, Volume 11, Issue 2, pp 108–127 | Cite as

Care(less) encounters: early maternal distress and the haunted clinic

  • Meredith Stone
  • Renata KokanovićEmail author
  • Alex Broom
Original Article


In this paper we consider early maternal distress and clinical care, drawing on narratives of women interviewed to populate an Australian health information website. We consider the notion of ‘care barriers’, which has become popular in the biomedical literature as a means of explaining why ‘not enough’ women seek out clinical care. As an alternative to barriers we propose ‘care entanglements’, offering a way of conceptualizing socioculturally situated and biographically embedded formalized care. In part we argue that clinical encounters are ‘haunted’ by women’s biographies, circulating discourses, and the relational clinical moment, which accounts for why some women reject formalized care. However we also contend that many women have in fact already ‘slipped through’ to the clinic, whether this be in their adoption of medical language to describe their distress, or in their enactments in designated clinical spaces. Finally we reflect more broadly on the maternal, care and distress.


Maternity Clinical care Subjectivity Narrative Psychoanalysis PND 



First and foremost, we express our gratitude to all research participants who shared with us their personal stories of emotional distress. The paper is based on data collected within two research projects, funded by the Australian Research Council Linkage Project (LP0990229) and Healthdirect Australia, a national, government owned, not-for-profit organisation. Thank you to Dr Kate Johnston-Ataata, ​who collected many interviews for the research that informed this paper, and to Maureen Robinson for her support. Renata Kokanović thanks RMIT University, which, through the RMIT University Vice-Chancellor’s Senior Research Fellowship, supported her completion of this paper. Finally, we are thankful to anonymous reviewers for their insightful comments that assisted us in refining the final version of this paper.


