Women’s experiences of psychosis in the perinatal period : Exploring the perspectives of couples and midwives

Turgoose, Molly and Murray, Craig and Sellwood, Bill and Chamberlain, Elizabeth (2023) Women’s experiences of psychosis in the perinatal period : Exploring the perspectives of couples and midwives. PhD thesis, Lancaster University.

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Abstract

This thesis explores the perspectives of couples and midwives regarding postnatal distress, specifically postpartum psychosis and perinatal psychotic-like experiences. It consists of three sections, a systematic literature review, an empirical research paper and a critical appraisal. The systemic literature review used Thomas and Harden’s (2008) methods for thematic synthesis to synthesise 17 studies exploring experiences of postpartum psychosis (PP) from mothers’ and partners’ perspectives. The review research question focused on mothers’ and partners’ experiences of their relationship with each other and their baby during PP, in addition to the impact of PP on these relationships. Four themes were generated: (1) The process of learning to adapt together; (2) Navigating the impact of the uncontrollable experience on our relationships; (3) This experience can strengthen or strain relationships; and (4) The journey through PP is a relational experience. Recommendations for clinical practice highlight the importance of services supporting women’s close relationships, and offering systemic interventions for families. The empirical paper aimed to explore midwives’ perspectives and perceptions concerning psychotic-like experiences (PLEs) in the perinatal period. Thematic analysis was used to analyse data from semi-structured interviews with 10 midwives. Four themes were developed: (1) Identifying psychotic-like experiences would not be as easy as it sounds: making decisions on behalf of women (2) Psychotic-like experiences can feel overwhelming; (3) This is my responsibility: I’ll do what I can to support women even if it’s hard; and (4) The system feels unsafe and insecure which makes the anticipated role in supporting psychotic-like experiences harder. The results emphasise the importance of systemic safety for midwives, alongside training and guidance for midwives to support them in supporting women with PLEs. The critical appraisal summarises the research findings and discusses strengths, limitations and methodological decisions alongside the author’s personal reflections on the work.