Exploring women’s experiences of identifying, negotiating and managing perinatal anxiety: a qualitative study

Oh, Soo Kyung; Chew‐Graham, Carolyn; Silverwood, Victoria; Shaheen, Sirah Aksa; Walsh-House, Jacqualyn; Sumathipala, Athula; Kingstone, Tom

doi:10.1136/bmjopen-2020-040731

Cited by 19 publications

(20 citation statements)

References 32 publications

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“… 83 84 Fear of judgement could prevent women from openly discussing their health concerns and delay help-seeking during the perinatal period. 85 Findings suggest that mHealth interventions can provide support to pregnant women and mothers who may feel hesitant to seek support in person due to the fear of being judged. The flexible nature of mHealth interventions enables accommodating users’ specific needs and tailoring the programme to their preferences (eg, cultural, literacy, language preferences).…”

Section: Discussionmentioning

confidence: 96%

“…Young women encountering decisions about abortion and infant feeding are at risk of social judgements and discrimination 83 84. Fear of judgement could prevent women from openly discussing their health concerns and delay help-seeking during the perinatal period 85. Findings suggest that mHealth interventions can provide support to pregnant women and mothers who may feel hesitant to seek support in person due to the fear of being judged.…”

Section: Discussionmentioning

confidence: 99%

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Effects of mHealth on the psychosocial health of pregnant women and mothers: a systematic review

et al. 2022

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ObjectiveTo investigate the roles of mobile health, or mHealth, in the psychosocial health of pregnant women and mothers.MethodsA systematic search was conducted in databases and grey literature including MEDLINE, Web of Science, CINAHL, PsycINFO, PsycARTICLES, Academic Search Complete, SocINDEX, Central Register of Controlled Trials, The Database of Abstracts of Reviews of Effects, NHS Economic Evaluation Database, Health Technology Assessment, UNICEF and WHO databases. Two searches were conducted to include original research articles published in English until 15 November 2021. Several tools were used to assess the risk of bias: revised Cochrane risk of bias tool for randomised trials, Risk of Bias in Non-randomized Studies of Interventions, National Heart, Lung, and Blood Institute quality assessment tool for cohort and cross-sectional studies, Critical Appraisal Skills Program checklist for qualitative studies and Mixed Methods Appraisal Tool for mixed-methods studies. Certainty of evidence was assessed using Grading of Recommendations Assessment, Development and Evaluation approach. Due to the high heterogeneity and variability of the included studies, data synthesis was conducted narratively.Results44 studies were included among 11 999 identified articles. Most studies reported mixed findings on the roles of mHealth interventions in the psychosocial health of pregnant women and mothers; mHealth improved self-management, acceptance of pregnancy/motherhood and social support, while mixed results were observed for anxiety and depressive symptoms, perceived stress, mental well-being, coping and self-efficacy. Furthermore, pregnant women and mothers from vulnerable populations benefited from the use of mHealth to improve their psychosocial health.ConclusionsThe findings suggest that mHealth has the potential to improve self-management, acceptance of pregnancy/motherhood and social support. mHealth can also be a useful tool to reach vulnerable pregnant women and mothers with barriers to health information and facilitate access to healthcare services. However, the high heterogeneity limited the certainty of evidence of these findings. Therefore, future studies should identify the context under which mHealth could be more effective.

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Section: Discussionmentioning

confidence: 96%

Section: Discussionmentioning

confidence: 99%

Effects of mHealth on the psychosocial health of pregnant women and mothers: a systematic review

et al. 2022

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“…The findings from this study are additive and complementary to the existing qualitative literature focused on prenatal people’s experiences with anxiety. The themes captured in this study reflect common themes highlighted across the literature, including stigma around perinatal mental health concerns and pregnancy as a period of uncertainty, in particular during the first trimester [ 1 , 2 , 4 ]. Of note, this study is the first to examine prenatal people’s experiences with anxiety using online public blog entries.…”

Section: Discussionmentioning

confidence: 89%

“…However, prolonged anxiety that is difficult to manage can be disruptive to everyday functioning and indicate an anxiety disorder. Qualitative research exploring pregnant and postpartum people’s experiences with prenatal, otherwise known as antenatal, anxiety have identified common elements across these experiences, including help-seeking barriers, a discrepancy between pregnancy expectations and lived experience, and the importance of peer support [ 1 – 4 ]. One online resource that allows prenatal people to ask questions about their physical and mental health and receive advice is blogs.…”

Section: Introductionmentioning

confidence: 99%

How do prenatal people describe their experiences with anxiety? a qualitative analysis of blog content

