Grieving for my former self: a phenomenological hermeneutical study of women’s lived experience of postnatal depression

Denise lawler, Marlene Sinclair

Research output: Contribution to journalArticle

Abstract

Abstract Aim. The aim of this study was to provide a deeper insight into the life world of women who have lived through postnatal depression (PND). Objectives. Gain insight into women’s lived experiences’ of PND and describe the meaning of the illness from the perspective of the people who have had experience of the illness. Method. A phenomenological, hermeneutical approach was used to describe women’s experiences of PND. A purposeful sample of seven women agreed to participate in the study. In-depth unstructured interviews were audiotaped and transcribed verbatim with consent from the participants. Transcriptions were processed using the hermeneutic circle: dialogue, fusions of horizons and metaphors to understand the meaning of the experience adapted from Dicklemann et al, (1989) and the participants confirmed the transcript interpretations. Findings/results. The findings were presented under the four existential lifeworlds – lived space, lived body, lived relations and lived time (Van Manen, 1990). All of the women experienced a loss of their former self after they went through a process of being a known person in a known world to an unknown person in an unknown world (Rubin, 1984). The women vividly described their brokenness and sorrow as they struggled to come to terms with their new image and their new role as a mother. It was after they had experienced a cycle of grief that they were able to accept their new self and new role as a mother. These women came to accept their experiences as normal. They felt they had to experience death of their former self before giving birth to their new persona. Implications. This perception of normal experience challenges midwives and mental health workers to redefine the meaning of normal and to review the consequences of labelling women as suffering from PND. The study calls for a review of current antenatal preparation for parenthood and challenges midwives to review commonly accepted beliefs that almost every woman naturally adjusts to the role of motherhood when their baby is born. New approaches are required in order to prepare women for the possible event of experiencing this sometimes ‘natural’ metamorphic state after giving birth.
LanguageEnglish
Pages36
JournalEvidence Based Midwifery
Volume1
Issue number2
Publication statusPublished - 2003

Fingerprint

Postpartum Depression
Midwifery
Mothers
Parturition
Metaphor
Grief
Mental Health
Interviews

Keywords

  • Hermeneutical phenomenology
  • grief
  • rebirth
  • postnatal depression
  • midwifery
  • women

