Not identifying with postnatal depression: a qualitative study of women’s postnatal symptoms of distress and need for support

Coates, Rose; Visser, Richard O. de; Ayers, Susan

doi:10.3109/0167482x.2015.1059418

Cited by 32 publications

(34 citation statements)

References 32 publications

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“…Many women in this study reported a lack of knowledge about PNA, which left them feeling distressed and confused about their symptoms, and acted as a barrier to seeking and receiving support. In line with research by Coates et al (40), most women in this study did not identify with descriptions of PND, so had little sense of what was actually wrong with them; particularly as the majority of perinatal mental health information, screening and interventions focuses on depression. The uncertainty of their situation seemed to feed their anxiety, and thus should be a primary target for intervention.…”

Section: Pna-specific Information and Supportsupporting

confidence: 58%

Supporting perinatal anxiety in the digital age; A qualitative exploration of stressors and support strategies.

Harrison

Moore

2020

Preprint

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Background: The period surrounding childbirth is one of profound change, which can often be experienced as stressful and overwhelming. Indeed, around 20% of women may experience significant levels of anxiety in the perinatal period. However, most women experiencing perinatal anxiety (PNA) go unrecognised and untreated. The Internet offers a potentially scalable solution to improve access to support, however a dearth of research in this area means that work is needed to better understand women’s experience of PNA, so that potential targets for intervention can be identified and possible barriers to support overcome. This study aimed to qualitatively explore women’s experience of anxiety triggers and support in the perinatal period; and gain insight into what online support is acceptable for women with PNA. Methods: Women who were either pregnant or within one-year post-partum were invited to participate in focus groups across the UK. Focus groups were used to allow a diversity of perspectives to be heard, while simultaneously promoting the identification and prioritisation of important support needs and solutions. Interviews were transcribed and thematically analysed.Results: Five key themes emerged in relation to women’s experience with PNA: holding unrealistic expectations of birth and motherhood; stigma; the importance of peer support; uncertainty and poor maternal confidence; and a lack of mental health support and knowledge. Perinatal women felt under-supported and poorly prepared for motherhood. A mismatch between their expectations and the reality of their experience, alongside a pressure to be the ‘perfect mum’ was the primary source of their anxiety. Furthermore, stigma associated with PNA may have exacerbated these issues and led to help-seeking avoidance. Overall, women felt these issues could be addressed via online support, through the delivery of more realistic information, providing psychoeducation about PNA symptoms and management, and the inclusion of authentic peer experiences. Thus, delivering evidence-based information and interventions online may provide a solution that is acceptable to this cohort. Conclusions: This work provides unique insight into potential sources of anxiety for women in the perinatal period, while also offering potential internet-based support solutions that are likely to be acceptable and helpful for women with PNA.

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Section: Pna-specific Information and Supportsupporting

confidence: 58%

Supporting perinatal anxiety in the digital age; A qualitative exploration of stressors and support strategies.

Harrison

Moore

2020

Preprint

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“…Study results revealed that mothers with 6-month old infants rated their maternal experience as more positive than negative and that mothers' appraisal of their pregnancy significantly predicted their appraisal of early motherhood. Other researchers found that mothers did not identify with the concept of postnatal depression and that the health-care system did not recognize symptoms of postnatal distress other than postnatal depression (Coates et al, 2015). It is important for health-care professionals to offer postnatal care that addresses mothers' emotional needs (Fenwick et al, 2013) and their unrealistic expectations of motherhood that have been socially constructed by their social norms and environment (Choi et al, 2005).…”

Section: My Mother Was Not a Good Parent And I Didn't Want To End Up mentioning

confidence: 99%

“It's Hard Being a Mama”: Validation of the Maternal Distress Concept in Becoming a Mother

Copeland¹,

Harbaugh²

2019

J Perinat Educ

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New mothers actively adapt to new demands and challenges in the mothering role but some may find this adjustment difficult and distressing, depending on their perceptions and resources. Previous research on maternal distress is primarily concentrated on needs of mothers with depression but nonpathological approaches of viewing difficulties in early parenting should be explored. A secondary analysis of a descriptive, qualitative study was completed on new, low-income mothers in early parenthood to determine how maternal distress influences mothers' transition to becoming a mother and to validate the use of the Maternal Distress Concept in the clinical setting. Findings reveal new mothers experience maternal distress on various levels: stress, adaptation, functioning, and connecting. Implications for practice and education are discussed.

