Healthcare professionals’ experiences and perceptions of providing support for mental health during the period from pregnancy to two years postpartum

Pope, Johanna; Redsell, Sarah; Houghton, Catherine; Matvienko-Sikar, Karen

Abstract

Objective: Mental health issues in the perinatal period are common, and can have negative consequences for maternal and child health. Healthcare professionals (HCPs) who provide women with perinatal care are well-placed to detect mental health issues and provide support. This study therefore examines HCPs’ experiences and perceptions of providing mental health support during the perinatal period, including during the COVID-19 pandemic.

Design: An exploratory realist qualitative study was conducted.

Setting: Republic of Ireland

Participants: A purposive sampling strategy was employed to recruit HCPs (e.g., general practitioners, midwives, public health nurses, practice nurses, doulas, and breastfeeding counsellors), via professional bodies in Ireland. An invitation to participate was also circulated via Twitter. A total of 18 HCPs participated in semi-structured interviews conducted between 18/8/2020 and 24/5/2021.

Measurements and findings: Semi-structured interviews were conducted according to a topic guide designed by a multidisciplinary team. Data were analysed using thematic analysis. Four themes were developed: ‘Supporting women in healthcare settings,’ ‘Skills and capacity to provide adequate care,’ ‘Structural barriers to care provision,’ and ‘The impact of the COVID-19 pandemic on stress support.’

Key conclusions: HCPs reported providing emotional support and advocacy, but highlighted challenges, including limited capacity to address women's concerns, clinical culture and hierarchy, insufficient organisational investment, and social inequities in support access. Some HCPs felt these barriers could lead to additional psychological harm. HCPs also reported that the pandemic had introduced novel stressors and changed the nature of the mental health support they provided.

Implications for practice: Interventions incorporating education and physical resources for HCPs, increased investment in specialist perinatal mental health services, increased investment in holistic supports, and changes to address cultural challenges in care environments, may facilitate – or enhance – support for women.

Citation

Pope, J., Redsell, S., Houghton, C., & Matvienko-Sikar, K. (2023). Healthcare professionals’ experiences and perceptions of providing support for mental health during the period from pregnancy to two years postpartum. Midwifery, 118, Article 103581. https://doi.org/10.1016/j.midw.2022.103581

• Journal Article Type: Article
• Acceptance Date: Dec 20, 2022
• Online Publication Date: Dec 24, 2022
• Publication Date: 2023-03
• Deposit Date: Jan 5, 2023
• Publicly Available Date: Dec 25, 2023
• Journal: Midwifery
• Print ISSN: 0266-6138
• Publisher: Elsevier
• Peer Reviewed: Peer Reviewed
• Volume: 118
• Article Number: 103581
• DOI: https://doi.org/10.1016/j.midw.2022.103581
• Keywords: Maternity and Midwifery; Obstetrics and Gynecology
• Public URL: https://nottingham-repository.worktribe.com/output/15715082
• Publisher URL: https://www.sciencedirect.com/science/article/pii/S0266613822003291?via%3Dihub