Academic journal article Research and Theory for Nursing Practice

Motherhood: A Discrepancy Theory

Academic journal article Research and Theory for Nursing Practice

Motherhood: A Discrepancy Theory

Article excerpt

Motherhood is a highly anticipated and positive event for most women. Society has constructed many ideal images of motherhood, giving women standards to live up to, and many times setting them up for disappointment. When this disappointment occurs, an emotional reaction follows, which may be fear, guilt, or shame. However, some women are able to experience this mismatch between an ideal and actual self and adapt with minimal emotional reaction. There was not a nursing theory that described this phenomenon. "Self-Discrepancy: A Theory Relating Self and Affect" (Higgins, 1987), from the psychology discipline provided concepts and definitions that could be used to derive a nursing theory. The derivation resulted in a testable mid-range theory that could have a significant impact on nursing interventions for postpartum mood disorders.

Keywords: motherhood; negative emotional response; discrepancy between expectations and reality; disenchantment; mid-range theory

The mental and physical changes that occur in early motherhood elicit a range of emotions from elation to devastation (Beck, 2002; Mercer, 2004). This adjustment to life as a new mother may be overwhelming and different from what the woman was expecting. Postpartum depression occurs in 9%-16% of all postpartum women in the United States and up to 19% worldwide (American Psychological Association, 2014; World Health Organization [WHO], 2008). Unfortunately, these statistics have remained unchanged over the last 15 years. Modifiable risk factors that may precede the diagnosis of depression have not been thoroughly examined. One phenomenon of interest that has not been thoroughly addressed in the literature is the implication of a discrepancy between the expectations and reality of motherhood. Although individual risks for postpartum depression have been identified, there are few evidence-based interventions focused on prevention.

The concepts of expectations, reality, and discrepancy have been explored in both qualitative and quantitative studies (Harwood, McLean, & Durkin, 2007; Kalmuss, Davidson, & Cushman, 1992; Lee, 2008; Luthar, Doyle, Suchman, & Mayes, 2001, Tammentie, Paavilainen, Astedt-Kurki, & Tarkka, 2004; Warner, 2006). The findings suggest a relationship between the concepts; however, a theory has not been developed to address this relationship. The concepts alone as well as within a theory, have implications for prenatal care on an international level. The occurrence of postpartum depression is not limited to the United States but affects cultures throughout the world. According to the WHO's (2014) estimates, 13% of women worldwide and 19% of women in underdeveloped countries suffer from postpartum depression. If theory-testing research supports the contribution of the discrepancy to postpartum depression, work can ensue to address prevention through education. Developing a theory to clarify the phenomenon of a discrepancy would ultimately guide health care providers in preparing women for motherhood during prenatal and postnatal education. Global implications for research may decrease postpartum depression rates, addressing what WHO (2008) calls the "leading cause of disease burden" among countries of all income levels.


Beck (2002) proposed a theory examining the development of postpartum depression using meta-synthesis, which included a theme called "incongruity between expectations and reality of motherhood" (p. 458). Beck cites multiple studies that show a link between the incongruity of expectations and reality of motherhood and postpartum depression but does not elaborate on the underlying psychological processes. Prior to Beck's meta-synthesis, sociologists interviewed mothers and found support for a link between misconceptions of motherhood and postpartum depression. However, they did not develop a theory to show how these conceptions were formed and how idyllic images of motherhood could contribute to postpartum depression (Mauthner, 1998, 1999). …

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