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Postpartum Depression and the Xnedlcallcatlon of Motherhood: a Comparison of Lay and Professional Views

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Postpartum Depression and the Xnedlcallcatlon of Motherhood: a Comparison of Lay and Professional Views Order Number 010B195 Postpartum depression and the xnedlcallcatlon of motherhood: A comparison of lay and professional views Ransdell, Lisa Lynn, Ph.D. The Ohio State University, 1990 Copyright ©1990 by RansdeU, IdeeLynn. All rights reserved. U-M-I 300 N. Zceb Rd. A nn A ibor, M I 48106 NOTE TO USERS THE ORIGINAL DOCUMENT RECEIVED BY U.M.I. CONTAINED PAGES WITH POOR PRINT. PAGES WERE FILMED AS RECEIVED. THIS REPRODUCTION IS THE BEST AVAILABLE COPY. POSTPARTUM DEPRESSION AND THE MEDI CALI 2ATI ON OF MOTHERHOOD* A COMPARISON OF LAY AND PROFESSIONAL VIEWS DISSERTATION Presented in Partial Fulfillment of the Requirements for the Degree Doctor of Philosophy in the Graduate School of the Ohio State University By Lisa L. Ransdell, B.A., M.A. ***** The Ohio S tate U n iv e rsity 1990 Dissertation Committee: Approved By Verta Taylor Katherine Meyer Joan Huber Adv i ser Department of Sociology Le i 1 a Rupp Virginia Richardson Copyright by Lis* L. R*n*d*l1 1990 ACKNOWLEDGEMENTS First and foremost I owe a debt of gratitude to my adviser, Dr. Varta Taylor. Her patiant criticisms and partinant insights guidad ma through tha dissartation procass and inspirad ma throughout my graduate school caraar. Additionally I am grataful to har for inviting ma in 1984 to work on tha rasaarch projact which lad to tha dissartat ion. It was a parfact blending of my interests in sociology and my cammitments as a feminist, and tha mix will keep ma interested in this topic for a long time to coma. Second, I am grateful to tha members of my d issa rtatio n committee, Katharine Mayer, Joan Huber, L eila Rupp, and Virginia Richardson. Their support and suggestions ware anormously helpful and tha time they devoted to reading various drafts of tha document was much appreciated. Third, I am grateful to tha mothers, physicians and other professionals who agreed to be interviewed. Their graciousnass with their time and their openness with their views and feelings exceeded my expectations. However awkward a researcher I may have been initially, they showed me what it is to be a practicing sociologist. Fourth, I thank Stephanie Spears for emotional support and intellectual assistance. Her unshakable -faith in my ability to persevere was as important as the sharing of her considerable sociological skills in my completion of this p ro je c t. Fifth, I appreciate the support of my colleagues at Denison University, especially Provost Barbara Hill. 1 also thank additional members of my family who helped with emotional support and in other tangible ways. My mother Betty H atfield and my s i s t e r Jo Johnson have always been there for me, and this solidarity has sustained me throughout my life. During the writing of the dissertation Dodridge, Dobbins and Durkheim also contributed significant support. Dodridge watched over me constantly, usually from under my computer table. Durkheim checked on me periodically, sharing conversation and kisses when I needed a lift. Finally, Dobbins made sure I got enough sleep with her insistence on a regular bedtime. VITA November 27, 1997 .................................................Born - C h illic o th e , Ohio 1979 ........................ ....B .A ., Hum anities, The Ohio State University 1982 ...................................................................................M.A. , Sociology, The Ohio State University 1981-1987............... .............................Teaching Assistant and Research Assistant, Depar tmen t of Soc i ology 1987 ...................................................................................Lecturer, Department of Soc i ol ogy/'Anthropol ogy, Denison University, Granv i11e , Oh i o 1988-present .............................................................Affirmative Action Officer, Coordinator of Women's Programs and Adjunct faculty member, Denison University, Granvi11e , Ohio PUBLICATIONS A. Articles and Book Chapters: Richardson, Laurel and Lisa Ransdell. 1988. "Sex-Based Stratification." Pp. 143-158 in The Dynamics of Sex and Gender : £ Sociolooical Perspective, by Laurel Richardson. New York: Harper and Row Publishers. Richardson, Laurel and Lisa Ransdell. 1988. "The Work World: Organization and Process." Pp. 172-190 in The Dynamics of. Sex and Gender: £ Sociolooical P e rsp e ctiv e, by Laurel Richardson. New York: Harper and Row Publishers. Richardson, Laurel, Mary Margaret Fonow and Lisa Ransdell. 1988. "Inequalities of Power, Property and Prestige." Pp. 159-171 in The Dynamics s ± Sex and Genderx £ Sociolooical Perspoctive■ New York: Harper and Row Publishers. i i i Ransdell, Lisa. 1978. "Sexism Invades the Classroom." Pol i t i c s Educati on. 1<3)iSummer. B. Book Reviewsi Ransdell, Lisa. 1985. Working Your Way to the Bottomi The Feminization s ± Poverty, by Hilda Scott. OJiifiSX a Xs. UJomen' s Studies Review. 