Maternal Perinatal Mental Health and Multiple Births: Implications for Practice

Fisher, Jane; Stocky, Andrew

doi:10.1375/twin.6.6.506

Cited by 19 publications

(32 citation statements)

References 39 publications

(64 reference statements)

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“…Maternal psychological morbidities are less widely recognized, but nonetheless prevalent (Fisher & Stocky, 2003). In one study of mothers of multiples at 3 months postpartum, 43% described themselves as being anxious, 30% depressed, and 76% exhausted (Hay et al, 1990).…”

Section: Introductionmentioning

confidence: 99%

Multiple Birth Families With Children With Special Needs: A Qualitative Investigation of Mothers’ Experiences

et al. 2012

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Multiple birth remains prevalent, with prematurity and subsequent disability being common complications. However, little is known of the experiences of mothers living with the combined circumstances of multiple birth, prematurity, and special needs. This paper reports an exploratory study using the qualitative technique of thematic analysis, to describe and interpret the experiences of 10 mothers of prematurely born multiple birth children with diverse special needs. Mothers were shocked to learn they were carrying multiple fetuses, including those who underwent in vitro fertilization with dual embryo transfer. Most experienced protracted concern over one or more babies’ survival during pregnancy, and prescribed bed rest was frequently associated with increased anxiety and other adverse psychological effects. Some experienced disenfranchised grief, such as those grieving the opportunity to bear a single child. The contrast with experiences of mothers of healthy, term singletons caused considerable distress. Feelings of detachment and unreality were common in the immediate postpartum period, possibly due to transient depersonalization. Having more than one newborn created practical and psychological problems during the neonatal period, particularly when infants were separated due to differences in medical status. The extent to which hospitals accommodated the multiple birth relationship varied and significantly affected mothers’ postnatal experiences. Mothers often felt guilty, particularly regarding inequality of care and attention they were able to provide to each child. This was especially problematic for multiples discordant for special needs status. The presence of one normally developing child complicated adjustment to the other's difficulties, and several experienced chronic sorrow. Serious maternal mental health difficulties were common but not universal. Available formal supports were generally perceived as inadequate, addressing some, but not all, of the mothers’ needs. Further work is needed to advance understanding of the relationships between mothers and their multiples, and to explore the implications of special needs within multiple birth families.

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Section: Introductionmentioning

confidence: 99%

Multiple Birth Families With Children With Special Needs: A Qualitative Investigation of Mothers’ Experiences

et al. 2012

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“…11 En realidad, la ansiedad experimentada por una madre acerca de la salud y el bienestar de sus hijos es observable en todos los embarazos, pero se intensifica especialmente en el caso de embarazos múltiples. Según el estudio de Fisher y Stocky, 12 en el caso de haber tenido una historia previa de infertilidad, las consecuencias pueden ser aún más negativas, debido a lo idealizado que los padres pueden tener el embarazo, y a la subestimación de los riesgos reales que puede conllevar. El problema surge cuando estos padres, teniendo miedo acerca del bienestar de sus hijos y de su capacidad para cuidarlos, creen no tener derecho a expresar esta ambivalencia después del tratamiento que han seguido.…”

Section: Ansiedadunclassified

“…El problema surge cuando estos padres, teniendo miedo acerca del bienestar de sus hijos y de su capacidad para cuidarlos, creen no tener derecho a expresar esta ambivalencia después del tratamiento que han seguido. 12 Que exista un mayor riesgo de presentar síntomas ansiosos no implica que éstos siempre se presenten, pero sí que puede aparecer un "mayor nivel de estrés en la mujer que se somete a un tratamiento de fertilidad, siendo mayor su preocupación acerca de su capacidad para ser buena madre". 8 Esta afirmación, sin embargo, no es apoyada por otros datos que concluyen que existe una mayor ansiedad acerca del cuidado de los niños en el caso de mujeres que tienen un embarazo múltiple de forma natural.…”

Section: Ansiedadunclassified

Evolución de los partos múltiples en la región de Murcia desde 1.996 hasta 2.008: implicaciones

et al. 2011

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“…Previous studies that evaluated psychopathological disorders in multiple pregnancies have demonstrated increased incidence of depression and anxiety (Baor & Blickstein, 2005;Campbell et al, 2004;Colpin et al, 1999;Ellison & Hall, 2003;Fisher & Stocky, 2003;Kalra et al, 2003;Klock, 2004;Leonard, 1998;Nys et al, 1998;Roca de Bes et al, 2008;Thorpe et al, 1991;Vilska et al, 2009;Yokoyama, 2003). Cataldo et al (2003) point out that the risks of multiple pregnancy bring about greater stress, and relate to the development of depression and anxiety (Pereira & Lovisi, 2008), increasing the risks of this type of pregnancy (DaSilva et al, 1998;Kennedy & Suttenfield, 2001;Loreto, 2003;Misri, 2000).…”

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confidence: 99%

Twin Pregnancies: Evaluation of Major Depression, Stress, and Social Support

et al. 2013

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Background: Twin pregnancies are at increased physiological and psychosocial risks. Objective: To investigate the prevalence of major depression in twin pregnancies and correlate with stress and social support. Method: The study included 51 pregnant women under specialized prenatal care who were evaluated by a Portuguese version of the semi-structured questionnaire Primary Care Evaluation of Mental Disorders (PRIME-MD) for Major Depression, and the Prenatal Psychosocial Profile (PPP) for evaluation of stress and social support. Results: Major depression was found in 33.3% of pregnant women, and prevailing symptoms were fatigue or loss of energy (100%), insomnia or hypersomnia (82.4%), changes in appetite (82.4%), decreased interest in daily activities (82.4%), and psychomotor agitation or retardation (82.4%). Among pregnant women who were diagnosed depressive, 76.5% also had a high level of stress and 47.1% complained about lack of social support. Statistical significance was found when correlating depression with perception of negative aspects of having twins and belief in significant body changes during pregnancy (p = .005 and .03, respectively). Marital status, occupation, and pregnancy planning were not significantly associated with the diagnosis of depression. Conclusion: Major depression occurs in one-third of pregnant women expecting twins and is associated with higher levels of stress and lack of social support. A multidisciplinary approach in these cases is fundamental to minimize further risks and complications.

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Maternal Perinatal Mental Health and Multiple Births: Implications for Practice

Cited by 19 publications

References 39 publications

Multiple Birth Families With Children With Special Needs: A Qualitative Investigation of Mothers’ Experiences

Multiple Birth Families With Children With Special Needs: A Qualitative Investigation of Mothers’ Experiences

Evolución de los partos múltiples en la región de Murcia desde 1.996 hasta 2.008: implicaciones

Twin Pregnancies: Evaluation of Major Depression, Stress, and Social Support

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