Pre-conception to parenting: a systematic review and meta-synthesis of the qualitative literature on motherhood for wome
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ORIGINAL ARTICLE
Pre-conception to parenting: a systematic review and meta-synthesis of the qualitative literature on motherhood for women with severe mental illness Clare Dolman & Ian Jones & Louise M. Howard
Received: 5 November 2012 / Accepted: 13 February 2013 / Published online: 23 March 2013 # Springer-Verlag Wien 2013
Abstract The majority of women with a severe mental illness (SMI) become pregnant and have children. The aim of this systematic review and meta-synthesis was to examine the qualitative research on the experiences of motherhood in women with SMI from preconception decision making to being a mother. The experiences of the health professionals treating women with SMI were also reviewed. Eleven databases were searched for papers published up to April 25, 2012, using keywords and mesh headings. A total of 23 studies were identified that met the inclusion criteria on the views of women with SMI, eight reported the views of health professionals including one which reported both. The meta-synthesis of the 23 studies on women's views produced two overarching themes Experiences of Motherhood and Experiences of Services. Sub-themes included the following: Guilt, Coping with Dual Identities, Stigma, and Centrality of Motherhood. Four themes emerged from the synthesis of the eight papers reporting the views of health professionals: Discomfort, Stigma, Need for education, and Integration of services. An understanding of the experiences of pregnancy and motherhood for women with SMI can inform service development and provision to ensure the needs of women and their families are met. Keywords Pregnancy . Severe mental illness . Systematic review . Qualitative research C. Dolman (*) : L. M. Howard Section of Women’s Mental Health, Health Service and Population Research Department, Box PO31 Institute of Psychiatry, King’s College London, De Crespigny Park, London SE5 8AF, UK e-mail: [email protected] I. Jones Department of Psychological Medicine and Neurology, MRC Centre for Neuropsychiatric Genetics and Genomics, Cardiff University, Cardiff CF14 14XN, UK
Introduction The majority of women with psychotic disorders are mothers (Howard et al. 2001; McGrath et al. 1999), but most research in this area has either focused on the subjects’ psychopathology and the potential harm to their children (Murray et al. 2003) or on service provision (Howard and Hunt 2008). Although in the past the fertility of women with severe mental illness (SMI) was considered to be lower than that of the general population (Howard et al. 2002), recent research has found it is increasing (Vigod et al. 2012). Concurrently, there has been a growing awareness internationally of the need to provide gender sensitive mental health services, e.g., Mainstreaming Gender and Women’s Mental Health (2003), and there is a developing literature on the experiences of mothers with SMI including their experiences of health services. The literature on health professionals’ perspectives on looking after mothers with SMI is limited and has usually focuse
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