Postpartum depression (PPD) is a medicalized condition that exists on a continuum of postpartum mood disorders. PPD is reported to be experienced by 10-15% of mothers and 10% of fathers during pregnancy or after the birth of a baby. PPD, as experienced by either parent, is considered a serious condition because of its potential short- and long-term negative impacts on the developing child. In this thesis I explore how motherhood and fatherhood are constructed in the context of articles on maternal and paternal PPD in Canadian and American newspapers. Specifically, I focus on how references to the opposite partner were used to position each parent, and how each parent was positioned with respect to the new baby. In the articles on maternal PPD, husbands were either inconsequential to the story, positioned as being absent, or constructed as supporting the mother through instrumental and action-oriented behaviours. In addition, mothers were constructed as lonely and isolated because of self-imposed limitations (e.g., feeling ashamed for not being happy). In the articles on paternal PPD, the mother-father relationship was based on differences and competition. Fathers were constructed as isolated, lonely and misunderstood, most often through mother-blaming, such as by positioning the mother as responsible for the father’s well-being (e.g., causing his PPD), and by labelling PPD “a woman’s domain.” Fathers’ loneliness was presented as being due to imposed limitations of others (e.g., others did not properly prepare fathers for fatherhood). Mothering was constructed as being instinctually skilled, tolerant, and self-sacrificing, with the inherent capability to manage multiple roles and changes. The mother-baby relationship was constructed as naturally joyful, all-important and –consuming. Fathers were not expected to be as skilled or instinctively prepared and tolerant, to engage in chores/childcare, or to be explicitly overjoyed with the baby. Mothers were blamed for their distress in the role, while others were blamed for fathers’ distresses. Gendered stereotypes in the parenting role were perpetuated in these newspaper articles. Parenthood was not constructed as a collaboration, but rather motherhood and fatherhood stood in isolation from each other, with motherhood positioned as the primary role. These constructions continue to maintain fathers in the background of parenthood as an “other,” and to position mothers as responsible for the well-being of her partner, child(ren) and herself.

Background: Health policies that seek to improve pregnancy outcomes focus on increasing the availability and access to prenatal care (PNC) services based on studies that support an association between insufficient PNC and adverse birth outcomes. These studies employ PNC utilization indices that measure the adequacy of PNC use, but these indices fail to account for the content or specific components of PNC. Objectives: The purpose of this study was to utilize PRAMS and birth certificate data to evaluate the content and quality of PNC in Virginia, and its impact on preterm birth and maternal postpartum health behaviors. Methods: Data was from the 2007 Virginia Pregnancy Risk Assessment Monitoring System (PRAMS). This population-based data is representative of all Virginia women who have had a live birth recently and included 1,236 female participants. Results: Inadequate PNC was associated with nearly a three-fold increase in risk of low birth weight (OR = 2.8, 95% CI = 1.5, 5.2), but not preterm birth. Women with adequate plus PNC were more likely to deliver infants who were preterm (OR = 10.2, 95% CI = 4.3, 24.4) and low birth weight (OR = 6.3, 95% CI = 4.2, 9.4). After adjusting for method of payment, income, and reported problems during pregnancy, women with lower income and no private insurance were more likely to have inadequate PNC (OR = 1.4, 95% CI = 0.5, 4.1) and (OR = 8.8, 95% CI = 1.3, 59.8), respectively. Provider discussions were not different based on adequacy of PNC. In addition, among women who received adequate PNC, those whose providers discussed postpartum birth control use were 4.5 times more likely to use birth control after delivery compared to women who did not receive education (95% CI=1.7, 11.8). Conclusion: The lack of strong associations between adequacy of PNC and birth outcomes indicate that there are other factors (intergenerational, stress, cultural) that may play a more prominent role in predicting maternal and infant health.

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