The impact of postpartum social support on postpartum mental health outcomes during the COVID-19 pandemic

I've Grown a Human, but I Don't Feel Like 'Me' Anymore: Body Image Narratives in Early Motherhood in Australia

INTRODUCTION

The postpartum period can be a wonderful time for women as they embark on motherhood. However, this time is not without its surprises and challenges as new mothers support the life of another and navigate the physical and psychological changes they experience. This transformation period can often negatively impact body image and self-esteem, which can lead to further adverse health outcomes for mothers and children.

METHODS

This research employs a qualitative design of semi-structured interviews with 20 Australian mothers with at least one child under four.

RESULTS

Using reflexive thematic analysis, our study identified three key themes: (i) navigating expectation vs experience: Physical and psychological transformations in the postpartum, (ii) navigating body image in a socially influenced world, and (iii) navigating well-being in a busy world: Balancing self-care and external demands.

CONCLUSIONS

The results highlight the influence of societal thin ideals on mothers' eating attitudes, the crucial role of support networks serving as protective factors against body image concerns, and the need for enhanced education and preparation to guide women through this transformative period. SO WHAT?: The findings shed light on the lived experiences of postpartum women, providing valuable insights into the complex interplay of body image, eating attitudes, and self-care practices, sharing information for healthcare and support interventions, aiming to improve overall health and well-being for mothers.

Exploring women's postpartum experiences during the COVID-19 pandemic: A mixed-method analysis

PROBLEM

While studies across the United States have explored how the perinatal period was affected by COVID-19, most studies have focused on pregnancy and delivery rather than on women's postpartum experiences.

BACKGROUND

Postpartum is a critical period of development for mothers and newborns, with factors such as maternal mental health and quality of mother-infant bonding playing instrumental roles in children's socioemotional outcomes. Yet, COVID-19 served as a significant stressor for many women and acted as a barrier to receiving postpartum supports.

AIM

The current mixed-method analysis further elucidates women's postpartum experiences during COVID-19.

METHOD

New mothers (N = 20) completed interviews on how the pandemic impacted their postpartum experience, as well as a survey about mental health and mother-infant bonding.

FINDINGS

Thematic analysis of interview data identified four themes: Uncertainty surrounding medical care and hospital policies; Lack of connection with social supports; Increased family bonding; Access to community resources. Survey data indicated 57.9 % of participants experienced anxiety symptoms, 68.4 % experienced depressive symptoms, and 36.8 % experienced some bonding difficulty. When evaluated together, it was found that women who endorsed time away from children during hospital stays had significantly lower postpartum anxiety and less difficulty bonding compared to women who did not endorse this subtheme, while women who reported isolation from leisure activities had significantly greater difficulty with bonding.

CONCLUSION

The study highlights the importance of information sharing around community resources and indicates a need for further exploration of how various forms of social support (e.g., immediate family vs. broader networks) impact the wellbeing of postpartum women.

Evaluation of discharge training given by nurses to postpartum mothers to artificial intelligence: an alternative approach to health care

OBJECTIVE

The present study aims to evaluate the discharge training given by nurses to postpartum mothers using artificial intelligence.

METHOD

The study used a qualitative research design with a descriptive thematic approach and was conducted in a state hospital's maternity ward between April and May 2024. Sixteen nurses with varying experience levels were selected through maximum variation sampling. Data were analyzed using coding and thematic analysis to understand participants' experiences.

RESULTS

Among the nurses, 81.25% held a bachelor's degree, 43.75% had 6-10 years of experience. Postpartum discharge training emphasized baby cues, sleep management, hygiene, and routine health checks. For maternal care, focus was on rest, vaccinations, avoiding heavy activity, psychological support, exercise, and nutrition. AI provided more comprehensive guidance in both maternal and infant care.

CONCLUSION

This study highlights that AI-assisted guidance is a valuable tool in postpartum discharge training, offering effective general advice. However, human input remains essential for specific and practical recommendations.

Preliminary impact of an mHealth education and social support intervention on maternal health knowledge and outcomes among postpartum mothers in Punjab, India

BACKGROUND

Significant disruptions in the perinatal continuum of care occur postpartum in India, despite it being a critical time to optimize maternal health and wellbeing. Group-oriented mHealth approaches may help mitigate the impact of limited access to care and the lack of social support that characterize this period. Our team developed and pilot tested a provider-moderated group intervention to increase education, communication with providers, to refer participants to in-person care, and to connect them with a virtual social support group of other mothers with similarly aged infants through weekly calls and text chat.

