Academic Scientific JournalsHow do new mothers perceive screening for perinatal depression?
Keywords:
mental health, postpartum depression, Edinburgh Postnatal Depression Scale, screening, perinatal careAbstract
Background
Countries recognize the risk of mental health difficulties during the perinatal period and the potential benefits of screening and early detection of depressive symptomatology. This study aimed to analyse mothers’ views on screening for postpartum depression (PPD) in Poland, where a new standard of perinatal care imposed (from January 2019) the obligation to monitor women’ postpartum mental state.
Material and methods
150 women participated in the study. In the first stage, PPD symptoms were assessed with the Edinburgh Postnatal Depression Scale (EPDS) among postpartum women during midwives’ home visits. The second stage consisted of a telephone survey with the EPDS and questions exploring mothers’ perception of midwife competencies in screening for PPD.
Results
Most women identified as relatively high midwives’ competencies in communicating information about PPD, interpretation of the EPDS score and their ability to create comfortable conditions of the assessment and further discussion about postpartum mental health changes. Women with an elevated level of PPD symptoms assessed as significantly lower midwives’ competence in this last aspect and those who had a caesarean section tend to assess as lower the usefulness of provided information on care of a newborn.
Conclusions
Midwives should be aware and prepared for a possible critical attitude of patients, which may be a sign of a depression. Otherwise, medical staff may not be willing to interact with a mother and offer her help and support. The ability to create a friendly condition in spite of adversity can contribute to the desire of women to undergo screening, discussion about the result and further treatment.
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References
Andersson, L., Sundström-Poromaa, I., Wulff, M., Åström, M., & Bixo, M. (2004). Implications of antenatal depression and anxiety for obstetric outcome. Obstetrics & Gynecology, 104, 467–476. https:// doi.org/10.1097/01.AOG.0000135277.04565.e9.
Bayrampour, H., McNeil, D. A., Benzies, K., Salmon, C., Gelb, K., & Tough, S. (2017). A qualitative inquiry on pregnant women’s preferences for mental health screening. BMC Pregnancy and Childbirth, 17, 339. https://doi.org/10.1186/s12884-017-1512-4.
Beattie, P. G., Rings, T. R., Hunter, M. F., & Lake, Y. (1994). Risk factors for wound infection following caesarean section. Australian and New Zealand Journal of Obstetrics and Gynaecology, 34, 398–402. https://doi.org/10.1111/j.1479-828X.1994.tb01256.x.
Beck, A. T. (1964). Thinking and depression: II. Theory and therapy. Archives of General Psychiatry, 10, 561–571. https://doi.org/10.1001/archpsyc.1964.01720240015003.
Christensson, K., Siles, C., Cabrera, T., Belaustequi, A., de la Fuente, P., Lagercrantz, H., Puyol, P., & Winberg, J. (1993). Lower body temperatures in infants delivered by caesarean section than in vaginally delivered infants. Acta Paediatrica, 82, 128–131. https://doi.org/10.1111/j.1651-2227.1993.tb12622.x.
Chrzan-Dętkoś, M., & Walczak-Kozłowska, T. (2020). Antenatal and postnatal depression – Are Polish midwives really ready for them? Midwifery, 83, 102646. https://doi.org/10.1016/j.midw.2020.102646.
Cornford, C. S., Hill, A., & Reilly, J. (2007). How patients with depressive symptoms view their condition: a qualitative study. Family Practice, 24, 358–364. https://doi.org/10.1093/fampra/cmm032.
Cox, J. L., Holden, J. M., & Sagovsky, R. (1987). Detection of postnatal depression. Development of the 10-item Edinburgh Postnatal Depression Scale. British Journal of Psychiatry, 150, 782–786. https:// doi.org/10.1192/bjp.150.6.782.
Dayan, J., Creveuil, C., Marks, M. N., Conroy, S., Herlicoviez, M., Dreyfus, M., & Tordjman, S. (2006). Prenatal depression, prenatal anxiety, and spontaneous preterm birth: a prospective cohort study among women with early and regular care. Psychosomatic Medicine, 68, 938–946. https://doi. org/10.1097/01.psy.0000244025.20549.bd.
