the care of a midwife, said:

They [midwives] were fantastic. I don’t know what I
would have done, really and honestly had I not had them
noticing stuff and asking me questions, because I was really, really withdrawn. They actually gave me a referral and all of that. (#4)

Others encountered obstacles as they endeavored to navigate the health care system.

“Obstetricians were regularly considered to be “too busy” or to have “zero interest in me as a person”. Women perceived that “there really wasn’t time to talk” with their obstetricians about their emotional health and that they were considered as “purely a body”. One woman, who had a particularly difficult time finding professional help said:

I guess she didn’t have time for the counseling or to look into it,
to talk to me further about it. She made it clear from the
beginning that if you had any other medical problems other than
pregnancy, that you would have to see your other doctor. (#15)
>

Making a connection

Making a connection with “the right” mental health professional was not immediate for all women. Because of their fear of not being believed, they needed to speak to someone who would understand and not judge.

They needed “somebody who specializes in this area”, someone who “recognized the complexity of my life as a woman and a mother”, that they felt was “asking me the right questions”, who was “understanding, sympathetic” and one who had “the time to listen”.

One woman “instantly felt better” because there was a good connection with her psychiatrist. Some women felt more comfortable when they were able “to speak to a woman”. As one woman stated:


Someone that I could tell my problems to and who won’t judge
me, who won’t say you are bad. I mean just imagine someone
sitting there and you’re getting to spill the beans, and knowing
that whatever you say is going to be confidential. She’s not
going to criticize you. (#17)

Women who did not make a connection with the healthcare provider simply stopped seeing them. As one woman said, “Well, I tried to find other therapists, and I saw one intermittently, and I feel like it’s not really that helpful, so haven’t continued in that.” (#11)

Part 6 will be published soon.

The researchers were Heather Bennett, Heather Boon, Sarah Romans and Paul Grootendorst. The above is a partially modified reproduction of their research. Also their references have been omitted for ease of reading.

Related articles:

Dealing with Depression during Pregnancy – Part 1

Depression During Pregnancy – Part 2

Women With Depression During Pregnancy – Part 3

Pregnancy: Depression, Antidepressant Drugs and The Baby – Part 4

Depressed? Drink Tea

Reference:

Bennett HA, Boon HS, Romans SE, Grootendorst P. Becoming the best mom that I can: women’s experiences of managing depression during pregnancy – a qualitative study. BMC Women’s Health 2007, 7:13 (11 September 2007). © 2007 Bennett et al., licensee BioMed Central Ltd.
This is an open access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

    

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