METHODS

We analyzed the preliminary effectiveness of the pilot intervention on maternal health knowledge through 6 months postpartum among 135 participants in Punjab, India who responded to baseline and endline surveys. We described change in knowledge of maternal danger signs, birth preparedness, postpartum care use, postpartum physical and mental health, and family planning use over time between individuals in group call (synchronous), other intervention (asynchronous), and control groups.

RESULTS

Participant knowledge regarding danger signs was low overall regarding pregnancy, childbirth and the postpartum period (mean range of 1.13 to 2.05 at baseline and 0.79 to 2.10 at endline). Synchronous participants had a significantly higher increase over time in knowledge of danger signs than asynchronous and control group participants. Birth preparedness knowledge ranged from mean 0.89-1.20 at baseline to 1.31-2.07 at follow-up, with synchronous participants having significantly greater increases in comparison to the control group. Synchronous participants had nearly three-fold increased odds of postpartum health check with a clinical provider than asynchronous participants (OR 2.88, 95% CI 1.07-7.74). No differences were noted in postpartum depressive and anxiety symptoms.

CONCLUSIONS

Preliminary effectiveness results are promising, yet further robust testing of the MeSSSSage intervention effectiveness is needed. Further development of strategies to support health knowledge and behaviors and overcoming barriers to postpartum care access can improve maternal health among this population.

Postpartum Mothers' Mental Health in a Conflict-Affected Region: A Cross-Sectional Study of Emotion Regulation and Social Support

Background: The transition through pregnancy, childbirth, and postpartum significantly impacts maternal mental health, influencing both individual and family well-being. While social support and emotion regulation serve as protective factors generally, their role and impact during periods of conflict remains understudied. Methods: We conducted a cross-sectional study of 400 Jewish mothers (up to two years postpartum) from a representative sample in Israel during a period of conflict. Participants were recruited through the Sekernet platform, a validated online survey tool in Israel. The study population included Jewish mothers up to two years postpartum, aged 18-45, without a history of diagnosed mental health disorders. Inclusion criteria specified mothers aged 18-45 and within two years postpartum, while exclusion criteria included mothers under 18, over 45, more than two years postpartum, or with a history of diagnosed mental illness or psychiatric disorders. Using validated instruments, we assessed psychological well-being (PWB), anxiety (GAD-7), perceived stress (PSS), resilience (CD-RISC), emotion regulation strategies (ERQ), quality of life (WHO-5), social support (MSPSS), and post-traumatic stress symptoms (PCL-5). Additionally, exposure to conflict-related media and direct exposure to war events were measured using self-reported questionnaires evaluating frequency and type of exposure during the conflict period. Results: Cognitive reappraisal and resilience positively correlated with psychological well-being (p < 0.01), while expressive suppression and general stress negatively correlated with both psychological well-being and quality of life (p < 0.01). Mediation analysis revealed that social support significantly mediated the effects of stress on psychological well-being (β = -0.060; p < 0.05) and quality of life (β = -0.05; p < 0.05). Additionally, exposure to conflict-related media and post-traumatic stress symptoms correlated with reduced well-being and increased anxiety. Conclusions: Our findings emphasize the vital roles of social support systems and adaptive emotional regulation strategies during the postpartum period, particularly in conflict settings. Healthcare providers should implement interventions that strengthen social support networks and teach adaptive emotion regulation skills to postpartum mothers in conflict zones.

Father-to-infant attachment and its associated factors during COVID-19 pandemic: a cross-sectional study

BACKGROUND

The attachment between father and infant is essential to a child's later development and well-being; yet, hardly any research has examined father-to-infant attachment during the outbreak of COVID-19. This study, therefore, aims to examine psychological, interpersonal, and health-related factors associated with father-to-infant attachment at 3-12 months postpartum during the pandemic.

METHOD

An online cross-sectional study was conducted between June and December 2021. A total of 775 fathers with at least one child aged 3-12 months were recruited. Participants completed measures of depression, COVID-19-related distress, relationship satisfaction, social support and other health-related factors including COVID-19 diagnosis and hospitalisation. Data on psycho-socio-demographic, obstetric, and COVID-19-related characteristics were also collected.