Cite this

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title = "Grieving for my former self: a phenomenological hermeneutical study of women’s lived experience of postnatal depression",
abstract = "Abstract Aim. The aim of this study was to provide a deeper insight into the life world of women who have lived through postnatal depression (PND). Objectives. Gain insight into women’s lived experiences’ of PND and describe the meaning of the illness from the perspective of the people who have had experience of the illness. Method. A phenomenological, hermeneutical approach was used to describe women’s experiences of PND. A purposeful sample of seven women agreed to participate in the study. In-depth unstructured interviews were audiotaped and transcribed verbatim with consent from the participants. Transcriptions were processed using the hermeneutic circle: dialogue, fusions of horizons and metaphors to understand the meaning of the experience adapted from Dicklemann et al, (1989) and the participants confirmed the transcript interpretations. Findings/results. The findings were presented under the four existential lifeworlds – lived space, lived body, lived relations and lived time (Van Manen, 1990). All of the women experienced a loss of their former self after they went through a process of being a known person in a known world to an unknown person in an unknown world (Rubin, 1984). The women vividly described their brokenness and sorrow as they struggled to come to terms with their new image and their new role as a mother. It was after they had experienced a cycle of grief that they were able to accept their new self and new role as a mother. These women came to accept their experiences as normal. They felt they had to experience death of their former self before giving birth to their new persona. Implications. This perception of normal experience challenges midwives and mental health workers to redefine the meaning of normal and to review the consequences of labelling women as suffering from PND. The study calls for a review of current antenatal preparation for parenthood and challenges midwives to review commonly accepted beliefs that almost every woman naturally adjusts to the role of motherhood when their baby is born. New approaches are required in order to prepare women for the possible event of experiencing this sometimes ‘natural’ metamorphic state after giving birth.",
keywords = "Hermeneutical phenomenology, grief, rebirth, postnatal depression, midwifery, women",
author = "Denise lawler and Marlene Sinclair",
note = "Reference text: References Baker C, Wuest J, Noerager Stern P. (1992) Medical slurring: the ground- ed theory/phenomenology example. Journal of Advanced Nursing 25: 18-22. Baker P. (2001) The tidal model: developing an empowering, person centred approach to recovery within psychiatric and mental health nursing. Journal of Psychiatric and Mental Health Nursing 8: 233- 40. Chilton H. (1940) In: Mothers: an illustrated treasury.(1993) Royle Publications: London. Bowlby J. (1980) Loss (Attachment and Loss: volume 3).Hogarth Press: London. Davidson L, Strauss JS. (1992) Sense of self in recovery from severe mental illness. British Journal of Medical Psychology 65: 131-45. Davidson L, Strauss JS. (1995) Beyond the psychosocial model: integrat- ing disorder, health and recovery. Psychiatry 58: 44-55. Diekelmann M, Allen D, Tanner C. (1989) The National League for Nursing criteria for appraisal of baccalaureate programs: a critical hermeneutic analysis.The National League for Nursing Press: New York. Engel GC. (1961) Is grief a disease? A challenge for medical research. Psychosomatic Medicine 23: 18-22. Forrest S. (1993) Toward understanding the self. Nursing Forum 28(2): 5-10. Fry AJ, Nguyen T. ( 1996) Culture and the self: implications for the perception of depression by Australian and Vietnamese nursing students. Journal of Advanced Nursing 23: 1147-54. Jones A. (1989) Managing the invisible grief. Senior Nurse 9(5): 26-7. Keane C. (1995).Mercier Press: Dublin. Koch T. (1994) Establishing rigour in qualitative research: the decision trial. Journal of Advanced Nursing 19(5): 976-86. Koch T. (1995) Interpretive approaches in nursing research. Journal of Advanced Nursing 21: 827-36. Koch T. (1996) Implementation of a hermeneutic inquiry in nursing: philosophy, riquor and representation. Journal of Advanced Nursing 24: 174-84. Kubler-Ross E. (1978) On death and dying.Tavistock Publication: London. Mander R. (1994) Loss and bereavement in childbearing.Blackwell Scientific Publications: Oxford. Markus HR, Kitayama S. (1991) Culture and the self: implications for cognition, emotion and motivation. Psychological Review 98: 224-53. Murphy-Lawless J, Kennedy P. (2002) The maternity care needs of refugee and asylum-seeking women: a research study conducted for the Women’s Health Unit Northern Area Health Board.University College Dublin: Dublin. Nochi M. (1998) Loss of self in the narratives of people with traumatic brain injuries: a qualitative analysis. Social Science Medicine 46(7): 869-78. Parkes CM. (1985) Bereavement: studies of grief in adult life. (2nd edition) Penguin Books: Harmondsworth. Parkes CM, Weiss RS. (1985) Recovery from bereavement.Basic Books: New York. Parkes CM, Stevenson-Hinde J, Marris P. (1991) Attachment across the life cycle.Routledge: London. Rose K. (1994) Unstructured and semi-structured interviewing. Nurse Researcher 3: 23-32. Rubin R. (1984) Maternal identity and maternal experience. Springer Publishing: New York: 52. Sadala MLA, de Camargo Ferreira Adorno R. (2002) Phenomenology as a method to investigate the experience lived: a perspective from Husserl and Merleau Ponty’s thought. Journal of Advanced Nursing 37(3): 282-93. Small R, Lumley J, Donohue L, Potter A, Waldenstrom U. (2000) Randomized controlled trial of midwife-led debriefing to reduce maternal depression after operative childbirth. British Medical Journal 321: 1043-7. Van Manen M. (1990) Researching lived experience: human science for an action sensitive pedagogy. State University of New York Press: New York. Walsh, M.P. (1995) Living after a death: a guidebook for the journey of bereavement. The Columbia Press: Dublin.",
year = "2003",
language = "English",
volume = "1",
pages = "36",
journal = "Evidence Based Midwifery",
issn = "1479-4489",
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TY - JOUR

