March-May, 2010 - Australian Journal of Advanced Nursing

RESEARCH PAPER
Interpersonal Support
Many women admitted the power balance within their
partner relationship changed once they had their
baby and began experiencing emotional distress.
Once difficulties were experienced, the ability to focus
on both the needs of her partner and of the baby
diminished, and she relied on him taking up ‘some
of the slack’. For many women this put significant
strain on their relationship and this was, at times,
difficult to emotionally and physically sustain:
‘I rang my husband to say you have to come in now,
I don’t care you haven’t slept, I’m not coping. So it
was huge for him to see me not being strong, when
I’m the strong one, and I’m strong for him’ (Private
hospital focus group).
Family background was also identified as having
an impact on both acknowledgment of emotional
health needs and help seeking behaviour. In
families described as having negative attitudes to
help seeking, the understanding was that it was the
role of families to manage difficulties. Women were
expected to only talk to their family and were limited
from seeking wider assistance: ‘my dad said why do
you have to keep (saying you’re not OK) – he didn’t
want me painting this impression to everyone that
things weren’t right with me. And so when I came
in here…I even lied to my family about why I came
in here’ (Private hospital focus group).
Baby Management
Difficulties in baby management were identified as
a major precipitating factor for feelings of parenting
inadequacy. There was also the belief if mothers
were unable to find a solution to a baby management
problem, this reflected negatively on their parenting
ability and they were a ‘failure as a parent’.
Perceived patronising attitudes of health professionals
also undermined the confidence of mothers and their
parenting abilities and a number of women felt
immense frustration with the support and advice
given. When professionals themselves had problems
managing the baby women felt relief and vindication:
‘even the nurse that I felt had the greatest rapport
with … said I don’t know what to do, I can’t do it,
what do you do at home?...you get to the point where
these people who’ve been doing it for 25years can’t
deal (with the child) and I’ve been doing this for six
months, what am I supposed to do now?...so it was
a relief as they can’t do it either, so it’s not just me’
(Private hospital focus group).
When asked about the type of baby management
advice supplied, a common response was women
struggled to utilise this advice, as they often received
conflicting information, even from the same health
service provider.
Help Seeking and Treatment Experiences
Women acknowledged a number of other factors,
aside from those already highlighted, as significant
inhibitors to help seeking: poor sleep, physical
discomfort from delivery complications, the inability to
think clearly and logically, lack of motivation, changes
in perception of body image and distinguishing
between the symptoms and consequences of
depression.
Views regarding the help provided by general
practitioners (GPs) were mixed. Many women were
ambivalent whilst others remarked that in many
instances, GPs attempted to normalise feelings and
provide reassurance, rather than actively treat or
manage a women’s mood. When this occurred, this
exacerbated feelings of low self esteem and guilt at
being unable to cope.
When medication was offered as a treatment option,
many women found it extremely difficult to weigh up
the risks and/or benefits of medication in relation
to the severity of their symptoms and the potential
side effects to their infant. Women felt shame at not
being able to cope on their own and stigmatised for
taking medication: ‘that was another issue for me
really to get over, was the fact that I did need help
in the form of that medication. It was very hard for
me to accept that, and I still feel very bad sometimes
that I have to take it. There’s been a couple of times
over the last three years that I’ve just stopped taking
it because it’s made me feel so bad that I’m taking
medication’ (Community focus group).
AUSTRALIAN JOURNAL OF ADVANCED NURSING Volume 27 Number 3 49