Unplanned pregnancies are a unique, yet significant risk factor in perinatal mental health. Our aim was to create an assessment tool to assess mother's views on contraception as part of the discharge planning process. We used a quantitative-qualitative approach. A clinician-guided questionnaire was completed by patients prior to their discharge from hospital and analysed using Microsoft Excel. Semi-structured interviews were used to explore views regarding family planning in greater depth. Interviews were recorded and transcribed verbatim onto Microsoft Word. Emerging themes were identified using a grounded theory thematic analysis approach. Eighteen inpatients were assessed at the Bethlem Mother and Baby Unit over a 4-month period (May-August 2015). Half of the women stated that the pregnancy was unplanned. The most common contraception methods used were condoms, followed by no method/natural cycle technique. Forty-four percent felt unsure of contraception options available and were keen for further advice and referral to family planning services. Interestingly, almost all the women interviewed stated that their experience of perinatal mental illness had changed their views on having more children. The contraception assessment tool is a short, simple questionnaire that can be adopted across inpatient and community settings. In cooperating family, planning into the discharge care plan could be protective in preventing future unplanned pregnancies in women at high risk of perinatal mental illness relapse. Performing the assessment also provided an added opportunity for psycho-education regarding reproductive health and medication use during the perinatal period. The tool also encouraged liaison with GPs and local family planning services.
Childbirth brings biological, socioeconomical, and psychological changes to women. Health professionals need to understand fully the mother's understanding of the concept of motherhood and family. Not only psychologists and psychiatrists but also all the health staff who are working in perinatal medicine are recommended to have receptive listening skills in communication. Then it is important to receive education and training on maternal mental health to provide their service. The staff must know that most risk factors which lead women to suffer disturbances of mental health are identified during pregnancy period and that severity is different between the normal range of maternal worries and psychiatric symptoms. Prevention, care, and treatment strategy throughout this period should be well designed to be carried out in a multidisciplinary way to women at risk or in need of care. Stigma of mental illnesses is an obstacle for women who seek emotional and psychiatric support. Maternal mental care system starting from pregnancy which covers all kinds of problems is important for well-being of mothers and their families.
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