TY - JOUR

T1 - Acceptability of identification and management of perinatal anxiety: a qualitative interview study with postnatal women

AU - Meades, Rose

AU - Moran, Patricia

AU - Hutton, Una

AU - Khan, Rafiyah

AU - Maxwell, Margaret

AU - Cheyne, Helen

AU - Delicate, Amy

AU - Shakespeare, Judy

AU - Hollins, Kathryn

AU - Pisavadia, Kalpa

AU - Doungsong, Pim

AU - Edwards, Rhiannon Tudor

AU - Sinesi, Andrea

AU - Ayers, Susan

N1 - Copyright © 2024 Meades, Moran, Hutton, Khan, Maxwell, Cheyne, Delicate, Shakespeare, Hollins, Pisavadia, Doungsong, Edwards, Sinesi and Ayers.

PY - 2024/11/7

Y1 - 2024/11/7

N2 - BACKGROUND: Anxiety in pregnancy and postpartum is highly prevalent but under-recognized and few women receive adequate support or treatment. Identification and management of perinatal anxiety must be acceptable to women in the perinatal period to ensure that women receive appropriate care when needed. We aimed to understand the acceptability to women of how anxiety was identified and managed by healthcare professionals.METHOD: We conducted in-depth qualitative interviews with 60 women across England and Scotland approximately 10 months after birth. Women were sampled from an existing systematically recruited cohort of 2,243 women who recorded mental health throughout pregnancy and after birth. All women met criteria for further assessment of their mental health by a healthcare professional. We analyzed the data using a theoretical framework of acceptability of healthcare interventions.RESULTS: Interview data fitted the seven constructs within the theoretical framework of acceptability. Women valued support before professional treatment but were poorly informed about available services. Services which treated women as individuals, which were accessible and in which there was continuity of healthcare professional were endorsed. Experience of poor maternity services increased anxiety and seeing multiple midwives dissuaded women from engaging in conversations about mental health. Having a trusted relationship with a healthcare professional facilitated conversation about and disclosure of mental health problems.CONCLUSION: Women's experiences would be improved if given the opportunity to form a trusting relationship with a healthcare provider. Interventions offering support before professional treatment may be valued and suitable for some women. Clear information about support services and treatment options available for perinatal mental health problems should be given. Physiological aspects of maternity care impacts women's mental health and trust in services needs to be restored. Findings can be used to inform clinical guidelines and research on acceptable perinatal care pathways in pregnancy and after birth and future research.

AB - BACKGROUND: Anxiety in pregnancy and postpartum is highly prevalent but under-recognized and few women receive adequate support or treatment. Identification and management of perinatal anxiety must be acceptable to women in the perinatal period to ensure that women receive appropriate care when needed. We aimed to understand the acceptability to women of how anxiety was identified and managed by healthcare professionals.METHOD: We conducted in-depth qualitative interviews with 60 women across England and Scotland approximately 10 months after birth. Women were sampled from an existing systematically recruited cohort of 2,243 women who recorded mental health throughout pregnancy and after birth. All women met criteria for further assessment of their mental health by a healthcare professional. We analyzed the data using a theoretical framework of acceptability of healthcare interventions.RESULTS: Interview data fitted the seven constructs within the theoretical framework of acceptability. Women valued support before professional treatment but were poorly informed about available services. Services which treated women as individuals, which were accessible and in which there was continuity of healthcare professional were endorsed. Experience of poor maternity services increased anxiety and seeing multiple midwives dissuaded women from engaging in conversations about mental health. Having a trusted relationship with a healthcare professional facilitated conversation about and disclosure of mental health problems.CONCLUSION: Women's experiences would be improved if given the opportunity to form a trusting relationship with a healthcare provider. Interventions offering support before professional treatment may be valued and suitable for some women. Clear information about support services and treatment options available for perinatal mental health problems should be given. Physiological aspects of maternity care impacts women's mental health and trust in services needs to be restored. Findings can be used to inform clinical guidelines and research on acceptable perinatal care pathways in pregnancy and after birth and future research.

KW - Adult

KW - Anxiety

KW - England

KW - Female

KW - Humans

KW - Interviews as Topic

KW - Patient Acceptance of Health Care/statistics & numerical data

KW - Perinatal Care

KW - Postpartum Period/psychology

KW - Pregnancy

KW - Pregnancy Complications/therapy

KW - Qualitative Research

KW - Scotland

U2 - 10.3389/fpubh.2024.1466150

DO - 10.3389/fpubh.2024.1466150

M3 - Article

C2 - 39575102

VL - 12

SP - 1466150

JO - Frontiers in Public Health

JF - Frontiers in Public Health

SN - 2296-2565

M1 - 1466150

ER -