7<6):5-7 Ransdell, Lisa. 1985. Sex and Advantage8 A Comparative. Macro-Structural Theory of Stratification, by Janet Chafetz and Sex S tr a tif ic a tio n ! Ch i 1d re n . Housework Jobs, by Joan Huber, Ohio State Women's Studies RfyifW, 7<2>i6-8. FIELDS OF STUDY Major Field: Sociology Studies in the Sociology of Sex and Gender {Professors Merta Taylor, Laurel Richardson, and Joan Huber); Studies in Medical Sociology (Professors Angelo Alonzo and Saad Nagi); Studies in The Sociology of the Family (Professor Joan Huber); Studies in Qualitative Research Methods (Professors Laurel Richardson, Henry Quarantelli, and Verta Taylor). Minor Field: Preventive Medicine (Professor Franklin Banks) TABLE OF CONTENTS ACKNOWLEDGEMENTS.........................................................................................................i i VITA...................................................... ..............................................................................i i j CHAPTER PAGE I. INTRODUCTION.........................................................................................................1 The Problem of Postpartum Emotional DiBorders......2 Deviance, Medicine and Social Control: The Phenomenon of Medi cal i zat i on.........................................10 Social Constructions of Health and Disease: Lax and Professional Concept!ons.............1 7 Deviance and the Mother Role.......................................................29 Theory: A Sociology of Knowledge and Feminist Approach.................... 28 Objectives of the Study.................... 31 II. RESEARCH METHODS...........................................................................................34 Interview s With M others.................. 38 Interviews With Physicians............................ 42 Procedures of Data Analysis: Interviews................ 4 6 Data Collection and Data Analysis: The Medical Li terature......................................................4 7 I I I . MOTHERS' CONCEPTIONS OF THEIR POSTPARTUM EMOTIONAL DIFFICULTIES.............................................. 50 Mothers' Descriptions of Their Feelings: The Dimensions of Postpartum Difficulties............................................ 9 3 Mothers' Views of Causation: Lay Typifications of the Causes of Postpartum Di sorders. .................. ,6 9 Chapter Summary and Discussion............................ 76 IV. LAY KNOWLEDGE AND THE RESOLUTION OF POSTPARTUM DIFFICULTIES............................................................................................ 7 9 Lay Knowledgei The Source and Content of Mothers" Information About Postpartum Emotional D ifficulties............................................... 8 1 The Resolution of Postpartum Difficulties! Help-Seeking and Einotion Work P r o c e s s e s ............................................... 89 Chapter Summary and Conclusions. ................. 1 0 9 V. PHYSICIANS' CONCEPTIONS OF POSTPARTUM EMOTIONAL DIFFICULTIES.................................................. 112 Influences on Physicians" Conceptions About Postpartum Emotional D ifficulties.........................115 The Nature of Physicians" Conceptions of Postpartum Disorders........................... 122 Physician Recommendations And Treatments For Postpartum Disorders................................................135 Chapter Summary and Conclusions..................... 140 V I. CONCEPTIONS OF POSTPARTUM EMOTIONAL DISTRESS DEPICTED IN THE MEDICAL LITERATURE..............................................143 How Conceptions Found in the Medical Literature Differ From Those of P ra c t i t i o n e r s . ................ .145 Theories of Causation and Recommendations For Treatment in the Medical Li t e r a t u r e ......................... .......151 Moral Entrepreneurs and Medical Claims-Makersi Organized Professional and Lay Advocacy for the Medicalizat i on of Postpartum Depression....................................................140 Chapter Summary and Conclusions.................................... 1 4 4 V II. CONCLUSIONS AND IMPLICATIONS...............................................................149 Summary of F in d in g s............ ...................................................... 170 Theoretical Implications of the Study....................................175 N o t e s . ................................................................ 181 Bi bl i og rap h y................................. 183 v i Appendices A. Post per turn Interview................................ 192 B. Newspaper A r t i c l e ................................................ 1 9 9 C. Medical Interview G uide................ 200 D. Medical Bibliography........................................................................2
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