265 The Professional Counselor | Volume 14, Issue 3 Discussion Overall, this study extends the understanding of rural mothers’ postpartum social and emotional experiences, which have been overlooked in the professional counseling literature. The present study provides a focused insight into the rurality and postpartum social and emotional experiences related to the broader category of childbirth experiences. Although there have been important and recent contributions to the literature related to counselors’ perceptions of rural women clients (Leagjeld et al., 2021), our study provides an even more focused account of a specific dimension of rural mothers’ postpartum social and emotional experiences. While the authors anticipated themes related to multigenerational support, postpartum family support, and community support due to the rurality of the setting, we were surprised to uncover more universal themes related to motherhood. Perhaps the most compelling finding is how participants experienced social and emotional powerlessness, which directly impacted their postpartum recovery. As mentioned in the literature review, a mother’s sense of self-efficacy, self-esteem, and empowerment has been found to impact maternal mental health (Fenwick et al., 2003; Molloy et al., 2021). Given the importance of autonomy as one of the fundamental principles of ethical behavior, according to the National Board for Certified Counselors (NBCC; 2023) and the American Counseling Association (ACA; 2014), the findings of this study highlight an important area of advocacy for the counseling profession. Participants in this study described proximal and systemic factors that impacted their experience of social and emotional powerlessness. Participants referenced these proximal factors through the way they described not having a choice or voice regarding their care during and after childbirth. Across the participants in this study, the experiences during and immediately after childbirth seemed to set a tone for their postpartum recovery, with powerlessness at birth serving as a precursor to powerlessness postpartum. Some of the participants hinted at what has been referred to in the anthropological literature as a technocratic model of birth whereby the birth experience is characterized by mechanistic separation and control, reducing mothers’ autonomy during birth (Davis-Floyd, 2004). Although this reference to this technocratic model pertains specifically to childbirth, the initial childbirth experiences of participants described as mechanical, separate, and informed by external control in this study point to the development of longerterm postpartum social and emotional powerlessness. This social and emotional powerlessness and autonomy might be related to the development of postpartum anxiety and depression. Although social support has been found to decrease the probability of a mother developing postpartum depression (Cho et al., 2022), it is possible, therefore, that social and emotional powerlessness may also contribute to the development of postpartum anxiety and depression. Although this relationship can be surmised through the findings of this study, additional explanatory (i.e., causal) analyses are needed to further confirm the social and emotional determinants of postpartum distress, such as powerlessness. Another important finding is that rural mothers desired and expressed an active openness to support their postpartum social and emotional experiences. Participants identified postpartum needs such as sustaining physiological routines, emotional processing of postpartum experiences, and exploring postpartum selfhood and identity. However, the participants in this study described experiencing barriers to supporting their postpartum social and emotional experience due to systemic barriers that impacted their ability to realize this desired support. The help-seeking theme reported in this study highlights that participants desired social and emotional help-seeking that was ultimately thwarted based on a variety of sociocultural factors such as geographic isolation, mental health stigma,
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