Dinos, S., Stevens, S., Serfaty, M., Weich, S., & King, M. (2004). Stigma: The feelings and experiences of 46 people with mental illness. Qualitative study. The British Journal of Psychiatry, 184, 176–181. https:// doi.org/10.1192/bjp.184.2.176.
Dziennik Ustaw (2018, poz. 1756). Rozporządzenie Ministra Zdrowia z dnia 16 sierpnia 2018 r. w sprawie standardu organizacyjnego opieki okołoporodowej [Journal of Laws of the Republic of Poland (2018 item 1756).
Regulation of the Minister of Health of August 16, 2018 on the organizational standard of perinatal care].
Earls, M. F., Yogman, M. W., Mattson, G., Rafferty, J., & Committee on Psychosocial Aspects of Child and Family Health (2019). Incorporating recognition and management of perinatal depression into pediatric practice. Pediatrics, 143, e20183259. https://doi.org/10.1542/peds.2018-3259.
Felder, J. N. (2019). Implementing the USPSTF recommendations on prevention of perinatal depression – opportunities and challenges. JAMA Internal Medicine, 179, 467–468. https://doi.org/10.1001/ jamainternmed.2018.7729.
Feltham, C. (2016). Depressive realism: Interdisciplinary perspectives. Taylor & Francis.
Fonseca, A., Gorayeb, R., & Canavarro, M. C. (2015). Women’s help-seeking behaviours for depressive symptoms during the perinatal period: Sociodemographic and clinical correlates and perceived barriers to seeking professional help. Midwifery, 31, 1177–1185. https://doi.org/10.1016/j. midw.2015.09.002.
Goldenberg, R. L., Culhane, J. F., Iams, J. D., & Romero, R. (2008). Epidemiology and causes of preterm birth. The Lancet, 371, 75–84. https://doi. org/10.1016/S0140-6736(08)60074-4.
Grote, N. K., Bridge, J. A., Gavin, A. R., Melville, J. L., Iyengar, S., & Katon, W. J. (2010). A meta-analysis of depression during pregnancy and the risk of preterm birth, low birth weight, and intrauterine growth restriction. Archives of General Psychiatry, 67, 1012–1024. https://doi.org/10.1001/archgenpsychiatry.2010.111.
Haaga, D. A., & Beck, A. T. (1995). Perspectives on depressive realism: Implications for cognitive theory of depression. Behaviour Research and Therapy, 33, 41–48. https://doi.org/10.1016/0005-7967(94)E0016-C.
Herishanu-Gilutz, S., Shahar, G., Schattner, E., Kofman, O., & Holcberg, G. (2009). On becoming a first-time mother after an emergency caesarean section: a journey from alienation to symbolic adoption. Journal of Health Psychology, 14, 967–981. https://doi.org/10.1177/135910530934120.5
Jomeen, J., Glover, L. F., & Davies, S. A. (2009). Midwives’ illness perceptions of antenatal depression. British Journal of Midwifery, 17, 296–303. https:// doi.org/10.12968/bjom.2009.17.5.42221.
Jones, C. J., Creedy, D. K., & Gamble, J. A. (2011). Australian midwives’ knowledge of antenatal and postpartum depression: a national survey. Journal of Midwifery & Women’s Health, 56, 353–361. https://doi.org/10.1111/j.1542-2011.2011.00039.x.
Jones, C. J., Creedy, D. K., & Gamble, J. A. (2012a). Australian midwives’ awareness and management of antenatal and postpartum depression. Women and Birth, 25, 23–28. https://doi.org/10.1016/j.wombi.2011.03.001.
Jones, C. J., Creedy, D. K., & Gamble, J. A. (2012b). Australian midwives’ attitudes towards care for women with emotional distress. Midwifery, 28, 216–221. https://doi.org/10.1016/j.midw.2010.12.008.
