Postpartum Depression, Marital Dysfunction, and Infant Outcome: A Longitudinal Study
Abstract
This longitudinal study explores the relationship of postpartum depression (PPD) and marital dysfunction on infant outcomes from birth to 2 1/2 years of age among middle-class, postpartum women. Participants were recruited during the prenatal period. Twelve mothers completed the study throughout a 2 1/2-year period. Questionnaires, semistructured interviews, and observations were used to collect data. Content analysis of the interviews (Morse & Field, 1995) was conducted and thematic patterns were identified. Clinical PPD and marital dysfunction (defined as little or no support or closeness, or verbal, emotional or physical abuse) characterized nearly one in three mothers. Four themes describing the women's postpartum progression were identified: stress, isolation, resentment, and eventual adjustment by creating a new normal. No major developmental delays or behavioral problems were found among the infants. Eight of the 12 mothers who were initially identified as breastfeeding nursed their infants for 6–18 months. Regardless of financial and educational advantages, mothers in the study experienced depression and marital dysfunction. These findings support other studies that confirm the lack of association of PPD with social class or marital status. Childbirth educators and other health care professionals are encouraged to continue providing expectant families with anticipatory education and community resources in order to increase awareness of mental health and marital risks during the postpartum transition.
While over 80% of pregnant women develop a relatively mild mood disturbance called “baby blues” (Rosenthal & O'Grady, 1992), postpartum depression (PPD) of a major or minor occurrence is a devastating mood disorder affecting approximately 12%–19% of all mothers (Beck, 1993, 1998; Beck & Gable, 2001). Despite considerable biological changes occurring during the postpartum period, a clear association between biologic variables and PPD has not been found. Variables such as prenatal depression and stressful life events (e.g., marital dysfunction or conflict) are gaining researchers' attention, with additional focus on effects to the infant. Given the potential significance of these variables, the purpose of this longitudinal study was to explore PPD, marital dysfunction, and infant outcome among a group ofmiddle-class, postpartum mothers. Aggregation of quantitative and qualitative data was utilized to enhance the depth of the findings.
Acknowledgments
This study was partially funded by a Research Enhancement Award to Dr. Cheryl Anderson from the University of Texas at Arlington.