Piedmont HealthCare Family Medicine, Statesville, North Carolina
Lehigh Valley Health Network, Allentown, Pennsylvania.
Ann Fam Med. 2017 Nov;15(6):540-545. doi: 10.1370/afm.2107.
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.
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.
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.
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.
本文通过自传体民族志研究产后抑郁症(PPD),探讨抑郁症的污名化和母性的文化期望。由于 PPD 的个人患病经历在初级保健文献中经常缺失,本文使用第一人称叙述和密集育母分析,探讨了寻求 PPD 治疗的障碍、增加医生使用筛查工具的信心和舒适度的需求,以及 PPD 污名对患者及其健康的影响。
自传体民族志作为初级保健中一种相对陌生的方法,用于阐明个人 PPD 患病经历。作者通过叙述作为妻子、母亲和患者的一系列经历,详细描述了密集育母文化下的个人经历。对一系列第一人称叙述进行主题分析,以进一步了解母性文化,并揭示 PPD 的污名化。
分析中出现了四个主题,揭示了密集育母文化理念和精神疾病污名化所带来的压力:本质主义、失败、羞耻和回避。
需要重新构建对母性和 PPD 的文化观念,以积极影响那些患有这种疾病的人的家庭互动和医疗保健体验。本文呼吁提供更广泛的诊断努力、更全面的护理,并在 PPD 的诊断和治疗方面与患者共同做出决策。