Postpartum depression (PPD) is a serious depressive episode arising in new mothers, with onset usually within a month after childbirth. Marked by severe sadness, anxiety, fatigue, inability to bond with the baby, and even suicidal thoughts, PPD results from a combination of hormonal changes, genetics, birth trauma, and lack of social support.
Gabriel, A. S., Ladge, J. J., Little, L. M., MacGowan, R. L., & Stillwell, E. E. (2023). Sensemaking through the storm: How postpartum depression shapes personal work–family narratives. Journal of Applied Psychology, 108(12), 1903–1923. https://doi.org/10.1037/apl0001125
Key Points
- This study takes an inductive, qualitative approach to uncover how the symptoms and treatment associated with postpartum depression (PPD) diagnosis drive sensemaking processes that shape working women’s identities and personal narratives around work and family.
- Key findings show that PPD serves as an “imposing identity” that interferes with mothers’ existing identities (e.g., professional identity) and emerging identities (e.g., maternal identity).
- The PPD diagnosis triggers a turning point that activates sensemaking around the discrepancies between women’s actual motherhood experiences and their expectations.
- Coping strategies like loss-oriented and restoration-oriented coping allow women to find their “way out” of PPD and engage in identity work to craft adaptive personal work-family narratives.
- These personal narratives focus on self-compassion, compassion toward others, and cross-domain prioritization of work, family, and self-identities in ways that meet women’s personal goals rather than societal ideals of motherhood and work.
- The study suggests practical implications for how organizations can support working mothers with PPD through flexibility, mental health benefits, and training managers on maternal mental health.
Rationale
The transition to motherhood is profoundly difficult for working women in ways that organizational research has overlooked (Ladge & Greenberg, 2015).
Up to 20% of new mothers experience postpartum depression (O’Hara & McCabe, 2013), a work-life shock event with significant symptoms. However, research on PPD in organizations is limited despite its critical implications for working mothers.
This study helps address these gaps by taking an inductive, qualitative approach centered on the research question: How do women navigate PPD’s symptoms and treatment at work and home?
The goal is to elucidate PPD’s role in shaping sensemaking processes regarding identities and personal narratives around working mothers’ professional and personal lives.
Method
The researchers conducted 41 interviews with working mothers diagnosed with PPD in the past five years. This included stay-at-home mothers and mothers working part-time or full-time. They also interviewed medical experts like obstetricians to provide additional perspectives on PPD.
The semi-structured interviews lasted 45-90 minutes and covered personal history, work history, PPD diagnosis and treatment, and the intersection of PPD with work and family. The researchers analyzed data in batches using open coding techniques from grounded theory methodology (Glaser & Strauss, 1967).
They assessed patterns in the data, refined ideas, and incorporated insights from identity and sensemaking theories to develop a process model explaining how PPD shapes working mothers’ identities.
Sample
The sample included 41 working mothers from diverse racial backgrounds who were formally diagnosed with PPD in the past five years. Most were White (30 women), married (36 women), working full-time (36 women), and had 1-3 children.
The average age was 35 years old. Most worked in salaried jobs (27 women) across industries like healthcare, engineering, education, business, and the military.
The sample also included 5 medical/health experts like an obstetrician who had experience treating PPD.
Results
The key themes capture PPD as a disruptive yet potentially transformational experience that drives intense sensemaking and identity work around the intersection of working mothers’ personal and professional roles.
- Culminating Symptoms of PPD as a First Turning Point: Hitting Rock Bottom: PPD causes escalating symptoms, including sadness, hopelessness, intrusive thoughts, sleep issues, disconnection from the baby, and self-isolation. Symptoms in new mothers accumulate to result in “hitting rock bottom” – a turning point with suicidal thoughts that prompts seeking help.
- Discrepancy Recognition as PPD Sensemaking Initiates: Sensemaking begins with the recognition of discrepancies between the difficult realities of PPD and women’s expectations of blissful motherhood.
- PPD Identity: An Imposing Identity: The PPD diagnosis becomes an imposing, interfering identity that disrupts working mothers’ existing identities and emerging maternal identity.
- Coping as a Means to Find a “Way Out”: Loss and restoration-oriented coping allows women space to process PPD changes and adapt to their new reality as working mothers with PPD. Loss-oriented coping involves grieving lost identities and expectations, while restoration-oriented coping means focusing efforts on handling new realities and roles as working mothers with postpartum depression.
