Understanding postnatal depression: a mother-centred approach.

Research findings on the causes and correlates of postnatal depression divide into two explanatory frameworks. The clinical/medical model identifies the mothers as being 'ill', and the social science model suggests a particular vulnerability to additional social stress factors. Despite attempts to predict those women at risk, and develop preventative programmes, most treatment initiatives are reactive, which is a direct result of the inconclusive nature of available evidence. The study reported here suggests that the concept 'postnatal depression' needs to be re-examined and that rather than it being an individual illness or vulnerability, it is more akin to a normal grief reaction and part of a normal postnatal profile. It only becomes a problem when it is defined and treated inappropriately. The implications from this research lead to a new approach to understanding the mother's experience of postnatal depression, and types of counselling and support which might effectively be employed by midwives and health visitors.