Becoming a mother: a study of current and potential response to Perinatal Mental Health

Abstract

Background : This research addressed two significant gaps: 1) theoretical framework for conceptualising the phenomena of becoming a mother and 2) significant training needs for midwives in responding to perinatal mental health difficulties experienced by patients. Research question: What is the experience of the midwives working with patients experiencing mental health difficulties during the perinatal period? Aims: --Investigate Irish midwives’ experiences of working with patients experiencing perinatal mental health difficulties --Identify theoretical models and presuppositions used by midwives --Critically assess whether existing presuppositions are relatable to psychoanalytic conceptualisation and whether psychoanalytic theories can bridge the gaps identified. Objectives: --Conduct in-depth interviews with experienced midwives across ROI maternity units --Analyse responses --Provide psychoanalytic perspectives for perinatal mental health difficulties --Develop theoretical framework for conceptualising ‘becoming a mother’ Method: Two-fold methodology. 1) Articulation of theoretical framework provided from psychoanalytic theory 2) Qualitative research with seven Irish midwives and a detailed Interpretive Phenomenological Analysis of the interview data. Results: Major superordinate themes as follows. --Approach, including two major subordinate themes Normal / normalising, instilling hope --Class (socio-economic background of service-users, antenatal education, psycho-education) --Education (training needs of service providers and lack of knowledge of service users) --Identification (making sense through one’s own experience of being mothered and mothering) --Nature vs Nurture (motherhood as inbuilt ability, natural instinct, personality, shaped by upbringing and culture) --Risk groups and factors (reflects contradictory groups/factors, indicting anyone from any background can experience difficulties) --Special cases (self-care, employee support, supervision, debrief) --Support (factors and terminologies) example: ‘hormone’ mentioned by two out of seven participants six and sixteen times, transition mentioned once, ‘change’ implied to lifestyle change among others but not to psychological changes. Conclusion: Lack of theoretical framework evident in qualitative data. Psychoanalytic literature can address this gap.