‘Can I still be a mum’?’ An exploration of the experience of women with formerly diagnosed severe mental health issues in relation to motherhood during the postnatal period

Ojiako, Theodora Onyinyechi (2023) ‘Can I still be a mum’?’ An exploration of the experience of women with formerly diagnosed severe mental health issues in relation to motherhood during the postnatal period. Doctoral thesis, Northumbria University.

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Abstract

Severe mental health issues are a substantial contributor to the global disease burden, and a significant cause of maternal morbidity and mortality in the perinatal period, with a prevalence of 1 in every 1,000 births. Women with a diagnosis of severe mental health issues (SMHI) are at higher risk of suicide or being admitted to hospital in the postnatal period. In addition, having a SMHI diagnosis influences the mother’s relationship with their infant
which can have further implications for both. While maternity services in the UK have gradually adopted more responsibility for women with SMHI, there are several factors such as stigma, discrimination and isolation, social, economic and physical environment inequalities that challenges the care for them. Currently, there is a lack of understanding for SMHI mother’s postnatal experiences. Thus, there is lack of evidence on how to best address these challenges for them and improve their postnatal experiences and ultimately help with reducing the risk of hospital readmissions or suicide.

The goal of this research was to understand, explore and develop a theory-based model on the experiences of women with SMHI in relation to motherhood during the postnatal period. A constructive grounded theory was employed, which was underpinned by the theoretical perspective of symbolic interactionism.

Ten women with SMHI were interviewed with the focus on their postnatal experiences in relation to motherhood. The semi structured interviews were conducted online, and participants were recruited from mental health hospitals in accordance with ethical approval standards. The age of participants were from 18 to 49 years with different social backgrounds. Data analysis was according to grounded theory method utilising a constant comparison approach, and theoretical sampling was facilitated by Mind genius software and Nvivo.

The generated Resilience-Led Behavioural Model (RLBM) for supporting SMHI mothers in the postnatal period had three categories. 1. personal resilience associated with coping mechanisms, hopes and sleep deprivation; 2. social context, such as family support cultural and religious issues, and stigma affecting access to services and 3. childbirth experiences, including met and unmet needs, anxiety, fear, bonding and attachment.

The core category was personal resilience, which seemed to have the greatest influence on participants experiences. They strived towards coping and adopting positive changes with effective support from families concerning their motherhood role. Accepting the reality of a situation, although it is unpleasant and uncomfortable, is a crucial component of cognitive flexibility. The RLBM highlights the behavioural changes and resilience adopted by women during their transition into motherhood. The RLBM, therefore, creates awareness and introduces new ways and ideas on coping for women with SMHI in relation to motherhood during the postnatal period.

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