T1 - Grieving for my former self: a phenomenological hermeneutical study of women’s lived experience of postnatal depression

AU - lawler, Denise

AU - Sinclair, Marlene

N1 - Reference text: References Baker C, Wuest J, Noerager Stern P. (1992) Medical slurring: the ground- ed theory/phenomenology example. Journal of Advanced Nursing 25: 18-22. Baker P. (2001) The tidal model: developing an empowering, person centred approach to recovery within psychiatric and mental health nursing. Journal of Psychiatric and Mental Health Nursing 8: 233- 40. Chilton H. (1940) In: Mothers: an illustrated treasury.(1993) Royle Publications: London. Bowlby J. (1980) Loss (Attachment and Loss: volume 3).Hogarth Press: London. Davidson L, Strauss JS. (1992) Sense of self in recovery from severe mental illness. British Journal of Medical Psychology 65: 131-45. Davidson L, Strauss JS. (1995) Beyond the psychosocial model: integrat- ing disorder, health and recovery. Psychiatry 58: 44-55. Diekelmann M, Allen D, Tanner C. (1989) The National League for Nursing criteria for appraisal of baccalaureate programs: a critical hermeneutic analysis.The National League for Nursing Press: New York. Engel GC. (1961) Is grief a disease? A challenge for medical research. Psychosomatic Medicine 23: 18-22. Forrest S. (1993) Toward understanding the self. Nursing Forum 28(2): 5-10. Fry AJ, Nguyen T. ( 1996) Culture and the self: implications for the perception of depression by Australian and Vietnamese nursing students. Journal of Advanced Nursing 23: 1147-54. Jones A. (1989) Managing the invisible grief. Senior Nurse 9(5): 26-7. Keane C. (1995).Mercier Press: Dublin. Koch T. (1994) Establishing rigour in qualitative research: the decision trial. Journal of Advanced Nursing 19(5): 976-86. Koch T. (1995) Interpretive approaches in nursing research. Journal of Advanced Nursing 21: 827-36. Koch T. (1996) Implementation of a hermeneutic inquiry in nursing: philosophy, riquor and representation. Journal of Advanced Nursing 24: 174-84. Kubler-Ross E. (1978) On death and dying.Tavistock Publication: London. Mander R. (1994) Loss and bereavement in childbearing.Blackwell Scientific Publications: Oxford. Markus HR, Kitayama S. (1991) Culture and the self: implications for cognition, emotion and motivation. Psychological Review 98: 224-53. Murphy-Lawless J, Kennedy P. (2002) The maternity care needs of refugee and asylum-seeking women: a research study conducted for the Women’s Health Unit Northern Area Health Board.University College Dublin: Dublin. Nochi M. (1998) Loss of self in the narratives of people with traumatic brain injuries: a qualitative analysis. Social Science Medicine 46(7): 869-78. Parkes CM. (1985) Bereavement: studies of grief in adult life. (2nd edition) Penguin Books: Harmondsworth. Parkes CM, Weiss RS. (1985) Recovery from bereavement.Basic Books: New York. Parkes CM, Stevenson-Hinde J, Marris P. (1991) Attachment across the life cycle.Routledge: London. Rose K. (1994) Unstructured and semi-structured interviewing. Nurse Researcher 3: 23-32. Rubin R. (1984) Maternal identity and maternal experience. Springer Publishing: New York: 52. Sadala MLA, de Camargo Ferreira Adorno R. (2002) Phenomenology as a method to investigate the experience lived: a perspective from Husserl and Merleau Ponty’s thought. Journal of Advanced Nursing 37(3): 282-93. Small R, Lumley J, Donohue L, Potter A, Waldenstrom U. (2000) Randomized controlled trial of midwife-led debriefing to reduce maternal depression after operative childbirth. British Medical Journal 321: 1043-7. Van Manen M. (1990) Researching lived experience: human science for an action sensitive pedagogy. State University of New York Press: New York. Walsh, M.P. (1995) Living after a death: a guidebook for the journey of bereavement. The Columbia Press: Dublin.

