Tara Lynn Frankhouser1, Nicole L Defenbaugh2,3. 1. Piedmont HealthCare Family Medicine, Statesville, North Carolina tara.frankhouser@piedmonthealthcare.com. 2. Lehigh Valley Health Network, Allentown, Pennsylvania. 3. University of South Florida, Morsani College of Medicine, Tampa, Florida.
Abstract
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.
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.
Authors: Bruce Arroll; Felicity Goodyear-Smith; Susan Crengle; Jane Gunn; Ngaire Kerse; Tana Fishman; Karen Falloon; Simon Hatcher Journal: Ann Fam Med Date: 2010 Jul-Aug Impact factor: 5.166
Authors: Robert A Bell; Peter Franks; Paul R Duberstein; Ronald M Epstein; Mitchell D Feldman; Erik Fernandez y Garcia; Richard L Kravitz Journal: Ann Fam Med Date: 2011 Sep-Oct Impact factor: 5.166