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Approximately 19% of women experience minor or major depression in the first three months following childbirth. Most research suggests that women with withdrawn attachment styles are less likely to be depressed. However, unlike mothers in Western culture, mothers in Japan with withdrawn attachment styles are reported to have greater potential to become depressed. Thus, the aim of this study was to describe the behaviors and situational awareness of Japanese mothers’ with withdrawn attachment styles during pregnancy in order to reveal the specific dynamics underlying the withdrawn style. Interview data were analyzed using qualitative thematic content analysis. Of the 84 women assessed, 12 were determined to have a withdrawn style, and based on the Mini-International Neuropsychiatric Interview, five demonstrated the onset of postpartum depression (PPD). Two themes regarding relationships with partners emerged including: 1) confiding behavior: the importance of what is shared; and 2) need to be heard: wanting sympathy rather than criticism. Additionally, three themes describing mothers’ experiences during the first postnatal month emerged: 1) overwhelming experiences: the childbirth experience; 2) seeking help: behavior changes altered relationships; and 3) experience with the baby. Withdrawn style mothers keep distance from crisis, avoid closeness with others, and opt to manage problems by themselves. However, childbirth and infant care are not easily managed in this style. Mothers who used childbirth to confide in their partners may have reduced the severity of insecurity or developed a more secure style. Healthcare professionals are in the best position to develop good relationships with new mothers and provide support that focuses more on emotional factors and self-esteem levels.

The Experience of Postpartum Depression among Mothers with Withdrawn Attachment Style during Pregnancy and the First Postnatal Month