RESULTS

Findings demonstrated that paternal depression (β = -.33, p < .001); relationship satisfaction (β = .19, p < .001); COVID-19-related psychological distress (β = -.14, p < .001) and social support (β = .13, p < .001) had a significant effect on father-to-infant attachment. Fathers who were multiparous, had COVID-19 diagnosis, and hospitalised due to COVID-19 were more likely to report poorer father-to-infant attachment. Paternal depression was the most influential factor on father-to-infant attachment, which attenuated the strength of the relationships between marital status, prematurity, history of trauma, sleep quality, and father-to-infant attachment once included into the analyses. No significant associations between educational level, employment, socioeconomic status, delivery mode, and father-to-infant attachment were observed.

CONCLUSION

These findings highlight the critical role of paternal psychological well-being in establishing healthy father-to-infant attachment and the relevance of having satisfied interpersonal relationships in promoting this early relationship particularly during crises such as COVID-19 pandemic.

Prevalence and predictors of postpartum depression in women in Kosovo

BACKGROUND

Postpartum depression (PPD) is a common mood disorder affecting women's mental health.

OBJECTIVES

This study aimed to explore the prevalence and predictors of PPD among women in Kosovo, including maternal age, economic status, mode of delivery, infant diet, and social support.

DESIGN

This is a quantitative cross-sectional study. Data were collected within a specified time.

METHODS

The Edinburgh Postnatal Depression Scale (EPDS) and Multidimensional Scale of Perceived Social Support (MSPSS) were administered to 192 women aged 18 to 49 years. Percentage, Kruskal-Wallis, Spearman's correlation, and regression analyses were used to analyze the data based on the research hypotheses.

RESULTS

The prevalence of possible PPD disorder was 49.5%. Significant differences were found in average depression based on economic status, maternal age, and diet. Although there were differences in the ranking of the means, no significant differences were found in the modes of delivery. Spearman's correlational analysis showed a significant negative relationship between PPD and the subdimensions of social support, especially family support (ρ = -0.57, p < 0.001). Multiple regression analysis revealed that maternal age, economic status, and infant diet were significant predictors of PPD (p < 0.05), whereas the mode of delivery was not a significant predictor (p > 0.05). Social support emerged as the strongest predictor, with higher perceived social support associated with lower depression scores.

CONCLUSION

These findings highlight the crucial role of social support in alleviating PPD and underscore the importance of providing support during this period to facilitate better outcomes.

Evaluating stress management approaches, types of social support and postpartum mental health during the COVID-19 pandemic: a cross-sectional study based in the United States

ABSTRACT

Objective

Reduced psychological well-being during the postnatal period may impair a birthing parent's ability to care for themselves and their child. We investigated stress management approaches, social support types, and the association between perceived social support and postpartum depression (PPD) and postpartum anxiety (PPA) among a cohort of postpartum individuals in the United States who gave birth during the COVID-19 pandemic.

Design

This study uses Wave 3 data from the COVID-19 and Reproductive Effects study. Qualitative data from previous data collection waves were used to define social support types. Multilinear regression models evaluated the association between perceived social support, PPD and PPA.

Setting

An online convenience sample.

Participants

Participants were approximately 12 months postpartum (mean 11.93 months, SD=2.03). Data were collected between July and September 2021.

Results

Complete data were available from 252 postpartum individuals (mean age=32.2 years). Playing with their children, watching television, connecting with others in person, engaging in social media and exercising were the five most commonly reported stress management strategies. Emotional support was the most commonly reported type of social support. Higher perceived social support was associated with lower PPD (B=-1.3, p value <0.0001, 95% CI=-1.7 to -0.8) and PPA (B=-2.3, p value <0.0001, 95% CI=-3.0 to -1.6).

Conclusion

Social support was an important way through which postpartum individuals managed stress during the COVID-19 pandemic. Playing with children, which may have been facilitated by work-from-home policies, and online interactions emerged as surprising adaptations to stress. Policymakers and healthcare systems should consider ways to increase opportunities for birthing parents to engage in these sorts of interactions (eg, extended parental leave policies and interventions to enhance perceived social support), especially during crises. Doing so may improve health outcomes for birthing parents and their children.

