It's All in Your Head: A Qualitative Examination of the Help-Seeking Experiences of Women Suffering Postpartum Psychosis.
TL;DR
It is emphasised that enhancing outcomes for women affected by postpartum psychosis requires increased focus within both research and clinical domains, ensuring that maternal distress is accurately identified, comprehended and validated.
Abstract
Background
Postpartum psychosis (PPP) is a rare, yet severe, perinatal psychiatric disorder that typically presents abruptly within several days after childbirth and requires urgent in-patient psychiatric care. Despite its severity, postpartum psychosis remains underrepresented in research and can be poorly understood in clinical healthcare settings, particularly regarding the detection of the disorder.
Aims
This exploratory qualitative analysis examines lived-experience perspectives on help-seeking, including barriers encountered when help-seeking, to develop a clearer understanding of the current pathways to detection and diagnosis of PPP.
Design
A qualitative study design was used to analyse interview transcripts.
Methods
Semi-structured interviews were conducted with 15 participants during 2024 which were thematically analysed.
Findings
Four key themes were identified: (1) recognising the unnameable (women's early insights and difficulties in articulating their experiences and symptoms), (2) invisible until visibly unwell (barriers to recognition of PPP healthcare professionals), (3) speaking without being heard (Frequency of misdiagnosis and lack of thorough medical investigation) and (4) falling through the cracks (the Australian healthcare systems inadequate capacity to support women experiencing PPP).
Conclusion
Unintentional medical gaslighting, which is the dismissal, reframing or invalidation of symptoms and or patient experiences, was evident through the frequent reframing and dismissal of the women's experiences and led to a disconnect between them and the Australian healthcare system. Misrecognition was evident across multiple dimensions including interpersonally and institutionally. It delayed access to care, fractured relationships and trust within the healthcare system and exacerbated psychological distress. IMPLICATIONS FOR THE PROFESSION AND/OR PATIENT CARE This study emphasises that enhancing outcomes for women affected by postpartum psychosis requires increased focus within both research and clinical domains, ensuring that maternal distress is accurately identified, comprehended and validated. IMPACT This study examined the help-seeking experiences of women experiencing postpartum psychosis in Australia. Medical gaslighting and frequent dismissal and reframing of the women's experiences by healthcare professionals were evident, which led to a disconnect between the women and the Australian healthcare system. This disconnect can impact the mother, the infant, the whole family unit by increasing psychological distress, the burden on family members, and disruptions to the mother-infant attachment, and the healthcare systems collectively. It emphasises that research and clinical domains need to focus on ensuring maternal distress is accurately identified, comprehended and validated. REPORTING
Methods
This study adhered to the COREQ for reporting interview-based qualitative research. PATIENT OR PUBLIC CONTRIBUTION This study did not include patient or public involvement in its design, conduct or reporting.