Postpartum Psychosis: A Foucauldian analysis of women's experiences of living with this diagnosis.

Abstract

Postpartum psychosis is thought to affect one or two women per 1000 deliveries (Kendell, Chalmers & Platz, 1987). The construction of this diagnosis as ‘rare’ has served to marginalise women who experience ‘psychosis’ in the postpartum period. This has been demonstrated not only in policy and service provision, but also in the paucity of academic research and the development of psychological interventions. This study sets out to explore how women are able to construct their experiences of postpartum psychosis, illustrating how material and discursive practices enable or constrain the telling of their stories. Ten women who had experienced a diagnosis of postpartum psychosis were interviewed. A discourse analytic approach, aligned with critical realist epistemology and informed by the work of Michel Foucault was used. Following analysis of the women’s talk, four discursive sites were identified, namely: Institutional Framing: Constructing Motherhood and Madness’; ‘Postpartum Psychosis: The Problematic Self’; ‘Lived Experience of a Duality: The Fragmented Self’ and ‘Survivors Story: A Mad Mum Reclaiming a Sense of Self and Educating Others’. The construction of a ‘survivor’ position served to reframe women’s experiences of postpartum psychosis, offering a more comfortable position to inhabit, other than identification as a ‘mad mum’. This study has demonstrated that the experience of postpartum psychosis is complex. The ways in which women talk about and make sense of their experience has been created and sustained through powerful institutions such as health and social care agencies that have set up the discursive positions of a mother and a mental health patient as antithetic to each other. The identified implications of this study have been highlighted for those who provide services, suggesting that they should be better informed to respond appropriately to women diagnosed with postpartum psychosis and their families.