Perceived Experiences and Needs of Digital Resources Among Postpartum Women in the United Arab Emirates: Qualitative Focus Group Study

BACKGROUND

The postpartum period is a critical phase in a woman's life, marked by various physical, psychological, and social challenges. In light of the rapid proliferation and uptake of digital technologies, particularly in the United Arab Emirates (UAE), mothers increasingly seek informational and emotional support from digital resources. No previous study has thoroughly explored the usage of various digital resources beyond telehealth services in the UAE. This literature gap is particularly relevant for the postpartum period, which remains largely understudied in the UAE.

OBJECTIVE

This study aims to delve into the digital experiences of postpartum women in the UAE by exploring the types of resources they navigate and the purposes those resources serve. In addition, it seeks to identify their perspectives and needs regarding digital resources that support their postpartum journey.

METHODS

Four focus groups were conducted synchronously on the web, involving a total of 27 multicultural mothers (mean age 32.47, SD 4.56 years), between 2 and 12 months post partum and living in the UAE. Descriptive interpretive thematic analysis was used to analyze the data.

RESULTS

Sixteen out of 27 women exhibited severe depressive symptoms at the time of the discussions (Edinburgh Postnatal Depression Scale score of >12). Two main themes were generated from the analysis: (1) Mothers' Experiences with Digital Resources: Participants valued digital resources for providing immediate information, convenience, and support. They primarily used these resources to seek information on infant health, parenting advice, and emotional support through web-based communities. However, the abundance of conflicting information and the pressure to conform to health recommendations often created stress and anxiety. (2) The Perceived Need for Digital Resources: Despite their extensive use of digital resources, mothers articulated the need for a reliable UAE government digital platform tailored specifically to postpartum care, offering trusted information on infant health and postpartum mental well-being. They also emphasized the need for tailored postpartum telemedicine services and moderated web-based discussion forums to foster peer support among mothers.

CONCLUSIONS

This study reveals the multifaceted role of digital resources in supporting mothers during the postpartum period, highlighting unmet needs that present opportunities for advancing postpartum care in the UAE. It demonstrates the importance of developing reliable digital solutions for postpartum women, especially regarding mental health and to enhance access to care through tailored telemedicine services. Collaborative efforts are required to ensure the implementation of user-centered digital platforms. Future research should focus on the diverse needs of postpartum women, including cultural sensitivity, the feasibility of telemedicine services, and the integration of partner support in digital interventions to improve maternal health outcomes.

Perceived stress and prenatal depression symptoms among couples with gestational diabetes mellitus: The mediating role of dyadic coping

PROBLEM

No studies have been conducted to examine the relationships between perceived stress, positive/negative dyadic coping, and prenatal depression symptoms in Chinese couples with gestational diabetes mellitus (GDM).

BACKGROUND

GDM is a stressful event for pregnant women and their partners, which may result in clinically significant prenatal depression symptoms in couples.

AIM

This study aims to examine the relationships and differences in perceived stress, positive/negative dyadic coping, and prenatal depression symptoms between Chinese pregnant women with GDM and their partners and to explore the mediating role of positive/negative dyadic coping.

METHODS

A cross-sectional study was conducted in Guangzhou, China, from January to October 2021. 402 pairs of GDM couples completed the questionnaires, including the Edinburgh Postnatal Depression Scale, the Chinese version of the Dyadic Coping Inventory, and the Perceived Stress Scale. Dyadic data was analyzed using the actor-partner interdependence mediation model.

FINDINGS

37.6 % of pregnant women with GDM and 24.6 % of their partners experienced clinically significant prenatal depression symptoms. Depression symptoms in couples mutually influence each other. Perceived stress was directly or indirectly related to their and partners' prenatal depression symptoms in GDM couples, with negative dyadic coping acting as a mediator. Maternal negative dyadic coping was also a partner-mediator.

DISCUSSION

The findings of the present study may provide healthcare professionals with a better understanding of the effect of the interpersonal interaction between the couples as a dyad on prenatal depression symptoms in Chinese context.

CONCLUSION

There were intrapersonal and interpersonal associations among perceived stress, negative dyadic coping, and prenatal depression symptoms in pregnant women with GDM and their partners. It suggests a need for screening clinically significant prenatal depression symptoms and decreasing perceived stress and negative dyadic coping among couples with GDM with a focus on pregnant women with GDM.