PY - 2003

Y1 - 2003

N2 - Abstract Aim. The aim of this study was to provide a deeper insight into the life world of women who have lived through postnatal depression (PND). Objectives. Gain insight into women’s lived experiences’ of PND and describe the meaning of the illness from the perspective of the people who have had experience of the illness. Method. A phenomenological, hermeneutical approach was used to describe women’s experiences of PND. A purposeful sample of seven women agreed to participate in the study. In-depth unstructured interviews were audiotaped and transcribed verbatim with consent from the participants. Transcriptions were processed using the hermeneutic circle: dialogue, fusions of horizons and metaphors to understand the meaning of the experience adapted from Dicklemann et al, (1989) and the participants confirmed the transcript interpretations. Findings/results. The findings were presented under the four existential lifeworlds – lived space, lived body, lived relations and lived time (Van Manen, 1990). All of the women experienced a loss of their former self after they went through a process of being a known person in a known world to an unknown person in an unknown world (Rubin, 1984). The women vividly described their brokenness and sorrow as they struggled to come to terms with their new image and their new role as a mother. It was after they had experienced a cycle of grief that they were able to accept their new self and new role as a mother. These women came to accept their experiences as normal. They felt they had to experience death of their former self before giving birth to their new persona. Implications. This perception of normal experience challenges midwives and mental health workers to redefine the meaning of normal and to review the consequences of labelling women as suffering from PND. The study calls for a review of current antenatal preparation for parenthood and challenges midwives to review commonly accepted beliefs that almost every woman naturally adjusts to the role of motherhood when their baby is born. New approaches are required in order to prepare women for the possible event of experiencing this sometimes ‘natural’ metamorphic state after giving birth.

AB - Abstract Aim. The aim of this study was to provide a deeper insight into the life world of women who have lived through postnatal depression (PND). Objectives. Gain insight into women’s lived experiences’ of PND and describe the meaning of the illness from the perspective of the people who have had experience of the illness. Method. A phenomenological, hermeneutical approach was used to describe women’s experiences of PND. A purposeful sample of seven women agreed to participate in the study. In-depth unstructured interviews were audiotaped and transcribed verbatim with consent from the participants. Transcriptions were processed using the hermeneutic circle: dialogue, fusions of horizons and metaphors to understand the meaning of the experience adapted from Dicklemann et al, (1989) and the participants confirmed the transcript interpretations. Findings/results. The findings were presented under the four existential lifeworlds – lived space, lived body, lived relations and lived time (Van Manen, 1990). All of the women experienced a loss of their former self after they went through a process of being a known person in a known world to an unknown person in an unknown world (Rubin, 1984). The women vividly described their brokenness and sorrow as they struggled to come to terms with their new image and their new role as a mother. It was after they had experienced a cycle of grief that they were able to accept their new self and new role as a mother. These women came to accept their experiences as normal. They felt they had to experience death of their former self before giving birth to their new persona. Implications. This perception of normal experience challenges midwives and mental health workers to redefine the meaning of normal and to review the consequences of labelling women as suffering from PND. The study calls for a review of current antenatal preparation for parenthood and challenges midwives to review commonly accepted beliefs that almost every woman naturally adjusts to the role of motherhood when their baby is born. New approaches are required in order to prepare women for the possible event of experiencing this sometimes ‘natural’ metamorphic state after giving birth.

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KW - grief

KW - rebirth

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KW - midwifery

KW - women

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JO - Evidence Based Midwifery

T2 - Evidence Based Midwifery

JF - Evidence Based Midwifery

SN - 1479-4489

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