Research and innovation

Progress needed on mental health care in pregnancy

Gaps remain in the understanding of women’s psychological needs during and after pregnancy, despite recent improvements in clinical practice, research suggests.

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Work still needs to be done to ensure that services meet the needs of women who are experiencing mental health problems, the study concludes.

Health and social care providers should be better informed about mental wellbeing during pregnancy – and beyond – to better support those affected, researchers say.

Women interviewed for the study felt there was a need for greater awareness of mental health difficulties during pregnancy. They also said there should be a more realistic portrayal in society of this time in a woman’s life.

Despite women describing positive experiences of perinatal mental health services, they felt there was a need for earlier referrals. Participants were often referred postnatally, receiving no input during pregnancy.

Wider range

The study, from the University of Edinburgh and NHS Grampian, highlights the need for women to have access to a wider range of treatments and alternatives to medication, such as access to psychological therapies or peer support.

Researchers interviewed 11 women with moderate mental health problems from urban and rural areas in Scotland for the study.

The research findings reveal the shame and stigma pregnant women with mental health problems experienced when they did not feel the way they thought they should.

Women felt pressured by unrealistic expectations, which portray pregnancy as an idyllic time without problems, during which they should feel happy and excited.

When participants’ experiences did not match this expectation, they felt guilty, ashamed and alone, according to the study, published in the journal Psychology and Psychotherapy: Theory, Research and Practice.

Knowledge gaps

Knowledge gaps still exist despite the positive clinical practice developments of recent years, researchers say.

Angus MacBeth, Senior Lecturer in Clinical Psychology at the University of Edinburgh, said the voices of those women interviewed for the study were a powerful reminder of work still to be done.

“We need to ensure that services have an optimal fit to the needs of the individual, especially during pregnancy, as well as once the baby is born,” said Dr MacBeth.

Participants often reported feeling trapped by their thoughts. Several felt disconnected from their pregnancy and failed to experience the bond or connection that they had anticipated, reinforcing their distress.

Such feelings of guilt and shame stopped the women from seeking help and sharing their emotions with others, researchers say.

“It is vital that health and social care providers, including the third sector, are well informed about perinatal mental health, so that they can effectively engage with individuals during pregnancy,” said Dr MacBeth.

Details of the study were initially published on the British Psychological Society website.

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