The experience of postpartum distress in the transition to motherhood: A study of one group of low-income mothers in South Africa

Du Toit, Simone (2017-12)

Thesis (MA)--Stellenbosch University, 2017.

Thesis

ENGLISH SUMMARY: The aim of this study was to explore a group of low-income South African mothers’ experience of maternal distress during the transition to motherhood. Research on mental illness in motherhood has largely focused on investigating the aetiology, prevalence rates and implications of thereof within a positivist framework. There is a dearth of studies in South Africa that has examined the lived experiences of maternal distress despite the need for a thorough and rigorous investigation of these issues from the perspective of the individual. This is especially important in South Africa, where understanding of the lived experiences of maternal distress is the first step in conceptualizing a more efficient approach to identifying and addressing postpartum distress in the resource-restricted, overburdened South African healthcare system. The present study used data from a larger research project entitled the Women’s Mental Health Research Project (WMHRP). The sample comprised of 11 low-income mothers who can be characterized as suffering from postpartum depression (given their scores on self-report measures). The longitudinal dimensions of the study enabled narrative trajectories to be collected and strategic construction and presentation of narratives to be explored. A grounded theory approach guided this study in which data was collected from interview transcriptions that were collected during the parent study. Data analysis followed the principles outlined by the social constructionist grounded theory methodology including the constant comparative method and a sequential process of open, axial, and selective coding of the data. Throughout the duration of the study, specific processes were carried out to ensure trustworthiness of the research findings. A social constructionist epistemological analytic approach, aligned with a feminist theoretical lens was used to analyse the findings. Seven superordinate categories emerged from the interviews: the mothers, the expectations and reality of motherhood, caregiving overload, dysfunctional interpersonal relationships, mothering in poverty, the physical body and motherhood and silencing of the self. These categories demonstrate how unprepared for motherhood the women were and how their expectations were based on the dominant ideology of motherhood. Overwhelmed, fatigued, ambivalent and unable to make sense of their experiences, the women continued to suffer in silence in a context of depleting resources and the loss of their former life, wellbeing and sense of self. This study has demonstrated that the experience of maternal distress is deeply embedded in the cultural context within which it occurs. The ways in which women make sense of their experience has been created and sustained through powerful institutions that serve to pathologize women who do not adhere to the dominant ideology of motherhood. These findings are supported by the broader literature on maternal distress. However, this study adds to the literature by identifying motherhood as a gendered practice situated within a powerful and normative ideology of gender inequality and poverty within a particular context. As such poverty, gender inequality and the ideology of motherhood are interrelated, mutually supporting systems of domination and their relationship is essential to understanding the distress experienced during the transition to motherhood. The theoretical and practical implications of the results are discussed with consideration of the study’s limitations. Recommendations for future research are also indicated.

AFRIKAANS OPSOMMING: Die doel van hierdie studie was om 'n groep lae-inkomste Suid-Afrikaanse ma’s se emosionele ervaring van nageboortelike nood te verken. Navorsing oor nageboortelike depressie het tot dusver meestal gefokus op die ondersoek na die etiologie, omskakelingskoers en implikasies van nageboortelike nood binne 'n positivistiese raamwerk. Daar is 'n gebrek aan studies wat die ondervindinge van nageboortelike nood ondersoek het ten spyte van die behoefte aan 'n deeglike en nougesette ondersoek van hierdie kwessies vanuit die perspektief van die individu. Dit is veral belangrik in Suid-Afrika, waar begrip van die gelewe ervarings van nageboortelike nood die eerste stap is in die konseptualisering van 'n meer doeltreffende benadering tot die identifisering en bekamping van nageboortelike nood in die hulpbron-beperkte, oorbelaste Suid-Afrikaanse gesondheidsorgstelsel. Die huidige studie maak gebruik van data uit 'n groter navorsingsprojek getiteld die Women’s Mental Health Research Project (WMHRP). Die steekproef het uit 11 lae-inkomste moeders bestaan wat kan gekenmerk word as lyers aan nageboortelike depressie (gegewe hul tellings op self-verslag maatreëls). ʼn Gegronde teorie benadering lei hierdie studie. Data is ingesamel en transkripsies van die onderhoude wat vir die groter studie gemaak is, is saamgestel. Data-analise het gebruik gemaak van die beginsels soos uiteengesit deur die sosiale konstruksionistiese gegronde teorie, insluitend die konstante vergelykende metode en 'n opeenvolgende proses van oop, aksiale en selektiewe data-kodering. Gedurende die verloop van die studie is spesifieke prosesse uitgevoer ten einde die betroubaarheid van die navorsingsresultate te verseker. 'n Sosiale konstruksionistiese epistemologiese analitiese benadering, in ooreenstemming met feministiese teorie is gebruik om die bevindings te analiseer. Sewe oorkoepelende kategorieë het na vore gekom uit die onderhoude: die moeders, die verwagtinge en realiteit van moederskap, versorging oorlaai, disfunksionele interpersoonlike verhoudings, moederskap in armoede, die fisiese liggaam en moederskapen en die swye van die self. Hierdie kategorieë demonstreer hoe onvoorbereid die vroue vir moederskap was en hoe hulle verwagtinge gebaseer is op die dominante ideologieë van moederskap. Die vroue gaan voort om te ly in stilte terwyl hulle oorweldig, moeg, ambivalent en nie in staat om sin te maak van hul ervarings nie in 'n konteks waar daar ’n tekort aan hulpbronne is en hulle nog die verlies van hul vorige lewe, welsyn en sin van die self ervaar. Hierdie studie het getoon dat die ervaring van nageboortelike nood gesetel is in die kulturele konteks waarbinne dit plaasvind. Die maniere waarop vroue sin maak van hul ervaring is geskep en in stand gehou deur kragtige instellings wat dien om vroue wat nie voldoen aan die dominante ideologie van moederskap nie te patologiseer. Hierdie bevindinge word ondersteun deur die breër literatuur oor moederlike nood. Hierdie studie voeg egter by die literatuur aan deur moederskap te identifiseer as 'n gendered-praktyk wat binne 'n bepaalde konteks van kragtige normatiewe ideologie van ongelykheid en armoede geleë is. As sulks, is armoede, gender en die ideologie van moederskap interafhanklik van mekaar. Wedersydse ondersteunende stelsels van oorheersing en hul verhouding is noodsaaklik om ’m begrip van die nood wat ervaar word gedurende die oorgang na moederskap tot stand te bring. Die teoretiese en praktiese implikasies van die resultate word met inagneming van die studie se tekortkominge bespreek. Aanbevelings vir toekomstige navorsing word ook gemaak.

Please refer to this item in SUNScholar by using the following persistent URL: http://hdl.handle.net/10019.1/102817
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