The Baby Blues: Mothers' Experiences After Adoption

143 Pages·2015·2.34 MB·English

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USF Tampa Graduate Theses and Dissertations USF Graduate Theses and Dissertations
January 2013
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Brigette Barno Schupay
University of South Florida, [email protected]
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Schupay, Brigette Barno, "The Baby Blues: Mothers' Experiences After Adoption" (2013). USF Tampa
Graduate Theses and Dissertations.
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The Baby Blues: Mothers’ Experiences After Adoption

by

Brigette Barno Schupay

A dissertation submitted in partial fulfillment
of the requirements for the degree of
Doctor of Philosophy
Department of Social Work
College of Behavioral and Community Sciences
University of South Florida

Major Professor: William Rowe, Ph.D.
Susan Allen, Ph.D.
David Kondrat, Ph.D
Victoria Hummer, MSW

Date of Approval: March 4, 2013

Keywords: depression, parenting, stress

Copyright© 2013, Brigette Barno Schupay
DEDICATION

I want to dedicate this dissertation to my mother, Gail Barno, whose
unconditional love has been the foundation of all things I have achieved in life.
I also want to dedicate this dissertation to my children, Sydney and Avery, in
hopes that they will be equally as blessed by my love for them and know all things are
possible.
ACKNOWLEDGEMENTS

To my committee chair, Dr. William Rowe, for his unwavering patience and for
reminding me on several occasions that I came too far not to succeed. Also, thanks to my
committee members Dr. Susan Allen, Dr. David Kondrat, and Victoria Hummer for their
time and thoughtful criticism along the way.
To Heart of Adoptions, Inc., Catholic Social Service of the Diocese of Dodge
City, Gift of Life Adoptions and the amazing mothers that volunteered their time and
personal stories to make my research come alive.
To my remarkable family that pitched in without question or hesitation at every
request for assistance and to my friends that tirelessly listened to me talk about earning
my Ph.D. I also want to acknowledge Jeanne Tate, the best adoption attorney anyone
could ever have and one of the best individuals anyone could be lucky enough to know.
Next, I must give a special thank you to the two men in my life that made this
dissertation possible. First, there really are no words to accurately thank Dr. Robert
Lucio for all his assistance during my journey. Robert provided support from the very
first panic attack until the very last. His kindness, intelligence and friendship enabled me
to reach the finish line. And finally, to my husband, Conrad Schupay, who supported my
doctoral ambitions from the very start the first day I met him. He provided for all my
needs so I could not give up, even when at times I thought I had two really good excuses
to do so.
TABLE OF CONTENTS

List of Tables iv

List of Figures v

Abstract vi

Chapter One: Introduction 1
Rationale for Study 5
Research Questions and Objectives 6

Chapter Two: Review of the Literature 7
Post-Adoption Depression 7
Societal Perception 10
Matching 11
Psychological Risk 12
Attachment 12
Infertility 13
Postpartum Depression 13
Risks Factors Related to Postpartum Depression 15
Assessment 17
Theoretical Assumptions Regarding Post-Adoption Depression 18
Summary of the Literature Review 19

Chapter Three: Research Design and Methodology 21
Study Design 21
Research Questions 22
Sampling Frame 22
Phase I- Qualitative 23
Participants 23
Instruments 23
Procedures 24
Phase II- Quantitative 24
Participants 24
Instruments 25
Informed Consent and Inclusion Criteria 25
Depression 26
Fatigue 27
Parenting Expectations and Life Change 27
i
Infant Temperament 28
Social Support 28
History of Depression 28
Medication Use 29
Socio-Demographic Variables 29
Comments 29
Definitions 29
Procedures 30
Pilot Testing 31
Study Variables 31
Data Analysis 32
Phase I- Qualitative 32
Phase II- Quantitative 32
Limitations 32

