Motherhood and Serious Mental Illness: a qualitative study of stigma, ‘risk’ and access to perinatal mental healthcare

The experiences of motherhood and mental illness are complex, especially for women with a history of serious mental illness (SMI). Health services provide support to women contemplating motherhood, during pregnancy and beyond, but delays in receiving care can have serious consequences for women and families. Research indicates socioeconomic and ethnic inequalities exist in relation to accessing perinatal mental healthcare and some have suggested stigma plays a significant role. Risk is a major concern of health professionals who care for women with SMI and literature on marginalised pregnancy suggests risk and stigma are closely linked. This thesis uses sociological perspectives on stigma, access, and risk to explore the reproductive-related experiences of women with SMI and their interactions with healthcare. Drawing from the experiences of 20 women with a (self-identified) history of SMI and 14 health professionals, the thesis contributes a critical understanding of how SMI affects women’s reproductive lives & care and is positioned at the intersection of the sociology of health and illness and health services research.
The findings demonstrate that SMI has a significant influence on women’s reproductive experiences including decisions about having children, of pregnancy and motherhood. Applying sociological lenses to the experiences of both participant groups reveals some of the institutional and structural forces that influence women’s experiences of stigma, access to care and how risk is conceptualised and responded to in relation to maternal mental health. The connecting of personal experiences to broader socio-political contexts is the value of sociological inquiry. The findings of this research complements the current literature on perinatal mental health by focusing on forces influencing women’s experiences and care beyond the level of the individual, providing a richer understanding of key issues in relation to maternal mental health and healthcare.