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Women’s experiences of seeking and receiving help for postpartum depression Munro, Pamela Joan


Postpartum depression (PPD) is a serious health issue that affectsl3% of women worldwide and has serious consequences for women and their families. Despite regular contact with healthcare services in the postpartum period, PPD remains largely unrecognized by women themselves, and undetected and untreated by healthcare providers. This study comprises the qualitative component of a collaborative four-part research project that explored the phenomenon of PPD. Grounded theory, a method aimed at generating a substantive theory about social phenomenon, was used to guide the research process. Thirty women who identified themselves as having experienced PPD participated in one of six focus group discussions conducted in the Fraser Valley Health Region of British Columbia. Constant comparative analysis of the qualitative data revealed a complex and evolving process of help seeking for PPD consisting of three phases. Women's choices of when to seek help, whom to seek help from, and what kind of help to seek differed among phases. The first phase, waiting to be rescued, was described by the women as falling apart, trying to survive, having nowhere to turn, and reaching the end of the line. Reaching the end of the line was a significant turning point in the help seeking process. The second phase, giving in and opening up, was characterized as putting self at risk, knocking on doors, trying out options, being influenced by beliefs about help seeking, and feeling better. Feeling better was experienced as an uneasy peace in which women continued to feel vulnerable to relapse. The third phase, tuning-in to self, was identified as looking back, moving forward, and finally a new sense of self, forever changed but ultimately wiser and stronger. Breaking the silence emerged as the core category in this substantive theory that describes women's difficult journey from silence to voice. The theory generated from this study increases knowledge about this important and difficult human experience and guides nurses in the assessment, planning, implementation, and evaluation of nursing care for women who experience PPD.

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