Family dynamics of postnatally depressed mothers - discrepancy between expectations and reality.

BACKGROUND The birth of a new family member always brings changes to family dynamics. The family has to adjust to a new situation and, although the time after childbirth is happy for most families, postnatal depression affects 10-15% of mothers annually. AIMS AND OBJECTIVES The purpose of this study was to ascertain families' experiences of family dynamics when the mother suffers from postnatal depression. DESIGN Nine families (nine mothers, five fathers) where the mother had displayed symptoms of postnatal depression took part for the study. METHODS Data were collected through interviews with nine families where the mother had scored 13 or more on the Edinburgh Postnatal Depression Scale, completed 6-8 weeks after childbirth. Families were offered the opportunity to volunteer for the interview while taking part in a follow-up study of postnatal depression in Finland. Interviews were analysed using the principles of grounded theory. RESULTS The findings showed that there was great discrepancy between expectations and reality in the depressed mothers' families. Parents, especially mothers, strove for perfection, perceived the infant to tie them down and had high expectations of family life. CONCLUSIONS Everyday family life and human relationships change, the depression and the parents' attitudes towards the infant manifest themselves in different ways, and support is of great importance. RELEVANCE TO CLINICAL PRACTICE Women, especially those expecting their first child need a great deal of information about mood changes after childbirth and the opportunity to discuss the changes brought about by the birth of a child.