title: Bad thoughts: Brazilian women's responses to mothering while experiencing postnatal depression.
abstract: OBJECTIVE
  this study explores Brazilian women's experiences of mothering of their infants while experiencing postnatal depression.
  
  
  METHODS
  a cross-language qualitative descriptive design.
  
  
  METHODS
  the sample was composed of 15 women diagnosed with postnatal depression in a psychiatric institute in São Paulo, Brazil. Open-ended interviews were conducted and the data underwent thematic analysis.
  
  
  RESULTS
  13 women worried that harm would come to their infants. Seven of these women self-identified as potential sources of harm, with two women physically hurting their infants. The remaining six women worried about unknown agents, such as disease, hurting their infants. In response to these bad thoughts, women mothered their infants in one of four ways: (1) transferred care, completely delegating this task to family members; (2) shared care, asking family members to share the responsibility; (3) sole care, having to look after their infants by themselves because they had no available family support; (4) and smother care, being hyper-vigilant, constantly watching their infants and not trusting infant care to anyone else.
  
  
  CONCLUSIONS
  the bad thoughts influenced the women's adaptation to mothering their infants. Health professionals should assess these thoughts early in the postnatal period and the women's mothering responses for the protection of mother and child.
authors: Duke University School of Nursing, DUMC 3322, 307 Trent Drive, Durham, NC 27710, USA. Electronic address: hudson.santos@duke.edu.
authors: Hudson Pires Oliveira
authors: HP
authors: Santos
authors: University of North Carolina at Chapel Hill School of Nursing, Carrington Hall, CB # 7460 Carrington Hall, Chapel Hill, NC 27599, USA. Electronic address: msandelo@email.unc.edu.
authors: Margarete
authors: M
authors: Sandelowski
authors: University of São Paulo at São Paulo School of Nursing, USP, Av Dr Eneas de Carvalho Aguiar 419, Cerqueira Cesar, São Paulo, SP 054470-3000, Brazil. Electronic address: drgualda@usp.br.
authors: Dulce Maria Rosa
authors: DM
authors: Gualda
mesh_terms: D000223:Adaptation, Psychological; D000328:Adult; D001938:Brazil; D019052:Depression, Postpartum / Q000523:psychology*; D005260:Female; D006760:Hospitalization; D006801:Humans; D007231:Infant, Newborn; D007407:Interviews as Topic; D008425:Maternal Behavior; D009034:Mother-Child Relations; D011247:Pregnancy; D011594:Psychometrics; D014177:Translations
keywords: Intrusive thoughts; Maternal care; Mother–infant interaction; Postnatal depression