Chapter Four: Results 34
Quantitative Analysis 34
Pre-Screening of Data 34
Descriptive Statistics 35
Mother’s Age 35
Ethnicity/Race 35
Sexual Orientation 36
Marital Status 36
Education Level 36
Employment Status 36
Spouse’s Employment Status 37
Number of Adopted and Biological Children 37
Total Number of Children 37
Adopted Child Age 37
Prior History of Depression 38
Medication 38
Adjusting to Parenting a New Baby 38
Support after Adoption 39
Infant Temperament 40
Fatigue 40
Research Questions 40
Research Question 1: Do mothers experience depression after
adopting a child? 40
Research Question 2: What factors are related to depressive
symptomatology? 40
Logistic Regression Analysis 42
Qualitative Analysis 45
Research Question 3: How is depression after adoption manifested? 45
Relationship with Child 45
Bonding and Attachment 45
Goodness of Fit 50
ii
Life Change 51
Relationship with Birth Parents 52
Guilt and Sadness 52
Care and Concern 53
Legal Issues 55
Relationship with Family and Friends 57
Family and Friends’ Response 57
Marital Relationship 58
Hospital Experience 59

Chapter Five: Discussion 62
Quantitative Research 62
Sample Characteristics 63
Findings 63
Question 1 63
Question 2 63
Qualitative Research 64
Sample Characteristics 64
Findings 65
Question 3 65
Relationship with Child 65
Relationship with Birth Parents 66
Relationship with Family and Friends 67
Hospital Experience 68
Limitations 69
Recommendations for Future Research 70
Implications for Social Work Practice 71
Conclusion 72

References Cited 74

Appendices
Appendix A: Tables and Figures 83
Appendix B: Internet Survey—Adoption! Tell me more! 97
Appendix C: Postpartum Depression Screening Scale (PDSS) 117
Appendix D: What Being the Parent of a New Baby is
Like- Revised (WPL-R) 118
Appendix E: The Multidimensional Perceived Support Scale (MPSSS) 123
Appendix F: Research Summary 125
Appendix G: Agency Consent Letters 126
Appendix H: Email Invitation to Participate 129
Appendix I: Permission from IRB 131

iii
LIST OF TABLES

Table 1: Summary of Studies Examining Risk Factors of PPD
(Strong/Moderate Predictors) 83
Table 2: Comparison of Postpartum Depression and Post-Adoption
Depression Risk Factors 84
Table 3: Study Variables 87
Table 4: Survey Sample Demographics Characteristics- Significance by
Depression Score 88
Table 5: Descriptive Statistics for PDSS Score Used as Dependent Variable 91
Table 6: Logistic Regression Classification Table 92
Table 7: Predicted Probability of Post-Adoption Depression 93
Table 8: Interviews- Sample Demographics Characteristics 94
Table 9: Semi-Structured Interview Guide 96

iv
LIST OF FIGURES

Figure 1: Belsky’s Determinants of Parenting Model 85
Figure 2: Post-Adoption Depression Model 86
Figure 3: Skewed Distribution of the Dependent Variable 90

v
ABSTRACT
It is not uncommon for new mothers to experience depression. However,
depression after the arrival of a child is not limited to biological mothers. The term Post-
Adoption Depression Syndrome (PADS) was created to capture the unique type of
depression that may occur after adopting a child. The nature and prevalence of
depression after adoption is still largely unknown since there is little published research
exploring the experiences of mothers in the first year after adopting a child. The
characteristics of this disorder are reportedly comparable to postpartum depression in a
biological mother. A review of postpartum literature reveals risk factors unrelated to
biology. The experiences of adoptive mothers were explored focusing on the
psychosocial and psychological risk factors of postpartum depression and challenges
specific to adoptive parenting were also considered.
Quantitative data were collected through an on-line survey. Findings revealed
that 25% of adoptive mothers experienced depressive symptoms after adoption. Lack of
support and increased fatigue were the most significant predictors of post-adoption
depression. Other factors related to increased depression were found, such as infant
temperament and marital status. Additionally, in-depth interviews with adoptive mothers
were conducted that illustrate the experiences and challenges specific to adoptive
parenting that may contribute to post-adoption depression. Implications for social work
vi