Women’s Postpartum Distresses as Viewed by and Expressed in the Leaflets of the Medical Institution

The transition to motherhood, one of the most significant events in a woman's life cycle, has both positive and negative ramifications (Taubman – Ben-Ari, Ben Shlomo, Sivan, & Dolizki, 2009). This transition, whether the first time with subsequent births, requires a process of change and reorganization from the personal, spousal, occupational, and social aspects. Therefore, the transition is understood to be one that can arouses stressors, and can cause distress. This experience encompasses a wide range of reactions, often defined as normative and common feelings of distress. These include anger, despondency and negative thoughts, baby-blues, and postpartum depression. The causes of this distress include the changes experienced by the woman with the transition to motherhood, loss of control over one’s appearance, femininity and sexuality, and perception of motherhood and identity. The distress thus experienced may also be caused by the social and personal expectations which frame motherhood as a positive experience, rejecting or socially silencing negative or ambivalent feelings.

The uniqueness of this study is twofold. First, it trains a spotlight on the responses of Israel’s medical establishment's to the normative distress of a woman in transition to motherhood. Second is the research method, which is underpinned by the analysis of documents published and distributed by the medical establishment (Israeli Health Care Services, hospitals, and the Ministry of Health), on the Internet, at Mother and Child Preventative Health Services and at Women's Health Centers. Social support is an acknowledged source of coping with adversity, research literature showing that instrumental, informational, and emotional support and appreciation provided by formal and informal support systems can alleviate the symptoms fo distress experienced by women during transition to motherhood, Nevertheless, it is surprising to find that most of the research on the subject relates to the relationship between social support and postnatal depression among mothers, and not to other forms of distress. The present study focuses on the formal support system, and aims to examine how the medical establishment offers support, and more specifically recognition, of the normative distress experienced by new mothers postpartum. An analysis of the printed and online documents published by medical institutions revealed nine aspects which relate to distress during the transition to motherhood. These are the extent and nature of the symptoms that characterize maternal distress; an explanation of the emotional jolt experienced during this period; the origins of postpartum distress; the length of time characterizing the distress; the level of recognition of the maternal distress; the degree of normalization of the onset of maternal distress; the degree of formal and/or informal support provided to postnatal women; reference to social and/or personality myths and expectations during the transition to motherhood; and reference to the transition as a life event. A gap was found with regard to the way in which Israeli Health Care Services (IHCS) and hospitals relate to maternal distress, reflecting their different perceptions. Furthermore, findings showed an uncommon response on the part of LIS Hospital in Tel Aviv, compared to the other hospitals. Sociological explanations for these gaps include: the therapeutic agenda that guides each institution, which differs between the IHCS and the hospitals; the birth medicalization process, which defines most of the responses associated with birth from a medical perspective; Israel’s pronatalist society, characterized by the motherhood myth; the emotional restraint that characterizes the transition to motherhood; and the perception of the city of Tel Aviv as a separate metropolis with unique characteristics. In addition to these, other explanations emerged. An economic explanation concerns the distribution of budgets between institutions; and a psychological explanation was connected to the perception of women as a subject or as an object, especially in religious public oriented institutions. The conclusions of this study show that IHCS tend to address the phenomenon of maternal distress more comprehensively and more deeply in their communications than the hospitals, where reference to this subject is lacking.