The trajectory of Brazilian women in postpartum depression: the challenge of putting the puzzle back together

Author(s)

Hudson Pires de Oliveira Santos Júnior

• Document type: Doctoral Thesis
• Press: São Paulo.
• Institution: Universidade de São Paulo (USP). Escola de Enfermagem (EE/SBD)
• Defense date: 2013-01-18

Examining board members

Dulce Maria Rosa Gualda; Regina Szylit Bousso; Lidia Aparecida Rossi; Maria de Fátima de Araújo Silveira; Maria Alice Tsunechiro

• Advisor: Dulce Maria Rosa Gualda

Abstract

Postpartum depression (PPD) is a mood disorder affecting women from different cultures, and is considered to be an international public health problem. However, there is still little scientific knowledge regarding the qualitative characteristics of the experience of PPD in the Latin American context, including Brazil. Given this lack of knowledge, the objective of this study was to understand the trajectory of a group of Brazilian women\'s experiences with PPD. This was an interpretive description study. The participants were 15 women with the clinical diagnosis of PPD, and 9 family members chosen by them. Data collection was performed in the city of São Paulo in the period of May 2011 to January 2012, through semistructured interviews. The data underwent inductive thematic analysis. As a result, it was understood that the trajectory of the women experiencing PPD led them to experience motherhood outside of the idealized standards, which consequently modified the way in which they understood their own identity. The analogy of a puzzle is used to describe the rearranging of the woman-mother image, composed of the two pieces \"identity\" and \"maternity,\" caused by PPD. The thoughts that the women experienced of hurting their children proved to be the factor most greatly affecting the puzzle piece \"maternity.\" As a response to this, they described different ways of exercising their motherhood. The puzzle piece \"identity\" took second stage due to the sociocultural importance given to maternity. Therefore, even when the depressive symptoms had affected the woman\'s individual ability, or her perception of herself, it was only when there was a failure to care for the child when questions arose regarding depression, generating the need for help. Family support, returning to social activities, and psychopharmacological treatment were all named as the main strategies to recover their health condition. However, it may be concluded that the woman-mother pieces never fit back together as they once had. The rearranging caused by the PPD was not reverted; the women had to adapt to a new \"normal,\" where their personal identity, their perception of motherhood, and their relationships with their children and partners had been negatively affected. The description and interpretation presented in this study may be used by healthcare professionals to understand the illness process of women in PPD, and provide innumerable possibilities for future research. (AU)

• FAPESP's process: 10/02453-4 - Bringing babies into the light of day... and staying in the dark... the postpartum depression in social and family context of women
• Grantee: Hudson Pires de Oliveira Santos Junior
• Support Opportunities: Scholarships in Brazil - Doctorate (Direct)