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“…Women not necessarily diagnosed as depressed may benefit from support in ways which then have developmental significance for infants, therefore universal provision of social-support packages should be considered. Coates et al (2015), in a small qualitative study involving in-depth interviews with new mothers, found that women wanted support to be on offer regardless of whether a mental-health diagnosis had been made and that the availability of post-natal support should be 'normalised' and universal. Coates et al (2014) note that therapeutic support could explore psychological processes such as 'distancing, guilt and self-blame' across different types of emotional difficulties.…”

Section: Social Support With Mothersmentioning

confidence: 99%

“…Moreover, as noted above, traumatising birth experiences are often overlooked and women left unsupported with unresolved feelings expected to just get on with it. Coates et al (2015) note that 'forms of emotional distress', other than PND, are often overlooked. Furthermore, anthropological research would seem to indicate that a healthy bond and secure base can be provided for babies by the regular involvement of several key caregivers (Blaffer Hrdy 1999;Lancy 2014); an overemphasis on a perceived need for one primary caregiver (the mother) in Western cultures may be part of what leads to PND and anxiety (Hogan 2012).…”

Section: Maternal Wellbeing: Further Reflectionsmentioning

confidence: 99%

The value of art therapy in antenatal and postnatal care: A brief literature review with recommendations for future research

Hogan¹,

Sheffield

Woodward

2017

International Journal of Art Therapy

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There is a very small body of literature addressing the use of the arts or art therapy in antenatal and post-natal care, and much of it is qualitative, including some rich and complex data which is worthy of discussion and consideration. Overall, it points to a promising use of supportive and therapeutic arts in this area. This article presents some background on the use of the arts specifically focusing on post-natal depression and birth trauma. It then moves on to present a brief survey of literature in the field, followed by some further reflections and discussion about further research needed to establish clinical utility and economic viability. Background: Post-natal depression (PND). By 2020 the number of births in England is predicted to increase to 691,038 per annum. Around 87% of women give birth in hospital-based obstetric units today, whilst survey evidence suggests that the vast majority of women would rather have a homebirth or use a midwifery unit (National Maternity Review 2016 p.20). Rates of maternal mortality have fallen to around 9 deaths per 100,000 births in the UK, with a significant cause of maternal death in the UK being suicide (Cantwell et al. 2011; Oates 2013, National Maternity Review 2016). Mental ill health is acknowledged as the largest cause of disability in the UK and post-natal depression (PND) is a significant public health problem (Downey and Coyne, 1990; Almond, 2009; Oates et al., 2004; World Health Organisation, 2010). Conservative estimates suggest that postnatal depression in England and Wales costs the NHS at least £45 million per annum (Knapp et. al., 2011). More recent figures for perinatal depression, psychosis and anxiety, posit a much higher global figure, with long-term costs at £8.1 billion per year in the UK (Bauer et al. 2014). Of these costs, nearly three-quarters (72%) relate to adverse impacts on children; the total figure equates to around £10,000 for each birth (Bauer, 2014, p. 1). Moreover, it is estimated that about half of all cases of perinatal depression and anxiety

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Not identifying with postnatal depression: a qualitative study of women’s postnatal symptoms of distress and need for support

Cited by 32 publications

References 32 publications

Supporting perinatal anxiety in the digital age; A qualitative exploration of stressors and support strategies.

Supporting perinatal anxiety in the digital age; A qualitative exploration of stressors and support strategies.

“It's Hard Being a Mama”: Validation of the Maternal Distress Concept in Becoming a Mother

The value of art therapy in antenatal and postnatal care: A brief literature review with recommendations for future research

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