“Narratives of Mothering”

Abstract

Background: Motherhood is a unique phenomenon and not uncommon in women with severe mental illness (SMI). However, little attention has been paid to the voices of these mothers with SMI as to how they navigate it. A qualitative exploration with a social constructivist paradigm was used to understand lived experiences of mothers with SMI during the child-rearing period. Methods: The study used a qualitative design with social constructivist paradigm to obtain data from 30 mothers with SMI who had children <5 years of age. One-to-one in-depth semi-structured interviews were conducted with transcription, and inductive thematic analysis was used to explore transcripts using Charmaz's grounded theory. Triangulation and respondent validation were used to ensure rigor. Results: Emergent categories (themes) were thoughts/feelings about childbearing (considering children as prized and long-awaited possession, motherhood as “therapeutic,” concerns about child's mental health), the impact of mental illness (problems in emotional bonding, separation from children, improved healthcare to serve the maternal role), unmet needs (support groups, empathy, responsibility-sharing, home-based treatment), and caregivers' reactions (blame, discrimination, institutionalization for mental healthcare, custody-related threats). Motherhood as a central part of their identity and burden of balancing “childcare and mental illness” was the overarching categories. Conclusion: The complex emotional journey of a mother with SMI from child-bearing to child-rearing is fraught with many challenges. Developing sensitive and tailored mental health care interventions and policies for them needs to include their own voices, which will improve maternal-child bonding as well as service utilization.