Institutionen för kvinnors och barns hälsa / Department of Women's and Children's Health
Abstract
Aim: The aim of this thesis was to examine the 1) consequences of
maternal depressive symptoms 2-3 months postpartum on parents
experiences of parenthood at one year and on parent-child
interactions15-18 months postpartum, and the 2) circumstances in the
early postpartum, which might predict depressive symptoms 2 months
postpartum.
Method: A community sample of 574 women was screened for depressive
symptoms, using the Edinburgh Postnatal Depression Scale (EPDS) two
months postpartum. Forty-two women (7%) showed signs of depression, and
24 of these women and 11 of their partners consented to be videotaped
during a parent-child interaction observation at 15-18 months. Twenty-one
women showing no signs of depression, and 14 of their partners were
selected as a comparison group. At one year, parents reported on their
experiences of parenthood. To study early indicators for depressive
symptoms parents were approached at the maternity clinic, Karolinska
University Hospital, Solna, One hundred and six couples filled out all
questionnaires about their maternity blues during a period of five
consecutive days in the first week after birth, and additionally
completed an EPDS, along with a questionnaire about their bonds to the
child. At two months postpartum, follow-up questionnaires about the
parents mood and bonding to the child were filled out. Twenty-two
mothers showing signs of depression at this occasion were interviewed
about their experiences of the first months with the child.
Results: The videotaped parent-child interactions15-18 months postpartum
showed that children of mothers who demonstrated signs of depression at 2
months exhibited less interest in and attention to an explorative play
situation with their mothers. Fathers in the families with a mother
showing signs of depression were, however, more positively involved with
their children and, in turn, their children showed less negative affect
in the interaction with their fathers than children in families where the
mother did not show signs of depression. In the interviews with mothers
having depressive symptoms at 2 months, it was found that the mothers
expressed strong feelings of guilt, failure, and unfulfilled
expectations. They struggled with life as it related to the self, with
the relations with partner and with the child. At one-year postpartum,
women with signs of depression at 2 months, experienced motherhood more
stressfully than did mothers without signs of depressive symptoms.
However, no difference was found in their respective partners
experiences of fatherhood. Severe blues, bonding problems and a partner
with depressed mood were found to be early indicators for depressive
symptoms in both mothers and fathers. For mothers, previous depression
and an emergency Caesarean section were also predictive for depressive
symptoms.
Conclusions: The results indicate that self-reported depressive mood in
mothers might affect the child negatively, but also that fathers might
compensate for the mother s mood. Postpartum depressive symptoms still
seems to be a hidden condition, since mothers do not easily talk about
their feelings. It is important to identify these women early. Thus, to
be attentive to severe blues and bonding problems during the first week
and to give the mothers an opportunity to speak about their feelings,
maybe through active listening without giving advise. This may
alleviate depressive symptoms and possibly prevent negative interactions
between mother and child in the future