Document Type



Doctor of Philosophy



Date of Defense


Graduate Advisor

Dr. Ruth L. Jenkins


Jean Bachman

Kim Stieglitz

Linda Bullock


Depression is a serious complication of the postpartum period that affects not only women but their children and families as well. Rural women are of particular concern because of the significant barriers to health care that they experience as a result of isolation, poverty, traditional beliefs, and a lack of accessible and adequate health related services. A review of the literature to identify evidence based nursing interventions that focused on primary and secondary prevention of postpartum depression revealed few interventions and there were no studies identified that targeted or even included women living in rural areas of the United States. The purpose of this study was to gain an understanding of postpartum depression symptoms as they are experienced by women living in a rural area of the Missouri Ozarks. Gadamerian hermeneutic phenomenology was the framework that guided this study. Women were eligible for inclusion in the study if they self-identified as experiencing at least two symptoms of depression after the birth of their infant. Ten women between two and eight months postpartum participated in the study. Data were collected through a series of three face to face interviews with the study participants. Transcripts of the interviews were analyzed using thematic analysis. Seven themes were identified: Overwhelmed and Stressed, Loss, Financial Concerns, Abandoned and Alone, Stuck Here, Fiercely Responsible, and Hopes and Dreams. The findings of this study provide a beginning understanding of rural women's experiences of living with postpartum depression symptoms. These findings offer clinicians and researchers a different view of the phenomenon that can be useful in the identification of postpartum depression symptoms as well as the development of interventions directed at primary and secondary prevention of postpartum depression in this population. The study also provides some insights into gaining and maintaining access to rural and underserved populations.

OCLC Number


Included in

Nursing Commons