The effect of the level of perceived social support in the postpartum period on maternal functioning and maternal attachment

AIM

This study aims to examine the effect of the level of perceived social support in the postpartum period on maternal functioning and maternal attachment.

METHODS

This study was conducted between January and May 2023 in two family health centers selected by simple randomization among 11 family health centers affiliated with the Health Directorate located in eastern Türkiye. The population of the study consisted of 410 mothers in the postpartum period who had babies aged 6-11 weeks old. Data were collected face-to-face using the "Personal Information Form", the "Multidimensional Scale of Perceived Social Support", the "Barkin Index of Maternal Functioning Scale" and the "Maternal Attachment Scale". Data analysis was performed using numbers, percentages, arithmetic means, independent groups t-tests, ANOVA, Pearson correlation analysis, and simple linear regression analysis.

FINDINGS

A positive, moderately significant relationship was found between maternal attachment and maternal functioning (r = 0.554; p < .05). A positive, moderately significant relationship was found between maternal attachment and perceived social support (r = 0.585; p < .05). A positive, highly significant relationship was detected between social support and maternal functioning (r = 0.861; p < .05).

CONCLUSION

This study found that postpartum women's attachment levels increased with the increase in their maternal functioning. It was also found that mothers' attachment levels increased with the increase in their perceived social support levels. Social support levels were proven to be effective on maternal functioning as well as maternal attachment. Women's maternal functioning levels were found to increase with the increase in their social support levels.

PRACTICE IMPLICATIONS

In light of these findings, pediatric nurses and obstetric nurses have great responsibilities. Starting from the prenatal period and including the postnatal period, both the mother and everyone around her should be explained the importance of social support.

Limb-girdle muscular dystrophy in pregnancy: a narrative review

Limb-girdle muscular dystrophy (LGMD) poses unique challenges for women during pregnancy, necessitating comprehensive care and tailored management strategies. The present narrative review aims to examine the unique challenges and management strategies required for women with LGMD during pregnancy. With over 30 genetic subtypes identified and the potential for additional discoveries through advanced diagnostic techniques, preconception counseling plays a crucial role in informing prospective parents about reproductive risks and available options. Baseline assessments, including cardiac and pulmonary evaluations, are essential to guide antenatal care, alongside genetic testing for precise diagnosis and counseling. Optimizing maternal health through respiratory exercises, cardiac monitoring, and individualized exercise and nutrition plans is paramount to avoid potential complications. During pregnancy, close monitoring of maternal and fetal well-being is important, with collaborative care between obstetricians and specialists. An individualized approach to delivery mode considering factors such as muscle strength, pelvic size, and fetal presentation is crucial. While vaginal delivery has been proven to be possible, the need for an emergency cesarean delivery should always be kept in mind. Regional anesthesia is preferred, with proactive planning for potential respiratory support. Bupivacaine has been shown to be effective with epidural catheters that may be used for prolonged relief with opioids like morphine and fentanyl, while also evaluating the patients' respiratory function. Postpartum considerations include pain management, mobility support, breastfeeding assistance, and emotional support. Early mobilization and tailored physiotherapy regimens may promote optimal recovery, while comprehensive breastfeeding guidance is needed to address challenges related to muscle weakness. Access to mental health resources and support networks is essential to helping individuals cope with the emotional demands of parenthood alongside managing LGMD. By addressing the unique needs of pregnant individuals with LGMD, healthcare providers can optimize maternal and fetal outcomes while supporting individuals in their journey to parenthood.

The Effect of Tele-Continuous Care on Maternal Functioning and Neonatal Perception among Iranian Primiparous Mothers: A Randomized Field Trial Study

Background/Objectives: New mothers face significant challenges during the postpartum period, which can impact their maternal performance. This study aimed to assess the effect of tele-continuous midwifery care on maternal functioning and neonatal perception in first-time Iranian mothers. Methods: A randomized controlled field trial was conducted from January to May 2023 on 48 first-time mothers in the postpartum ward at Arash Women's Hospital, Tehran. Participants were randomly assigned to either an intervention or control group. The intervention group received tele-continuous care for six weeks postpartum, while the control group received standard care. The Barkin Index of Maternal Functioning (BIMF) and the Neonatal Perception Inventory (NPI) were used to collect data in the second and sixth weeks after delivery. Data were analyzed using SPSS 26. Results: The mean age was 26.2 ± 4.8 years in the intervention group and 28.0 ± 6.1 years in the control group. An independent t-test revealed a significant difference in maternal functioning (BIMF score) between the intervention and control groups by the sixth week postpartum (p < 0.0001). A significant improvement in BIMF scores was observed within the intervention group from the second to the sixth week (p = 0.007). However, the McNemar's test on the NPI showed no significant difference in the proportions of negative and positive maternal perceptions within the intervention group (p = 0.219) and in the control group (p = 0.508). Conclusions: Tele-continuous midwifery care effectively enhances maternal functioning during the vulnerable postpartum period, highlighting the necessity of ongoing support for new mothers.

