The distressing case of modern mothering : expectations, losses, and postnatal distress : a thesis presented in partial fulfilment of the requirements for the degree of Doctor of Clincal Psychology at Massey University, Palmerston North, New Zealand

Abstract

Becoming a mother is a significant milestone for women. Pregnancy and childbirth epitomise the most natural and normal of processes, and yet, paradoxically, they are increasingly pathologised as a medical event. This discourse of disease which surrounds motherhood has contributed to control of childbirth moving away from women as women lose confidence in their ability to perform this most natural of processes unaided. Along with losing confidence in their ability to manage the event of becoming a mother, women are losing their confidence to be a mother, and to mother instinctively, instead relying on media, on literature, and on others to tell them how best to do this most natural of roles. Some argue motherhood has been subjected to media manipulation and a process of sanitisation which exposes women to mothering myths from which they build their expectations of motherhood. This creates unrealistic expectations of motherhood and therefore it is little wonder women lose confidence in their ability to mother. And if motherhood is natural and normal, how do we understand the rates of postnatal distress reported in mothers? In order to answer that question this thesis proposes a new model of postnatal distress, which argues postnatal distress is caused by the disparity between women’s prenatal expectations and their postnatal experiences. Given all women experience a disparity between expectations and experience yet not all women report postnatal distress, a moderator variable, loss, was introduced. Elements of this new refined model were subsequently tested and it was found women hold a number of expectations prior to becoming pregnant and these expectations reflect a belief in a mythical image of mothering and mothers. Given postnatal distress has a definitive trigger, and a definitive risk population it is ideally suited to a preventative intervention. This thesis culminates with the design and piloting of such an intervention developed from the new model. The intervention uses a mindfulnessbased approach which comprises a three session group format, designed to be implemented with first-time mothers during pregnancy. Findings suggest the protocol can be implemented in a meaningful way and provide initial support for the acceptability and workability of the protocol.