Do psychosocial interventions have an impact on maternal perception of perinatal depression?
Poor perinatal mental health, in particular depression, affects at least 10% of new mothers in the UK. Current best practice recommends the use of talking therapies or medication; however, many women choose not to use medication or are deterred from accessing NHS services. Those who can access NHS treatment often face a long waiting list to see a clinician or therapist. Untreated perinatal depression has an impact on the health and wellbeing of women and babies, so it is essential to consider alternative psychosocial interventions delivered by non-clinicians.
This review aims to explore the effects of psychosocial interventions on maternal perception of perinatal depression.
A systematic review was conducted on seven quantitative studies examining the effect of psychosocial interventions in reducing maternal symptoms of depression. Interventions focused either on physical activity or peer support, measuring depression scores with a validated screening tool.
The seven reviewed studies considered either physical activity or peer support-based interventions. There is some evidence that antenatal group peer support may benefit women in the antenatal period and that postnatal peer telephone support may be helpful for primiparous women.
Further large-scale research is required to ascertain the effectiveness of a range of interventions in improving maternal perception of perinatal depression.
Perinatal mental health is a key issue in contemporary maternity care, with suicide continuing to be a leading cause of maternal death in the UK (Knight et al, 2014). The most recent Confidential Enquiries into Maternal Deaths and Morbidity report found that maternal death rates by indirect causes have not reduced in recent years, with a woman being more likely to die as a result of suicide (0.67/100 000) than obs tetric complications such as genital tract sepsis (0.50/100 000) (Knight et al, 2014). Perinatal mental illness is defined as a mental health condition that is prevalent in pregnancy, around childbirth or up to 1 year following birth, and may include depression, anxiety, psychosis or bipolar disorder (O'Hara and Wisner, 2014).
Although the National Institute for Health and Care Excellence (NICE, 2014) estimates that 10% of all new mothers are affected by a perinatal mental health condition, it has been argued that actual figures may be far higher as many women do not seek help (Flynn et al, 2006). Depression is the most commonly diagnosed perinatal mental illness (NICE, 2014). Perinatal depression is defined in this paper as depression, new or pre-existing, experienced during preg nancy (antenatal depression) or up to 1 year postpartum (postnatal depression). Contemporary research acknowledges that the entire period is an inter linking transitionary phase of life for women, with external factors influencing maternal mental health even prior to conception (Rallis et al, 2014). In addition, having an untreated antenatal or pre-existing mental health issue significantly increases the risk of developing a postnatal mental health condition (O'Hara and Wisner, 2014).
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