Kendig, S., Keats, J. P., Hoffman, M. C., Kay, L. B., Miller, E. S., Moore Simas, T. A., Frieder, A., Hackley, B., Indman, P., Raines, C., Semenuk, K., Wisner, K. L., & Lemieux, L. A. (2017). Consensus bundle on maternal mental health: Perinatal depression and anxiety. Journal of Obstetric, Gynecologic & Neonatal Nursing, 46, 272–281. https://doi.org/10.1016/j. jogn.2017.01.001.
Kingston, D. E., Austin, M. P., McDonald, S. W., Vermeyden, L., Heaman, M., Hegadoren, K., Lasiuk, G., Kingston, J., Sword, W., Jarema, K., Veldhuyzen van Zanten, S., McDonald, S. D., & Biringer, A. (2015a). Pregnant women’s perceptions of harms and benefits of mental health screening. PLoS One, 10, e0145189. https://doi.org/10.1371/journal.pone.0145189.
Kingston, D. E., Biringer, A., McDonald, S. W., Heaman, M. I., Lasiuk, G. C., Hegadoren, K. M., McDonald, S. D., Veldhuyzen van Zanten, S., Sword, W., Kingston, J. J., Jarema, K. M., Vermeyden, L., & Austin, M. P. (2015b). Preferences for mental health screening among pregnant women: a cross-sectional study. American Journal of Preventive Medicine, 49, e35–e43. https://doi.org/10.1016/j.amepre.2015.03.026.
Kingston, D. E., Biringer, A., Toosi, A., Heaman, M. I., Lasiuk, G. C., McDonald, S. W., Kingston, J., Sword, W., Jarema, K., & Austin, M. P. (2015c). Disclosure during prenatal mental health screening. Journal of Affective Disorders, 186, 90–94. https:// doi.org/10.1016/j.jad.2015.07.003.
Knight, M., Nair, M., Tuffnell, D., Shakespeare, J., Kenyon, S., & Kurinczuk, J. J. (2017). Saving lives, improving mothers’ care – lessons learned to inform maternity care from the UK and Ireland confidential enquiries into maternal deaths and morbidity 2014-2016. National Perinatal Epidemiology Unit, University of Oxford.
Kozhimannil, K. B., Pereira, M. A., & Harlow, B. L. (2009). Association between diabetes and perinatal depression among low-income mothers. JAMA, 301, 842–847. https://doi.org/10.1001/jama.2009.201.
Kurki, T., Hiilesmaa, V., Raitasalo, R., Mattila, H., & Ylikorkala, O. (2000). Depression and anxiety in early pregnancy and risk for preeclampsia. Obstetrics & Gynecology, 95, 487–490. https://doi.org/10.1016/ S0029-7844(99)00602-X.
Logsdon, M. C., Tomasulo, R., Eckert, D., Beck, C., & Dennis, C. L. (2012). Identification of mothers at risk for postpartum depression by hospital-based perinatal nurses. MCN: The American Journal of Maternal/Child Nursing, 37, 218–225. https://doi. org/10.1097/NMC.0b013e318251078b.
McIntosh, J. (1993). Postpartum depression: Women’s help‐seeking behaviour and perceptions of cause. Journal of Advanced Nursing, 18, 178–184. https:// doi.org/10.1046/j.1365-2648.1993.18020178.x.
Mollart, L., Newing, C., & Foureur, M. (2009). Midwives’ emotional wellbeing: Impact of conducting a structured antenatal psychosocial assessment (SAPSA). Women and Birth, 22, 82–88. https://doi. org/10.1016/j.wombi.2009.02.001.
Netsi, E., Pearson, R. M., Murray, L., Cooper, P., Craske, M. G., & Stein, A. (2018). Association of persistent and severe postnatal depression with child outcomes. JAMA Psychiatry, 75, 247–253. https:// doi.org/10.1001/jamapsychiatry.2017.4363.
