The Lived Experience of Postpartum Distress - An Integrated Approach to Social and Psychological Support in the Workplace and Community

Abstract

This thesis portfolio consists of chapters which contain two journal articles, and a third, applied section, which take the reader through a process from ideation, to formation and finally practical application. It begins with an account of personal experience with maternal postpartum depression, then explores postpartum depression and distress beyond the biomedical definitions, concluding with a number of models within which the lived experience of new mothers with postpartum distress make sense. With absent social support at the crux of the lived experience, a review of social supports in Australia is presented in Paper 1. A narrative review of social support, including the recommendations in the literature and concluding with recommendations for best practice, are presented. The research identifies the common failing to distinguish qualitatively between social support elements and finds that despite the array of various social supports on offer in Australia, collectively they fail to address the overall functional support needs of new mothers. Paper 1 finds that current standards of social support for new mothers experiencing postpartum distress fail to be adequately addressed in terms of the 5 key areas of social support: information, appraisal, instrumental, emotional and social companionship support. Nor are adequate supports being providing for mothers experiencing postpartum distress (PPDS). Paper 2 explores PPDS in Sweden, acknowledged as providing world’s best practice in the areas of information, instruments and social supports postpartum. With PPD rates similar to those in Australia, and in a context of many political and economic similarities, Sweden provides the perfect context in which to explore what is missing in terms of support. The researcher spent 3 months in Sweden conducting qualitative research, participant observation and semi-structured interviews, in order to provide a comprehensive analysis of the postpartum experience for new mothers in different national contexts and what, if anything may be missing in terms of social and other needed support. The research brings to light 4 themes, with resulting insights through the ethnographic process of cultural submersion. Notions of cultural embeddedness, equality and freedom are explored. It is found that despite the provision of substantial state provided social supports the needs of mothers with PPDS were not adequately addressed. Participants expressed the desire for trusted, informal relationships with women who had experienced similar emotions. Section 3 takes a different approach. Drawing from the psychological research of papers 1 and 2, the third and final element of the portfolio, further explores the roots of PPDS, discussing biomedical, feminist and evolutionary perspectives. From this, a Biocultural Theory is offered as inclusive of these three approaches, establishing culture as the formidable arena for systemic change. Interviews are held with various high profile members of corporate Australia, exploring postpartum experiences from the personal lives, and professional roles of leaders in human resources, people and culture, equality, public sector employment and as heads of teams. Through categorisation and analysis of the responses, a model for Workplace Social Support is designed, and a business case is presented to address the recommendations found across diverse literature; much of which was confirmed by papers 1 and 2. The premise is simply, that 1) informal, individualised emotional and appraisal support are what women seek in the postpartum period, 2) women in Australia and Sweden are likely to return to paid work within 2 years of the birth of their child, and as such, 3) the workplace is the most obvious place this support should be offered. This research aims to do two things: address current postpartum social support needs based on existing cultural values and practices and explore the capacity for systemic change through the actions of individuals, corporations and policy makers. An innovative, first of its kind, business case is presented, established and was set to be piloted prior to COVID19. The business model includes consultancy, education and training to corporate Australia, and positions itself within a new social paradigm. An example of one the Village Foundation’s offerings is the implementation of a face-to-face mentoring program between experienced employees, and new employees, in which parents are supported to smoothly transition, both practically and emotionally, into motherhood and back into paid work, before, during and after parental leave. The program is supported by facilitated training through a secure, company specific software application and communication materials. The case is made to benefit two distinct cohorts – the individual and related networks, and also Australian industry, which loses over 700 million dollars annually to perinatal mental health related loss of productivity and staff turnover. This portfolio follows substantive investigation into the nature of postpartum depression and postpartum distress, and offers a practical approach, applying the recommendations and findings of the first two papers in an effective, practical and sustainable manner.