Associations between dyadic coping, marital satisfaction, and prenatal depression symptoms among couples with gestational diabetes mellitus

AIMS/BACKGROUND

Coping with gestational diabetes mellitus (GDM) presents significant challenges for pregnant women and their partners, which may result in elevated prenatal depression symptoms. However, research has predominantly centred on pregnant women with GDM, with little involvement of their partners. To understand their dyadic interactions, it is imperative to involve GDM couples in the study. This study aims to examine the interplay between dyadic coping and prenatal depression symptoms among GDM couples and to explore the possible mediating role of marital satisfaction.

DESIGN/METHOD

A cross-sectional study was conducted in Guangzhou, China. A total of 400 couples completed the Dyadic Coping Inventory, Locke-Wallace Marital Adjustment Scale, Edinburgh Postnatal Depression Scale, and sociodemographic data sheet. The actor-partner interdependence mediation model was utilised for dyadic data analysis.

RESULTS

Overall, 13.0% of pregnant women with GDM and 8.3% of partners experienced elevated prenatal depression symptoms. Dyadic coping was directly or indirectly related to their own and partners' prenatal depression symptoms in GDM couples, with marital satisfaction acting as a mediator. Specifically, positive dyadic coping was associated with lower prenatal depression symptoms, while negative dyadic coping exhibited an opposite relationship.

CONCLUSION

The prevalence of elevated prenatal depression symptoms was high in GDM couples. It is important to view pregnant women with GDM and their partners as a dyad of a transactional system in prenatal clinical care. Couple-centred interventions targeting to enhance positive dyadic coping and mitigate negative dyadic coping might be beneficial to prevent and alleviate prenatal depression symptoms.

The associations between social support and mental health among Chinese immigrant pregnant and parenting women

BACKGROUND

While it is recognized that social support can alleviate mental health symptoms, this relationship is not well-understood among Chinese pregnant and parenting immigrants in the United States. This study aims to bridge this gap by exploring the relationships between different types of social support and women's anxiety and depression, and examining how these associations vary with pregnancy status.

METHODS

Data were obtained from a cross-sectional survey conducted in Simplified Chinese or Mandarin between March-June 2021 among 526 women who were pregnant and/or parenting a child under five years. The Patient-Reported Outcomes Measurement Information System (PROMIS) Anxiety, Depression, and Social Support scales were used to measure anxiety, depression, and social support levels. Descriptive statistics, t-tests, chi-square tests, and Pearson's correlations were employed for analysis. Hierarchical regression was conducted to investigate the main and interaction effects of social support types and pregnancy status on mental health outcomes.

RESULTS

Compared to non-pregnant women, pregnant women reported higher mean scores for anxiety (non-pregnant: 55, pregnant: 59, p < 0.01) and depression (non-pregnant: 54, pregnant: 56, p = 0.02). Instrumental support displayed a significant main effect in relation to anxiety (β=-0.13, p = 0.01) and depression (β=-0.16, p < 0.01); emotional support exhibited a significant main effect solely on depression (β=-0.13, p = 0.01). Notably, the interaction effects between pregnancy status and both instrumental (β=-0.28, p = 0.01) and emotional support (β=-0.42, p < 0.01) were significant for anxiety. In contrast, informational support did not exhibit a significant impact on either anxiety or depression.

CONCLUSIONS

The findings indicate that tailoring support to the cultural context is crucial, especially for pregnant women in this Chinese immigrant community, with instrumental and emotional support being particularly beneficial in mitigating maternal anxiety.

