Rural Women’s Experiences of Living with Postpartum Depression Symptoms

Depression is a serious complication of the postpartum period that affects not only women but their children and families as well. Rural women are particularly vulnerable because of the significant barriers to health care they experience as a result of isolation, poverty, traditional beliefs, and a lack of accessible and adequate health related services. A review of the literature to identify interventions focusing on primary and secondary prevention of postpartum depression revealed few evidence based interventions and no studies that targeted or included women living in rural areas of the United States. Until more is known about rural women who are experiencing postpartum depression or postpartum depression symptoms, it will remain difficult to diagnose and even more difficult to design interventions with the potential to help these women and their families.

The purpose of this study was to gain an understanding of postpartum depression symptoms as they are experienced by women living in rural areas. Gadamerian hermeneutic phenomenology was the framework that guided the study. Purposive sampling was used as the appropriate method to identify and recruit women who were living in rural areas and experiencing postpartum depression symptoms. Rural women were eligible for inclusion in the study if they self-identified as experiencing at least two symptoms of postpartum depression after the birth of a healthy term infant, were eligible for Medicaid or Missouri MC+, and lived in a rural county with no towns having a population greater than 2,500. Ten women between two and eight months postpartum participated in the study. Data were collected through a series of in depth face-to-face interviews with the participants, field and journal notations, and demographic questionnaires. Data were analyzed using thematic analysis consistent with Gadamer’s approach to hermeneutic phenomenology. Seven themes were identified: Overwhelmed and Stressed, Loss, Financial Concerns, Abandoned and Alone, Stuck Here, Fiercely Responsible, and Hopes and Dreams. The findings of this study provide a beginning understanding of rural women’s experiences of living with postpartum depression symptoms. This is an important step in identifying postpartum depression in rural women and in the development and implementation of nursing interventions for this population. In addition, this study provides insights into gaining and maintaining access to rural and underserved populations through planning and networking, understanding and respect for local customs and lifestyles, and giving voice to those who believe that what they have to say is neither heard nor valued.