- A Second Turning Point: Identity Work Shaping Personal Work–Family Narratives: Coping facilitates identity work where women determine new personal narratives around compassion, work-family balance, and self-care.
- Cross-Domain Prioritization of One’s Self, Work, and Family Identities: Personal narratives focus on prioritizing the self, work, and family in ways that meet women’s personal goals rather than societal ideals.
- The Importance of Compassionate Responding to Oneself and Others: Personal narratives also emphasize self-compassion and compassion towards others at work and home.
- How Nonwork and Workplace Supports Shape PPD Sensemaking and Overall Experiences: Social support and antisupport of family, friends, and coworkers influence women’s PPD coping, identity work, and crafting of adaptive narratives.
Insight
Rather than viewing PPD as an endpoint outcome of organizational factors like discrimination or lack of support, this study reconceptualizes PPD as a work-life shock event that activates an intricate sensemaking process for working mothers.
Crucially, the symptoms and treatment associated with PPD’s imposing identity force women to engage in identity work to determine new personal priorities and narratives around self-care, work, and family.
By foregrounding PPD’s direct role in shaping mothers’ inner dialogues and coping strategies, this research provides a more holistic, process-oriented understanding of how working women navigating PPD reconstruct their identities across life domains.
The resultant focus on self-compassion and cross-domain balance represents personal growth from adversity.
Opens avenues for research on imposing identities, maternal mental health, gendered organizations, and posttraumatic growth
Strengths
- Uses rigorous qualitative methodology (credibility checks, multiple coders, adequate sampling to reach saturation)
- Provides transparent documentation of procedures and analysis decisions
- Incorporates diverse sample of 41 working mothers across occupations, races, backgrounds
- Triangulates data using additional interviews with medical experts on PPD
- Develops insightful theoretical model inductively from rich interview data
- Situates findings in multidisciplinary literature on identities, sensemaking, mental health
Limitations
- Retrospective self-reports could limit accuracy due to recall bias
- Sample lacks diversity (mostly white, educated, salaried workers) limiting generalizability
- Did not compare formally diagnosed versus undiagnosed PPD populations
- Cross-sectional data provides snapshot versus longitudinal process
- Focused only on birthing mothers rather than non-birthing parents with PPD
Clinical Implications
Treating postpartum depression requires psychologists to appreciate it as an imposing identity that fundamentally alters working mothers’ sense of self, rather than minimizing it as transient mood fluctuation.
Clinicians should normalize patients’ difficulty adjusting and make space for processing loss while restoring priorities that support self-compassion.
This involves facilitating helpful coping orientations, identity transitions between work and family, and crafting personal narratives that reject societal ideals about intensive mothering or ideal workers.
Psychologists should cultivate self-compassion while harnessing compassion for others to benefit patients’ networks. Maximizing support from partners, relatives, colleagues and friends aids coping and growth.
Finally, clinicians need to correct misconceptions and judgmental rhetoric that isolates new mothers, helping patients’ networks appreciate postpartum depression’s disruptive yet transformational catalyst for posttraumatic growth and positive identity changes. With multidomain support, patients’ suffering containing seeds of resilience for themselves and their organizations.
References
Primary reference
Gabriel, A. S., Ladge, J. J., Little, L. M., MacGowan, R. L., & Stillwell, E. E. (2023). Sensemaking through the storm: How postpartum depression shapes personal work–family narratives. Journal of Applied Psychology, 108(12), 1903–1923. https://doi.org/10.1037/apl0001125
Other references
Glaser, B. G., & Strauss, A. L. (1967). The discovery of grounded theory: Strategies for qualitative research. Aldine.
Ladge, J. J., & Greenberg, D. N. (2015). Becoming a working mother: Managing identity and efficacy uncertainties during resocialization. Human Resource Management, 54(6), 977-998. https://doi.org/10.1002/hrm.21651
O’Hara, M. W., & McCabe, J. E. (2013). Postpartum depression: Current status and future directions. Annual Review of Clinical Psychology, 9(1), 379–407. https://doi.org/10.1146/annurev-clinpsy-050212-185612
Keep Learning
- How might organizations adapt their parental leave policies to better support working mothers at risk of PPD? What tradeoffs might this entail?
- What responsibilities do organizations have when it comes to supporting working parents’ mental health? Where should we draw the line?
- How might interventions designed to provide social support for pregnant employees considering PPD implications for recipients? Could these backfire or introduce new problems?
- What types of organizational cultures might be particularly helpful or harmful when working mothers are coping with imposing identities like PPD?
