published_or_final_version / abstract / toc / Clinical Psychology / Master / Master of Social Sciences

D.Cur. / The postpartum-period is a very emotional time for the mother with a new baby, which increases her need for support. Various factors contribute to this need for support, such as the change from the extended family to the nuclear family, which has reduced the number of network persons. The hospitalisation period of the mother after the birth of a baby has also decreased drastically, owing to the high medical costs associated with the birth of a baby. This results in the mother being discharged from the hospital much earlier and her accessibility to professional support being limited thereby. This source of support, namely the professional person who provides the mother with support, is also insufficient since the growth of the population far exceeds that of the nursing occupation, and the need is to huge for only professional persons to provide in. If the mother does not receive the necessary support that she may need, it could lead to postpartum-depression, which has a detrimental effect not only on the mother but also on the new baby and the mother's family. This research is therefore vitally important to the midwife, as it ensures a healthy mother and baby, not only in the hospital environment but also at home in her community where she must live and raise her baby. Community support to the mother during the postpartum-period is a relatively unfamiliar field in midwifery. Although the term community support is often used, the definition thereof has not yet been clarified, and it is used in different contexts, with different meanings. The term community support to the mother has therefore not yet been adequately described within the context of the postpartum-period. The objective of this research is to investigate and describe, and analyse the term community support to the mother during the postpartum-period, and to identify the characteristics of community support to the mother during the postpartum-period, as well as the network persons who must provide this community support to the mother, in order to establish the necessary guidelines for the provision of sufficient community support to the mother during the postpartum-period.

Thesis (MA)--University of Stellenbosch, 2002 / ENGLISH ABSTRACT: This review examines the medical model's conceptualisation of postnatal depression (pND) from a feminist perspective. The arguments are fourfold: Firstly, it argues that the fundamental problem underlying the concept of PND is its conception as existing on a continuum with psychosis at the most severe end and maternity blues at the least severe end. The link with psychosis implies that it is potentially pathological requiring medical and psychiatric intervention. On the other hand its link with maternity blues gives scientific credence to continued research on emotional sequelae of reproduction that are below the psychiatric threshold of urgency. Secondly, the medical model's construction of PND implies that women are predisposed to mental illness because of their ability to bear children and thus pathologises normal experiences of childbirth. Thirdly, the medical model's preoccupation with classification and categorisation has become little more than an exercise in labeling that has removed women from their own experiences. Focusing on birth as an activity that is separate from the rest of pregnancy objectify women and ignores the socio-political context within which they give birth and care for their infants. Fourthly, it is argued that a different way of researching postpartum mood disorders is necessary to overcome a reductionistic and pathological model of childbirth. This is important if healthcare delivery hopes to provide adequate treatment for all women in the postnatal period. Especially in South Africa, where the dominant culture has for many years defined the experiences of the 'other', it is important to generate research that should include the 'voices' of the 'other' to prevent hegemonic practice from assuming an expert understanding of PND. This review does not deny the contributions from the medical establishment, but argues that a critique of its underlying assumptions is important to prevent women from being further marginalised by ignoring the socio-political context in which their lives are embedded. The implications for research within South Africa are also addressed. / AFRIKAANSE OPSOMMING: Hierdie oorsig ondersoek die mediese model se konseptualisering van postnatale depressie vanuit 'n feministiese perspektief. Die argument is vierledig: Eerstens blyk die konseptualisering van postnatale depressie, naamlik dat dit op 'n kontinuum bestaan, met psigose aan die mees disfunksionele kant en 'maternity blues' aan die minder ernstige kant, 'n fundamentele, onderliggende probleem te wees. Die verband met psigose impliseer dat postnatale depressie potensieel patologies is en mediese en psigiatriese insette benodig. Die verband met 'maternity blues' aan die ander kant, bied wetenskaplike begronding vir volgehoue navorsing op die gebied van emosionele aspekte van kindergeboorte wat nie van psigiatriese belang is nie. Tweedens impliseer die mediese model se konstruksie van postnatale depressie dat vroue 'n predisposisie tot geestessiektes het bloot deur die feit dat hulle die vermoë het om kinders voort te bring. Sodoende word patologiese kenmerke gekoppel aan normale ervarings van kindergeboorte. Derdens het die mediese model se beheptheid met klassifikasie en kategorisering verval in etikettering wat vroue van hul eie ervarings vervreem. Deur te fokus op geboorte as 'n aktiwiteit wat verwyder is van die res van swangerskap maak van vroue objekte wat verwyderd is van die sosio-politieke konteks waarbinne hulle geboorte skenk en sorg vir hul babas. Vierdens word dit beredeneer dat 'n nuwe benadering tot navorsing oor postpartum gemoedsteurings daar gestel behoort te word om 'n reduksionistiese en patologiese model van kindergeboorte te voorkom. Dit is belangrik as gesondheidsorgdienste hoop om toereikende behandeling te bied vir alle vroue in die postnatale periode. Veral in Suid-Afrika, waar 'n dominante kultuurgroep vir so lank die ervarings van ander omskryf het, is dit belangrik om navorsing voort te bring wat die 'stemme' van die 'ander' insluit om sodoende te verhoed dat die heersende praktykvoeringe van die dag 'n eensydige deskundige-verstaan van postnatale depressie voorveronderstel. Hierdie oorsig ontken nie die bydraes van die mediese model nie, maar beredeneer die feit dat 'n kritiese beskouing van die onderliggende aannames belangrik is om sodoende te verhoed dat vroue verder gemarginaliseer word deurdat die sosio-politieke konteks waarin hul lewens gegrond is, buite rekening gelaat word. Die implikasies vir navorsing binne 'n Suid-Afrikaanse konteks word dus ook ondersoek.