“Nobody Listened”. Mothers’ Experiences and Needs Regarding Professional Support Prior to Their Admission to an Infant Mental Health Day Clinic

Abstract

Challenges during the perinatal period can lead to maternal distress, negatively affecting mother-infant interaction. This study aims to retrospectively explore the experiences and needs regarding professional support of mothers with difficulties in mother-infant interaction prior to their admission to an infant mental health day clinic. In-depth semi-structured interviews were conducted with 13 mothers who had accessed an infant mental health day clinic because of persistent severe infant regulatory problems impairing the wellbeing of the infant and the family. Data were transcribed and analyzed using the Qualitative Analysis Guide of Leuven (QUAGOL). Three themes were identified: ‘experience of pregnancy, birth, and parenthood’; ‘difficult care paths’; and ‘needs and their fulfillment’. The first theme consisted of three subthemes: (1) ‘reality does not meet expectations’, (2) ‘resilience under pressure’, and (3) ‘despair’. Mothers experienced negative feelings that were in contradiction to the expected positive emotions associated with childbirth and motherhood. Resilience-related problems affected the mother-child relationship, and infants’ regulatory capacities. Determined to find solutions, different healthcare providers were consulted. Mothers’ search for help was complex and communication between healthcare providers was limited because of a fragmented care provision. This hindered the continuity of care and appropriate referrals. Another pitfall was the lack of a broader approach, with the emphasis on the medical aspects without attention to the mother-child dyad. An integrated care pathway focusing on the early detection of resilience-related problems and sufficient social support can be crucial in the prevention and early detection of perinatal and infant mental health problems.

A Supported Online Resilience-Enhancing Intervention for Pregnant Women: A Non-Randomized Pilot Study

“…Additionally, the intervention was specifically designed for expectant mothers incorporating multiple components: resilience-enhancing exercises, online group sessions and a peer support platform. These components were selected based on the needs of mothers whose resilience was under pressure during pregnancy and the first year after childbirth [46]. Ayers et al [47] stated that intervention research needs to move away from a 'one-size fits all' approach [47].…”

Development of a resilience-enhancing intervention during and after pregnancy: a systematic process informed by the behaviour change wheel framework

“…A systematic review by Scope et al (2017) [ 34 ] suggests that how information is provided, is important because of the existing stigma regarding perinatal mental health problems and asking for this type of information. Realistic information about common experiences can promote more informed expectations about the changes that come with the transition to parenthood, which supports resilience [ 25 ]. There is a need for prenatal programmes that aim to promote resilience by stimulating existing protective factors and taking into account women’s perspectives on resilience and perinatal mental health.…”

“…Participants were recruited in a semi-residential infant mental health facility in a psychiatric centre in Belgium [ 25 ]. This facility focuses on families of infants with persistent regulatory and/or developmental problems.…”

“…Based on these criteria, 21 out of 42 mothers admitted to the infant mental health services were eligible. Of these, 13 mothers gave consent to take part in the study [ 25 ].…”

“…All concepts used were listed, evaluated, and discussed by members of the research team (SVH, MB, AB). For further details on the recruitment, data collection, and analysis, we refer to the study of Nuyts et al (2021) [ 25 ], since this phase was part of a broader research project.…”