Student midwives’ knowledge of perinatal mental health
Psychiatric illness is a leading indirect cause of maternal mortality. Earlier studies suggest serious discrepancies in the training and knowledge of midwives with regard to perinatal mental health.
To explore the knowledge and experience of student midwives in the care of women with perinatal mental health problems.
A modified questionnaire was distributed to student midwives near completion of 3-year and 78-week midwifery programmes.
Students often under-estimated the risk of women with existing mental health problems developing a serious mental health problem during pregnancy or in the postpartum period. Students felt ill-prepared and lacked confidence in caring for women with serious mental health problems.
Recommendations from the findings of this study indicate (1) a review of undergraduate midwifery education in relation to perinatal mental health is needed; (2) a larger study, involving a more diverse sample of students, would enable generalisation to a wider population.
Psychiatric illness is a leading indirect cause of maternal mortality and morbidity in the UK. A confidential report on the causes of maternal death suggests that a significant number of women die during pregnancy and in the postpartum period as a result of suicide (Centre for Maternal and Child Enquiries (CMACE), 2011). Despite recommendations to improve the care women receive, including prediction, detection and referral of mental health problems (National Institute for Health and Care Excellence (NICE), 2007), there have been no significant reductions in maternal suicide of women within 6 months of giving birth since 1997 (CMACE, 2011).
Perinatal mental illness is also associated with maternal and infant morbidity. For example, the infants of women who experience anxiety and depression during pregnancy have increased risk of intrauterine growth retardation (Kim et al, 2013) and pre-term delivery (Grote et al, 2010). Women who experience anxiety and depression are also more susceptible to developing hypertension and pre-eclampsia (Bansil et al, 2010) and have more operative deliveries than other women (Bansil et al, 2010). The behaviour and development of the child may also be affected by maternal anxiety and depression during pregnancy and in the postpartum period (Bauer et al, 2014; Glover, 2014; Graignic-Phillipe et al, 2014). For example, infants of mothers who experienced depression, stress and anxiety during pregnancy have been found to be at increased risk of developing attention deficit disorders, emotional problems and impaired cognitive development (Glover, 2014).
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