Midwives’ perceptions and experiences of caring for women who experience perinatal mental health problems: An integrative review

Abstract

the findings indicate midwives require continuous professional development opportunities that address knowledge, attitudes to PMH, communication and assessment skills. However educational and training support in the absence of appropriate referral pathways and support systems will have little benefit.

Professional issues in maternal mental health scale (PIMMHS): The development and initial validation of a brief and valid measure

“…Permission to use items from the original scale was obtained from one of the authors (MR-D). For the purposes of this study, the scale was then developed based on the contemporary literature to relate to the now recognised broader set of professional issues in PMH 4 . Questions therefore focused on a number of areas that were potentially considered adaptable, such as the midwives' and woman's willingness to discuss PMH, time, location of the assessment, Research paper stigma, cultural issues and confidence in the systems, and support available for women with PMH (see Supplementary File 1).…”

“…This has remained a significant finding in subsequent UK reports 2,3 . However, the consequences of PMHP in terms of maternal, paternal, child and societal life-threatening outcomes is well documented and acknowledged internationally 4 . In a global context, the assessment and management of perinatal mental health problems (PMHPs) is now an integral part of the midwives' role, as well as of concern to all practitioners within a maternity context 5 .…”

“…Midwives are in a unique and ideal position to effectively identify women at risk and facilitate early intervention 7 . However, a multitude of factors, including reluctance of women to disclose how they are feeling, lack of recognition of the signs of PMHPs by women and healthcare professionals 8 , and a reluctance of professionals to identify affected women because of lack of skills or resources, contribute to failure in recognition and treatment 4,9,10 . Failure to disclose may well be linked to both stigma and culture.…”

“…Interestingly, stigmatised attitudes can also be expressed in a desire to protect a woman from feeling uncomfortable and/ or being 'labelled' and lead to the failure to record mental health history and action a referral into specialist services 14 . Lack of time in maternity settings and the absence of clearly defined or timely care pathways have also been identified as barriers to the effective prediction and detection of PMHP across a decade of evidence 12,[17][18][19][20] , as well as a lack of specialist PMH teams and midwives' knowledge of available options 4 . This is supported by women's experiences of maternity care when they have mental health problems, which reflects huge inequities in service provision 9 and lack of knowledge of what services are available 21 .…”

“…This is supported by women's experiences of maternity care when they have mental health problems, which reflects huge inequities in service provision 9 and lack of knowledge of what services are available 21 . Noonan et al 4 , suggest that midwives are constrained in their ability to provide care for women in many ways but that a lack of referral options, educational and organisational supports, as well as busy practice environments, are key areas that influence midwives' confidence and practice. They state that 'future research should continue to examine the impact of contextual factors on the provision of PMH care' (p. 19).…”