Pierce

Reynolds

Hardman

et al. 2022

BMC Pregnancy Childbirth

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Background Despite elevated prevalence rates of prenatal (antenatal) anxiety across studies (13–21%), and prenatal people’s use of the Internet to search for pregnancy-related information and support, research investigating prenatal people’s experiences with online mental health communication, such as blogs, is lacking. This study examined blog entries focused on anxiety in pregnancy to better understand prenatal people’s Internet discourse concerning their experiences with anxiety. Methods A Google search using the keywords “anxiety,” “pregnant,” and “blog” resulted in N = 18 blogs that met inclusion criteria (public blog written in English describing a personal experience with prenatal anxiety in 250 words or more). Blog content was analyzed using a thematic analytic approach based on grounded theory principles. Results Three main themes capturing prenatal people’s experiences with anxiety as written in public blog content were developed from qualitative analyses: 1) etiology (subthemes: before pregnancy, during the current pregnancy, related to a previous pregnancy), 2) triggers (subthemes: uncertainty, perceived lack of control, and guilt and shame for not having a normal pregnancy), and 3) symptoms (subthemes: intertwined emotional, cognitive and physical symptoms, in addition to behavioural symptoms). Conclusions Our findings demonstrate a need for perinatal professionals to address anxiety symptoms and triggers in pregnancy. One way to address this may be by providing credible information regarding prenatal mental and physical health to pregnant people through online mediums, such as blogs. Bloggers often discussed experiencing a combination of emotional, cognitive, physical, and behavioural symptoms, which suggests that medical and mental health professionals should work collaboratively to provide care for prenatal people experiencing anxiety. Furthermore, Cognitive Behavioural Therapy (CBT) addresses these types of symptoms, which suggests that interventions developed or adapted to meet this populations’ needs could employ this therapeutic approach. Future research should explore the reasons why prenatal people experiencing anxiety engage with blogs, the characteristics of bloggers and readers, the impact of the blogging experience on both the blogger and their audience, and the information quality of blog content.

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“…There also remains uncertainty around what constitutes ‘risk’ and the need for additional care in pregnancy. Women experiencing anxiety may also under-report this on the self-identification measure due to fear of being judged or worry that this would be considered a sign of poor parenting [ 24 , 25 ]. Answering ‘yes’ to the individual symptoms of anxiety as elicited by the EPDS – which women may or may not associate with anxiety – may be perceived as more acceptable than self-identifying as having anxiety.…”

Section: Discussionmentioning

confidence: 99%

Identifying postnatal anxiety: comparison of self-identified and self-reported anxiety using the Edinburgh Postnatal Depression Scale

Fellmeth

Harrison

McNeill

et al. 2022

BMC Pregnancy Childbirth

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Background Identifying women with perinatal anxiety is important in order to provide timely support and prevent adverse outcomes. Self-report instruments are commonly used in maternity settings. An alternative is to ask women directly whether they self-identify as having anxiety. We examine the agreement between self-reported and self-identified anxiety at 3 months postpartum and compare the characteristics of women with self-reported and self-identified anxiety. Methods A secondary analysis of national maternity surveys conducted in 2014 in England and Northern Ireland was conducted. Self-reported anxiety was assessed using the Edinburgh Postnatal Depression Scale anxiety subscale (EPDS-3A). Agreement between self-reported and self-identified anxiety was measured using Cohen’s kappa. Logistic regression was used to identify characteristics of women in each group. Results In our sample of 6752 women, 14.2% had self-reported anxiety, 5.9% had self-identified anxiety and 3.5% were positive on both measures. Among those with self-identified anxiety, 58.1% also had self-reported anxiety. Of those with self-reported anxiety, 24.4% also had self-identified anxiety. Statistical agreement between the two measures was minimal with Cohen’s kappa 0.283 at an EPDS-3A threshold of ≥6. Among both self-identified and self-reported anxiety groups, psychological factors were the strongest associated factors. Women with self-reported anxiety had higher odds of being from Northern Ireland (OR 1.81); having a mixed or unhappy reaction to the pregnancy (OR 1.65); living without a partner (aOR 1.37); and antenatal depression (aOR 1.32). Women with self-identified anxiety had higher odds of physical problems (OR 1.84); and being of Black or minority ethnicity (OR 0.39). Conclusions Asking postnatal women directly whether they self-identify as having anxiety identifies a different group of women from those who score highly on self-report measures. Women with self-identified anxiety may benefit from further follow-up and support.

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Exploring women’s experiences of identifying, negotiating and managing perinatal anxiety: a qualitative study

Cited by 19 publications

References 32 publications

Effects of mHealth on the psychosocial health of pregnant women and mothers: a systematic review

Effects of mHealth on the psychosocial health of pregnant women and mothers: a systematic review

How do prenatal people describe their experiences with anxiety? a qualitative analysis of blog content

Identifying postnatal anxiety: comparison of self-identified and self-reported anxiety using the Edinburgh Postnatal Depression Scale

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