Assessing mental health during pregnancy: An exploratory qualitative study of midwives’ perceptions |
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| Institution: | 1. The Royal Berkshire NHS Foundation Trust, London Road, Reading, Berkshire RG1 5AN, United Kingdom;2. Kingston University and St George''s University of London, United Kingdom;1. Department of Midwifery, Jessenius Faculty of Medicine in Martin, Comenius University in Bratislava, Malá Hora 5, Martin 036 01, Slovakia;2. Department of Physiology, Jessenius Faculty of Medicine in Martin, Comenius University in Bratislava, Malá Hora 4C, Martin 036 01, Slovakia;3. Department of Foreign Languages, Jessenius Faculty of Medicine in Martin, Comenius University in Bratislava, Malá Hora 5, Martin 036 01, Slovakia;4. Jessenius Faculty of Medicine, Biomedical Center Martin, Bioinformatics Unit, Comenius University in Bratislava, Malá Hora 4C, 036 01 Martin, Slovakia;1. Department of Epidemiology & International Public Health, School of Public Health, Bielefeld University, Universitätsstr. 25, Bielefeld 336015, Germany;2. ZIG OWL, Centre for Innovation in health care industry, Paulusstr. 1, Bielefeld 33602, Germany;3. Institute for General Practice, Hannover Medical School, Hannover, Germany;4. Department of Public Health, Brandenburg University of Technology, Senftenberg, Germany;1. Amsterdam UMC Vrije Universiteit Amsterdam, VU Medical Center, Department of Obstetrics and Gynaecology, De Boelelaan 1117, Amsterdam 1081 HV, the Netherlands;2. Department of Child Health, TNO, P.O. Box 3005, Leiden 2301 DA, the Netherlands;3. Amsterdam UMC Midwifery Science, AVAG, Van der Boechorstraat 7, Amsterdam 1081 BT, the Netherlands;4. The Netherlands Department of Clinical Psychology, Vrije Universiteit, Van der Boechorststraat 1, Amsterdam 1081 BT, the Netherlands;5. Amsterdam Public Health (APH) Research Institute, Van der Boechorststraat 7, Amsterdam 1081 BT, the Netherlands;1. School of Psychiatry, University of New South Wales, Sydney Australia;2. Karitane, Sydney Australia;3. The Mater Hospital, Sydney;4. Royal Australian and New Zealand College of Obstetricians and Gynaecologists;5. Gidget Foundation Australia;6. Australasian Birth Trauma Association;7. University of Sydney, Sydney Australia |
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| Abstract: | BackgroundMental health disorders are estimated to affect between 10% and 20% of women who access maternity services and can be defined as a public health issue due to the potential consequences for women, children and families. Detecting problems early in pregnancy can significantly improve outcomes for women and their families. However, mental health problems are not being consistently identified in routine midwifery practice and little is known from current literature about midwives’ practice in relation to current national guidelines or the impact models of care have on assessing maternal mental health.ObjectiveTo identify midwives’ views about barriers and facilitators to screening for mental health in pregnancy using current UK guidelines.DesignNine community midwives from a single district general hospital in the south of England were recruited to take part in focus groups. Thematic analysis was used to extract key themes from the data.FindingsThree key themes were identified from the focus groups and included system factors, social factors and trust. Barriers and facilitators to screening maternal mental health were associated with the initial ‘booking’ appointment’ and differences in models of care. Barriers to screening were defined as high workload, poor continuity, and a lack of trust between women and midwives.ConclusionsThis study highlights key barriers and facilitators associated with mental health screening during pregnancy, including issues of trust and uncertainty about women's willingness to disclose mental health conditions. Further research is required to evaluate the relationship between women and midwives in contemporary practice and the influence this may have on maternal mental health. |
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