Nicole, L., Duffett‐Leger, L., Stewart, M., Hegadoren, K., Dennis, C. L., Rinaldi, C. M., & Stoppard, J. (2007). Canadian mothers’ perceived support needs during postpartum depression. Journal of Obstetric, Gynecologic & Neonatal Nursing, 36, 441–449. https:// doi.org/10.1111/j.1552-6909.2007.00174.x.
O’Hara, M. W., & McCabe, J. E. (2013). Postpartum depression: Current status and future directions. Annual Review of Clinical Psychology, 9, 379–407. https:// doi.org/10.1146/annurev-clinpsy-050212-185612.
Orr, S. T., & Miller, C. A. (1995). Maternal depressive symptoms and the risk of poor pregnancy outcome: Review of the literature and preliminary findings. Epidemiologic Reviews, 17, 165–171. https://doi. org/10.1093/oxfordjournals.epirev.a036172.
Patel, R. R., Peters, T. J., & Murphy, D. J. (2005). Prenatal risk factors for caesarean section. Analyses of the ALSPAC cohort of 12 944 women in England. International Journal of Epidemiology, 34, 353–367. https://doi.org/10.1093/ije/dyh401.
Polityka Zdrowotna (2019). Polska z jednym z najwyższych odsetków cięć cesarskich w Europie [Poland with one of the highest caesarean section rates in Europe]. Retrieved from https://www.politykazdrowotna.com/41449,polska-z-jednym-znajwyzszych-odsetkow-ciec-cesarskich-w-europie [accessed July 21, 2020].
Roth-Kleiner, M., Wagner, B. P., Bachmann, D., & Pfenninger, J. (2003). Respiratory distress syndrome in near-term babies after caesarean section. Swiss Medical Weekly, 133, 283–288.
Rubertsson, C., Wickberg, B., Gustavsson, P., & Rådestad, I. (2005). Depressive symptoms in early pregnancy, two months and one year postpartum-prevalence and psychosocial risk factors in a national Swedish sample. Archives of Women’s Mental Health, 8, 97–104. https://doi.org/10.1007/s00737-005-0078-8.
Steger, M. F., & Kashdan, T. B. (2009). Depression and everyday social activity, belonging, and well-being. Journal of Counseling Psychology, 56, 289–300. https://doi.org/10.1037/a0015416.
Swain, J. E., Tasgin, E., Mayes, L. C., Feldman, R., Todd Constable, R., & Leckman, J. F. (2008). Maternal brain response to own baby‐cry is affected by caesarean section delivery. Journal of Child Psychology and Psychiatry, 49, 1042–1052. https:// doi.org/10.1111/j.1469-7610.2008.01963.x.
Vikhareva Osser, O., & Valentin, L. (2010). Risk factors for incomplete healing of the uterine incision after caesarean section. BJOG: An International Journal of Obstetrics & Gynaecology, 117, 1119–1126. https://doi.org/10.1111/j.1471-0528.2010.02631.x .
Wallis, A. B., & Saftlas, A. F. (2009). Is there a relationship between prenatal depression and preeclampsia? American Journal of Hypertension, 22, 345–346. https://doi.org/10.1038/ajh.2009.28.
Wisner, K. L., Miller, E. S., & Tandon, D. (2019). Attention to prevention. Can we stop perinatal depression before it starts? JAMA Psychiatry, 76, 355–356. https://doi.org/10.1001/jamapsychiatry.2018.4085.
Wu, J., Viguera, A., Riley, L., Cohen, L., & Ecker, J. (2002). Mood disturbance in pregnancy and the mode of delivery. American Journal of Obstetrics and Gynecology, 187, 864–867. https://doi.org/10.1067/ mob.2002.127126.
Xu, H., Ding, Y., Ma, Y., Xin, X., & Zhang, D. (2017). Caesarean section and risk of postpartum depression: a meta-analysis. Journal of Psychosomatic Research, 97, 118–126. https://doi.org/10.1016/j.jpsychores.2017.04.016.
