Care and self-reported outcomes of care experienced by women with mental health problems in pregnancy: Findings from a national survey.
Jane Henderson, Julie Jomeen, Maggie Redshaw
PMID 29145155WHAT IT FOUND
Women who reported mental health problems in pregnancy had more postnatal depression and anxiety, poorer baby relationships, and felt staff listened less.
Support, advice and treatment were associated with mixed outcomes.
Key findings
01Women who reported a mental health problem in pregnancy had more postnatal depression, anxiety and poorer relationships with their babies.
02They received more antenatal checks and saw the same named midwife more often, but rated staff interaction less positively and were less satisfied with information, choice and involvement.
03Two-thirds of women with antenatal mental health problems received advice or support and one-third received treatment, but receiving support or advice was associated with more depression, especially at one month.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
The survey had a 47% response rate and under-represented young women, single mothers, women born outside the UK and women in deprived areas. Women's antenatal mental health problems were self-reported and not explicitly defined or clinically diagnosed. Because the data were collected after birth and analysed cross-sectionally, the survey cannot show that support, advice or treatment caused better or worse outcomes. Missing values were high for some composite outcome variables. The association between receiving support or advice and depression was reduced after adjusting for whether women had consulted a professional for anxiety or depression, so severity may confound the finding.
The easy way to misread this
Do not conclude that support or advice made postnatal depression worse. This is a cross-sectional survey, and adjusting for whether women sought professional help for anxiety or depression reduced the association.