An exploration into women's and families' experiences of postpartum psychosis

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Abstract

This thesis provides a detailed exploration on the experiences of women with postpartum psychosis and those of their family members. The thesis consists of three papers: 1) a systematic literature review, 2) an empirical study, and 3) a critical evaluation and reflection on the research process. The systematic literature review (Paper 1) is a metasynthesis of qualitative research investigating the experiences of women with postpartum psychosis and family members, with emphasis on the processes perceived to be involved in recovery. Fifteen studies, capturing the views of 103 women and 42 family members were identified for inclusion. Thirteen subthemes and four main themes were identified: 1) Experiencing the unspeakable, 2) Loss and disruption, 3) Realigning old self and new self and 4) Social context. The findings offer new insight into the unique experience of postpartum psychosis and demonstrates that recovery does not follow a linear path. Key areas for service development and further research opportunities are highlighted. The empirical study (Paper 2) attempted to expand the findings from the systematic literature review by investigating the psychological experiences, needs and preferences of women recovering from postpartum psychosis and family members. Thirteen women and eight family members were interviewed and their data analysed using thematic analysis. Twelve subthemes were organised around three main themes: 1) Seeking safety and containment, 2) Recognising and responding to the psychological impact and 3) Planning for the future. The outcomes highlighted the complexity and longevity of recovery. A number of psychological needs were reported, which could be partly met through psychological intervention. Further research is needed to develop, implement and evaluate interventions. The critical evaluation and reflection chapter (Paper 3) provides an overview and appraisal of the research process, including reflections on decision making and lessons learned. It provides a final overview of the clinical implications highlighted within paper one and two. The paper highlights the importance of qualitative investigation to capture the depth of individual experience and inform the development of complex interventions. The paper concludes that postpartum psychosis is a complex and multifaceted experience, in which a range of needs and intervention must be considered and further exploration is necessary to improve clinical practice.

Keyword(s)

Family ; Perinatal mental health ; Psychological intervention ; Recovery ; Women

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