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What enables or prevents women with depressive symptoms seeking help in the postnatal period?

02 April 2019
15 min read
Volume 27 · Issue 4

Abstract

Background

Perinatal mental health problems affect approximately 20% of women. The most common condition is postnatal depression; however, many women do not seek help.

Aims

To identify and synthesise evidence on factors that enable or prevent help-seeking in women with depressive symptoms in the postnatal period.

Methods

A qualitative systematic review was conducted using electronic databases and pre-determined eligibility criteria.

Findings

Thematic synthesis of the included studies (n=4) identified the following themes: the influence of healthcare services, the influence of others and the influence of women themselves. Help-seeking was shaped by women's ability to recognise their symptoms, the reactions (experienced or anticipated) of others and the organisation of services.

Conclusion

An improved interface between maternity and mental health services and enhanced health professional interactions are needed. However, meaningful change may require empowering women's self-assessment and public health messages to improve understanding of postnatal depression.

Up to 20% of women experience a mental health problem in the perinatal period, (the period spanning conception to 1 year after birth) (Bauer et al, 2014). The immediate and long-term costs of perinatal anxiety and depression are estimated at £6.6 billion for each year of births in the UK, equating to approximately £8500 per woman giving birth (Bauer et al, 2014; 2016). The costs reflect the immediate and transgenerational effects of perinatal mental health, which affect the woman, her child and family through, for example, children's emotional and behavioural development and interparent relationships (Letourneau et al, 2013; Norhayati et al, 2015; Oakhill, 2016). In the UK, suicide is the leading direct cause of maternal death in the postnatal year (Knight et al, 2017). Routine assessment of mental health by midwives, including symptoms of depression, was introduced in the UK approximately 10 years ago (National Collaborating Centre for Mental Health, 2007) and remains a key priority for service delivery.

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