title: A Thematic Analysis of Stigma and Disclosure for Perinatal Depression on an Online Forum.
abstract: BACKGROUND
  Perinatal mental illness is a global health concern; however, many women do not get the treatment they need to recover. Some women choose not to seek professional help and get no treatment because they feel stigmatized. Online forums for various health conditions, including perinatal mental health, can be beneficial for members. Little is known about the role that online forums for perinatal mental illness play in reducing stigma and subsequent disclosure of symptoms to health care providers and treatment uptake.
  
  
  OBJECTIVE
  This study aimed to examine stigma and disclosure in forums and describe any potential disadvantages of forum use.
  
  
  METHODS
  An online forum for mothers was examined and 1546 messages extracted from 102 threads from the antenatal and postnatal depression section. These messages were subjected to deductive systematic thematic analysis to identify common themes regarding stigma and disclosure of symptoms and potential disadvantages of forum use.
  
  
  RESULTS
  Two major themes were identified: stigma and negative experiences of disclosure. Stigma had 3 subthemes: internal stigma, external stigma, and treatment stigma. Many women were concerned about feeling like a "bad" or "failed" mother and worried that if they disclosed their symptoms to a health care provider they would be stigmatized. Posts in response to this frequently encouraged women to disclose their symptoms to health care providers and accept professional treatment. Forum discourse reconstructed the ideology of motherhood as compatible with perinatal mental illness, especially if the woman sought help and adhered to treatment. Many women overcame stigma and replied that they had taken advice and disclosed to a health care provider and/or taken treatment.
  
  
  CONCLUSIONS
  Forum use may increase women's disclosure to health care providers by challenging their internal and external stigma and this may strengthen professional treatment uptake and adherence. However, a few posts described negative experiences when disclosing to health care providers.
authors.affiliation: Centre for Maternal and Child Health, School of Health Sciences, City University London, London, United Kingdom. Donna.Moore.1@city.ac.uk.
authors.forename: Donna
authors.identifier: http://orcid.org/0000-0001-6733-9461
authors.initials: D
authors.lastname: Moore
authors.forename: Susan
authors.identifier: http://orcid.org/0000-0002-6153-2460
authors.initials: S
authors.lastname: Ayers
authors.forename: Nicholas
authors.identifier: http://orcid.org/0000-0003-0752-9049
authors.initials: N
authors.lastname: Drey
keywords: Internet; depression; eHealth; online; perinatal