Antenatal depression: mothers’ awareness and professional responses

Abstract

Increasingly, attention is shifting away from a focus on postnatal depression to the recognition that depression may be a recurrent experience in many women’s lives with the perinatal period constituting a time of particular vulnerability. This article reports on a study undertaken in one primary care trust which explored mothers’ and practitioners’ experience and awareness of antenatal depression and considered the service response offered by midwives and health visitors. The mothers who participated in focus groups felt ill prepared for the possibility that depression could occur during pregnancy. They identified social and role expectations as well as professional attitudes and service delivery models as barriers to disclosing feelings of depression during this period. The midwives and community nurses surveyed placed rather less emphasis than mothers on the value of continuity of care in pregnancy in promoting disclosure of mental health problems. Community midwives appeared less confident than health visitors in detecting and responding to antenatal depression but both groups of professionals had little knowledge of relevant community services. Co-ordination between midwives and health visitors appeared limited and contact with mental health services was lower than might have been anticipated; the general practitioner (GP) was still seen as the key resource in cases of antenatal depression. However, many of the mothers participating in the study found GPs unresponsive to expressions of negative feelings in pregnancy. The article considers approaches for increasing awareness and detection of antenatal depression and improving co-ordination between services.