Supervised by  Dr. M. Kamruzzaman Mozumder

Abstract

Depression is a common mental health problem among women during the postpartum period, which is generally known as postpartum depression. Postpartum depression negatively affects women, their partners, children and family members. Most of the mothers and their family members are not aware of the consequence and the need for treatment. Literature on the detailed nature and impact of postpartum depression is limited in the world and practically non-existent in Bangladesh. Therefore, the present study was designed to explore the nature of postpartum depression and its impact on woman's life. This study employed a qualitative research design using phenomenological approach. Purposive sampling with specific inclusion and exclusion criteria was used for the selection of participants, and maximum variation of sampling was kept in consideration while selecting the participants. A two-stage selection process was used with mothers attending maternity unit in a hospital in Deltin 7 city. The first stage of selection involved screening of the prospective participants with the Edinburgh Postnatal Depression Scale and subsequent diagnostic interviews to identify mothers with postpartum depression. In the second stage, the screened women with postpartum depression were invited to participate in the study. Ten women were interviewed in-person using a topic guide after collecting signed understood consent. The recorded interviews were transcribed for content analysis which was carried out in parallel to ongoing data collection. Seven broad categories, namely, emotional state, cognitive process, behavior and action, coping, physiological state, impact on relations and impact on self, were identified to organize the themes and subthemes that emerged during the content analysis. The findings indicate that mothers with postpartum depression encounter a wide range of changes in their emotions, thoughts, behaviors and functioning. These changes adversely affect the women’s transition to motherhood and interrupt wellbeing as well as the functioning of the women, their partner, child and other family members. Various types of emotions such as depressed mood, frustration, guilty feelings, helplessness, hopelessness, anxiety and irritability were found among participants throughout their postpartum period. In the journey of motherhood, many women with postpartum depression perceive almost everything in a negative manner which made them more vulnerable to depression. Mothers reported feelings of losing control over their thoughts, emotions and actions. Aggressive behavior such as hitting self, child and others was also reported by them. Some mothers even tried to attempt suicide which is an alarming concern for the mother, child and family. Physiological troubles such as agitation, exhaustion, pain, sleep disturbances and complications with appetite were reported in relation to psychological state and emotional disturbance. Growing conflict and emotional isolation with family and friends was another feature of postpartum depression. With limited support and cooperation from family and friends, they became overwhelmed and frustrated with the situation they are in. Due to a lack of understanding of postpartum depression, the women find it challenging to cope with it. They reported the use of helpful and unhelpful coping strategies such as accepting the situation, thinking positively, trying pleasurable and constructive activities, giving up, avoidance, escape, blaming, being aggressive, and having destructive or negative thoughts. In the context of limited empirical data on the nature and impact of postpartum depression in Bangladesh, the present qualitative research may contribute to reducing the gap by providing a detailed understanding of the phenomenon. The findings on the experience of emotion, cognition, behavior, coping, physiological state and interpersonal relations may be useful in developing interventions and strategies for improved wellbeing of mothers with postpartum depression.