Providing mental healthcare for postpartum women in Indonesia: a qualitative phenomenological study
In Indonesia, 26% of postpartum mothers experience perinatal mental health issues. Midwives have a vital role in supporting postpartum mothers with their mental health. The aim of this study was to determine midwives’ perceptions and experiences of providing postpartum mental healthcare.
This phenomenological qualitative study took place between November 2020 and January 2021. Data were collected through in-depth online interviews with 20 midwives working in healthcare settings in Surabaya, Indonesia, who had provided postpartum care for at least 3 years.
The data were split into midwives’ perceptions and midwives’ experiences. The four themes for midwives’ perceptions were ‘a midwife's role as a companion and supporter’, ‘mental health needs to be addressed during pregnancy’, ‘a midwife's important role providing mental healthcare for postpartum mothers’, and ‘providing holistic care, not just physical’. The six sub-themes for midwives’ experiences were ‘identifying issues by examining attitude’, ‘an intensive approach to initial treatment’, ‘collaborative care or referrals for patients who need further treatment’, ‘openness and a co-operative attitude determine success’, ‘physical and social aspects of successful healthcare’ and ‘midwives need standard guidelines’.
Midwives have an essential role in postpartum mental healthcare, and adopt an intensive approach. There is a need for national guidelines to assist midwives in providing mental healthcare.
Globally, it is estimated that around 13% of postpartum mothers experience mental health disorders, especially postpartum depression (World Health Organization, 2015). This prevalence is increasing in developing countries, which have a prevalence of almost 20% (Fisher et al, 2012; World Health Organization, 2015). In Indonesia, an estimated 26% of postpartum mothers experience depression (Nurbaeti et al, 2018). Postpartum depression, as an example of postpartum mental health disorders, can be caused by negative experiences of childbirth, but women without birth trauma may also experience it, even up to 2 years after birth (Slomian et al, 2019; Hutchens and Kearney, 2020).
Studies have identifed some causative factors, including pre-existing trauma, personality, medical conditions, birth outcomes, social support and environment (Lopez et al, 2017; MacKinnon et al, 2017; Dekel et al, 2020; Delgadillo and Gonzalez Salas Dugne, 2020). Additionally, postpartum mental health disorders can affect women of different parity, education and employment status (Knight et al, 2018). These issues can trigger lifelong negative effects for mothers, babies and families (Bradley and Slade, 2011; Knight et al, 2018; Dekel et al, 2020).
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