Untold motherhood encounters : an autoethnographic account of postpartum psychosis in Malta

Abstract

This autoethnography explores my lived experience with postpartum psychosis in Malta, focusing on the intersection of personal, familial, and professional narratives. Through a qualitative lens, this research incorporates the voices of key collaborators: my mother, husband, sister, former Head of School, my perinatal psychiatrist, and midwife present during my hospital admission. The results reveal that my experience with postpartum psychosis, while profoundly personal, is also shaped by broader social dynamics, including cultural, systemic, and relational influences. For example, despite the pervasive stigma surrounding mental health in Malta, which led me to conceal my pre-psychotic depression, I received significant material support from my close network. However, no one detected the warning signs of depression until the condition escalated into a full-blown psychotic episode. This may have been partly due to my own efforts to mask my depression, influenced by the idealised narrative surrounding motherhood. Emotionally, I did not feel entirely ‘safe’ with those around me, reflecting how my attachment style contributed to the situation. My avoidant tendencies may have played a role in the progression of my condition. The findings also highlight that severe stressors served as unavoidable triggers. Additionally, the midwives lacked experience with postpartum psychosis. My treatment improved after diagnosis. My twin sister, a midwife, also helped to ensure that I received treatment at the main state hospital in a gynae ward together with my baby while other mothers with postpartum psychosis are to this day separated from their baby and referred to a psychiatric hospital. This study's strengths include the use of autoethnography to capture my lived experience with postpartum psychosis, the incorporation of the father's perspective, and the contributions of my co-storytellers. Policy recommendations include improving family-work policies, evidence-based training for healthcare professionals on maternal mental health, integrating family therapists and peer experts into care services, and ensuring equitable treatment for all patients.