  1. American Psychiatric Association. 2013. Diagnostic and statistical manual of mental disorders, 5th ed. Arlington, VA: American Psychiatric Association Publishing.CrossRefGoogle Scholar
  2. Armstrong, D. 1995. The rise of surveillance medicine. Sociology of Health & Illness 17 (3): 393–404.CrossRefGoogle Scholar
  3. Avrahami, E. 2003. Impacts of truth(s): The confessional mode in Harold Brodkey’s illness autobiography. Literature and Medicine 22 (2): 164–187.CrossRefGoogle Scholar
  4. Barad, K. 2007. Meeting the universe halfway: Quantum physics and the entanglement of matter and meaning. Durham, NC: Duke University Press.CrossRefGoogle Scholar
  5. Barad, K. 2010. Quantum entanglements and hauntological relations of inheritance: Dis/continuities, SpaceTime enfoldings, and justice-to-come. Derrida Today 3 (2): 240–268.CrossRefGoogle Scholar
  6. Baraitser, L. 2009. Maternal encounters: The ethics of interruption. New York: Routledge.Google Scholar
  7. Beardsworth, S. 2004. Julia Kristeva: Psychoanalysis and modernity. Albany: SUNY Press.Google Scholar
  8. Bechdel, A. 2012. Are you my mother?: A comic drama. New York: Houghton Mifflin Harcourt.Google Scholar
  9. Berlant, L. 2008. The female complaint: The unfinished business of sentimentality in American culture. Durham: Duke University Press.CrossRefGoogle Scholar
  10. Beyondblue. 2016. Just speak up. Accessed 27 Mar 2017.
  11. Bilszta, J., J. Ericksen, A. Buist, and J. Milgrom. 2010. Women’s experience of postnatal depression: Beliefs and attitudes as barriers to care. Australian Journal of Advanced Nursing 27 (3): 44–54.Google Scholar
  12. Blackman, L. 2010. Embodying affect: Voice-hearing, telepathy, suggestion and modelling the non-conscious. Body & Society 16 (1): 163–192.CrossRefGoogle Scholar
  13. Blackman, L. 2015. Affective politics, debility and hearing voices: Towards a feminist politics of ordinary suffering. Feminist Review 111 (1): 25–41.CrossRefGoogle Scholar
  14. Bollas, C. 1987. The shadow of the object: Psychoanalysis of the unthoughtknown. New York: Columbia University Press.Google Scholar
  15. Byatt, N., K. Biebel, R. Lundquist, T. Moore Simas, G. Debordes-Jackson, J. Allison, and D. Ziedonis. 2012. Patient, provider, and system-level barriers and facilitators to addressing perinatal depression. Journal of Reproductive and Infant Psychology 30 (5): 436–449.CrossRefGoogle Scholar
  16. Butler, J. 1997. The psychic life of power. Stanford: Stanford University Press.Google Scholar
  17. Butler, J. 2001. Giving an account of oneself. Stanford: Fordham University Press.Google Scholar
  18. Chattoo, S., and W. Ahmad. 2008. The moral economy of selfhood and caring: Negotiating boundaries of personal care as embodied moral practice. Sociology of Health & Illness 30 (4): 550–564.CrossRefGoogle Scholar
  19. Cho, G.M. 2008. Haunting the Korean diaspora: Shame, secrecy and the forgotten war. Minneapolis: University of Minnesota Press.Google Scholar
  20. Circle of Moms. 2017. Circle of Moms. Accessed 30 Mar 2017.
  21. Clough, P. 2009. Reflections on sessions early in an analysis: Trauma, affect and “enactive witnessing”. Women and Performance: A Journal of Feminist Theory 19 (2): 149–159.CrossRefGoogle Scholar
  22. Conrad, P., and A. Rondini. 2010. The internet and medicalization: Reshaping the global body and illness. In Culture, bodies and the sociology of health, ed. E. Ettorre, 107–120. London: Routledge.Google Scholar
  23. Cvetkovich, A. 2012. Depression: A public feeling. Durham: Duke University Press.CrossRefGoogle Scholar
  24. Dennis, C., and L. Chung-Lee. 2006. Postpartum depression help-seeking barriers and maternal treatment preferences: A qualitative systematic review. Birth 33 (4): 323–331.CrossRefGoogle Scholar
  25. Department of Health. 2009. Framework for the national perinatal depression initiative 2008-09 to 2012-13. Accessed 27 Mar 2017.
  26. Derrida, J. 1994. Specters of Marx: The state of the debt, the work of mourning and the new international. New York: Routledge.Google Scholar
  27. Devisch, I. 2013. Jean-Luc Nancy and the question of community. London: Bloomsbury.Google Scholar
  28. Ettinger, B.L. 2010. (M)other re-spect: Maternal subjectivity, the ready-made mother-monster and the ethics of respecting. Studies in the Maternal 2 (1): 1–24.CrossRefGoogle Scholar
  29. Fine, M., and C. Glendinning. 2005. Dependence, independence or inter-dependence? Revisiting the concepts of “care” and “dependency”. Ageing & Society 25 (4): 601–621.CrossRefGoogle Scholar
  30. Fisher, M. 2014. Ghosts of my life: Writings on depression, hauntology and lost futures. London: Zero Books.Google Scholar
  31. Flinders, D. 2001. Nel Noddings, 1929–. In Fifty modern thinkers on education: From Piaget to the present, ed. J. Palmer, 210–214. London: Routledge.Google Scholar
  32. Foucault, M. 1973. Madness and civilization: A history of insanity in the age of reason. New York: Vintage.Google Scholar
