Maternal depression and maternal role
Prenatal and postpartum depressions are estimated to affect from9to19%ofwomen(Gavinetal.2005).Thesedisorders are defined asdepressed moodoccurring duringpregnancy or within 1 year of childbirth, respectively, on a daily basis with at least four of the following associated comorbid symptoms: sleep disturbance, weight loss, decreased energy, agitation/retardation,guilt,decreased concentration,and thoughtsof selfharm (APA 2013). A woman with prenatal depression has
limited ability to cope with existing stressors. Subsequently, prenatal depression is one of the strongest predictors of postpartum depression (Beck 2001; Katon et al. 2014;O ’Hara 2009). Following childbirth, women must cope with changes in body function, hormone shifts, increased self-care requirements, enormous infant care responsibilities, and social role expectations.These demands onpostpartummothers may explain boththepredictiverelationshipofprenataldepressionto postpartumdepressionandalsothe highincidenceofpostpartum depression. Extending Rubin’s(1967) initial work on maternal role attainment, Mercer (2004) describes Bbecoming a mother^ as a process occurring after the birth of each newborn child whereby a mother develops a new maternal role. Maternal role is considered a mother’s integration of mothering identity and behavior into her life, including confidence and satisfaction in that role(Mercer 1985).This process is theresultof acomplex interchangeofbehaviorsbetweenamotherandherinfantwithin a variety of changing contexts. Factors believed to affect the development of one’s maternal role may include a mother’s health, culture, knowledge, and age (Mercer 2004). An early study (Mercer and Ferketich 1994) found multiple factors that significantly contribute to maternal confidence including selfesteem, mastery, and fetal attachment. Fowles (1998) found thatpostpartumdepressionwasstronglycorrelatedwithmaternal perceived competence in mothering. More recently, Emmanuel and colleagues (2011) found a significant relationship for both prenatal depression and postpartum depression with maternal role. Prenatal and postpartum depressions were not tested simultaneously, so it is unclear whether they made unique contributions or if they represented a process of risk rather than two independent predictors. These previous studies further suggest that depression can alter a woman’s perception of her maternal role. However, these studies arguably miss an important factor as they do not consider the contribution of perceptions of infant temperament to maternal role.