  33. Foucault, M. 2008. The birth of the clinic. London: Routledge.Google Scholar
  34. Frank, A. 1997. Illness as moral occasion: Restoring agency to ill people. Health: An Interdisciplinary Journal for the Social Study of Health, Illness and Medicine 1 (2): 131–148.CrossRefGoogle Scholar
  35. Frank, A. 1998. Stories of illness as care of the self: A Foucauldian dialogue. Health: An Interdisciplinary Journal for the Social Study of Health, Illness and Medicine 2 (3): 329–348.CrossRefGoogle Scholar
  36. Frosh, S. 2013. Hauntings: Psychoanalysis and ghostly transmissions. London: Palgrave Macmillan.CrossRefGoogle Scholar
  37. Frosh, S. 2016. Relationality in a time of surveillance: Narcissism, melancholia, paranoia. Subjectivity 9 (1): 1–16.CrossRefGoogle Scholar
  38. Goodman, J. 2009. Women’s attitudes, preferences and perceived barriers to treatment for perinatal depression. Birth 30 (1): 60–69.CrossRefGoogle Scholar
  39. Greenhalgh, S. 2001. Under the medical gaze: Facts and fictions of chronic pain. London: University of California Press.Google Scholar
  40. Hirsch, M. 1981. Mothers and daughters. Signs 7 (1): 200–222.CrossRefGoogle Scholar
  41. Hollway, W. 2015. Knowing mothers: Researching maternal identity change. New York: Palgrave Macmillan.CrossRefGoogle Scholar
  42. Kokanović, R., and J. Flore. 2017. Subjectivity and illness narratives. Subjectivity 10 (4): 329–339.CrossRefGoogle Scholar
  43. Kokanović, R., and M. Stone. 2018. Listening to what cannot be said: Broken narratives and the lived body. Arts and Humanities in Higher Education 17 (1): 20–31.CrossRefGoogle Scholar
  44. Kristeva, J. 1977. Polylogue. Paris: Seuil.Google Scholar
  45. Lacan, J. 1973. The four fundamental concepts of psychoanalysis. Harmondsworth: Penguin.Google Scholar
  46. Laplanche, J. 1999. Between seduction and inspiration: Man. New York: Unconscious. (in Translation).Google Scholar
  47. Lupton, D. 2013. The digitally engaged patient: Self-monitoring and self-care in the digital health era. Social Theory and Health 11 (3): 256–270.CrossRefGoogle Scholar
  48. Massumi, B. 2003. Navigating movements: An interview with Brian Massumi. 21 C Magazine. Accessed 30 Mar 2017.
  49. Miller, P., and N. Rose. 2008. Governing the present: Administering economic, social and personal life. Cambridge: Polity.Google Scholar
  50. Mol, A. 2008. The logic of care: Health and the problem of patient choice. London: Routledge.Google Scholar
  51. Nicolson, P. 1998. Psychology, science and the transition to motherhood. London: Routledge.Google Scholar
  52. Noddings, N. 1984. Caring: A feminine approach to ethics and moral education. London: University of California Press.Google Scholar
  53. Oakley, A. 1980. Women confined: Towards a sociology of childbirth. Oxford: Martin Robinson.Google Scholar
  54. Ram, K., and M. Jolly. 1998. Maternities and modernities: Colonial and postcolonial experiences in Asia and the Pacific. Cambridge: Cambridge University Press.CrossRefGoogle Scholar
  55. Raphael-Leff, J. 2000. Spilt milk: Perinatal loss and breakdown. London: Institute of Psychoanalysis.Google Scholar
  56. Robinson, L. 2016. Adele: Queen of hearts. Vanity Fair. Accessed 30 Mar 2017.
  57. Rose, N. 1990. Governing the soul: The shaping of the private self. London: Free Association Books.Google Scholar
  58. Rowe, J. 2015. Is this my beautiful life?. Sydney: Allen & Unwin.Google Scholar
  59. Shields, B. 2006. Down came the rain: My journey through postpartum depression. New York: Christa Incorporated.Google Scholar
  60. Stone, A. 2012. Feminism, psychoanalysis and maternal subjectivity. New York: Routledge.Google Scholar
  61. Stone, M., and R. Kokanović. 2016. “Halfway towards recovery”: Rehabilitating the relational self in narratives of postnatal depression. Social Science and Medicine 163: 98–106.CrossRefGoogle Scholar
  62. Turner, B.S. 1992. Regulating bodies: Essays in medical sociology. London: Routledge.CrossRefGoogle Scholar
  63. Watson, N., L. McKie, B. Hughes, D. Hopkins, and S. Gregory. 2004. (Inter)dependence, needs and care: The potential for disability and feminist theorists to develop an emancipatory model. Sociology 38 (2): 331–350.CrossRefGoogle Scholar
  64. Wetherell, M. 2013. Affect and discourse—what’s the problem? From affect as excess to affective/discursive practice. Subjectivity 6 (4): 349–368.CrossRefGoogle Scholar

Copyright information

© Macmillan Publishers Ltd., part of Springer Nature 2018

Authors and Affiliations

  • Meredith Stone
    • 1
    • 2
  • Renata Kokanović
    • 1
    • 3
    Email author
  • Alex Broom
    • 4
  1. 1.Social and Global Studies CentreRMIT UniversityMelbourneAustralia
  2. 2.Hunter New England Local Health DistrictTamworth Base HospitalTamworthAustralia
  3. 3.Monash Centre for Health Research and Implementation (MCHRI), Monash Public Health and Preventative MedicineMonash UniversityMelbourneAustralia
  4. 4.School of Social SciencesUniversity of New South WalesSydneyAustralia

Personalised recommendations