"Finding my voice again" - women's experiences of psychological therapy in perinatal secondary care settings: a qualitative study

Introduction

Although women often experience mental health comorbidities in the perinatal period, the evidence-base for psychological therapy across diagnostic boundaries in the perinatal period remains limited. As there is a need to understand experiences of therapy, irrespective of diagnosis, to inform intervention provision, the aims of this study were to explore women's experiences of psychological therapy for perinatal mental health difficulties and to identify the mechanisms that women attributed to the most significant therapeutic change for themselves and/or the mother-infant relationship.

Method

Semi-structured interviews were conducted with 16 women who received therapy within specialist perinatal community mental health settings in the Northwest of England, the UK. Interview data were analysed using reflexive thematic analysis.

Results

One overarching theme entitled participant life stories were at the heart of therapy was identified alongside three other main themes: 1.) We're in this together - therapeutic bond and establishing a coherent sense of self, 2.) Surfing the urge to 'fix' feelings - Sitting with emotions improved regulation and 3.) Seeing myself in a new light - Shifting self-blame to self-compassion enhanced self-efficacy. Theme 1 consisted of three subthemes. Participants described the quality of the therapeutic relationship as the fundamental foundation to (re)connecting with their needs, values and boundaries, which improved their sense of agency, self-esteem, therapeutic engagement and self-understanding. Shifting emotional avoidance to emotional engagement improved their self-regulation. Considering alternative factors that could have contributed to their experiences helped them to defuse self-blame and enhance self-compassion. Finally, changes in their mental health led to positive relational changes in their relationship with their infant and improved communication with partners.

Discussion

Sensitivity, engagement and responsivity experienced in the therapist-woman relationship was reported to be mirrored in the mother-infant relationship. Developing a coherent sense of self and self-regulation skills both appeared to heighten women's self-compassion and empathy for their infants, which also seemed to improve their ability to tolerate uncertainty and mixed emotions within themselves and their infants. The mechanisms of change in the perinatal period are important to consider at a stakeholder, therapist and service management level to parsimoniously and best meet the needs of women and the mother-infant relationship.

Enhancing immigrant families' mental health through the promotion of structural and community-based support

Immigrant communities in the United States are diverse and have many assets. Yet, they often experience stressors that can undermine the mental health of residents. To fully promote mental health and well-being among immigrant communities, it is important to emphasize population-level policies and practices that may serve to mitigate stress and prevent mental health disorders. In this paper, we describe the stressors and stress experienced by immigrant families, using Sunset Park, Brooklyn as an example. We discuss ways to build structures and policies in support of equitable environments that promote mental health at the population level and enable families and their children to thrive.

Understanding the Psychological Risks to Maternal Mental Health, Maternal-Infant Bonding, and Infant Development During the COVID-19 Pandemic

This short review summarizes two recent U.S.-based studies in which researchers evaluated the impact of the COVID-19 pandemic on postpartum outcomes. The first study examined the neurodevelopmental status of infants born to women infected with SARS-CoV-2, and the second examined psychological risks to maternal-infant bonding. Results indicated that pandemic-related stressors likely contributed to diminished maternal-infant health outcomes. It is imperative that nurses stay informed on the latest science exploring the impact the pandemic has had on the health and well-being of pregnant persons and infants.

Social support during pregnancy and the risk of postpartum depression in Polish women: A prospective study

Social support has been proposed as an important determinant of women's physical and emotional well-being during pregnancy and after childbirth. Our study aimed to examine the association between the risk of postpartum depression (PPD) and perceived social support during pregnancy. A web-based prospective study survey was conducted among Polish women. The level of social support was measured with the Berlin Social Support Scales during pregnancy. Four weeks after the birth the risk of PPD was assessed using the Edinburgh Postpartum Depression Scale. Data from 932 mothers aged 19-43 (mean 30.95; SD 3.83) were analyzed using multinomial logistic regression. Higher perceived available support (emotional and instrumental), currently received support (emotional, instrumental and informational), satisfaction with the support, and sum of score were all associated with lower risk of PPD, after controlling for selected covariates (woman's age, socioeconomic status, parity status, place of residency, education, child's Apgar score, type of delivery, complications during birth, kin assisting the labor, breastfeeding). Our results suggest that the more social support the pregnant woman receives, the lower is her risk of PPD. Since humans evolved as cooperative breeders, they are inherently reliant on social support to raise children and such allomaternal help could improve maternal well-being.

Sociodemographic Correlates of Postpartum Depression: A Survey-Based Study

Objective: Post-partum depression (PPD) has been reported in about one-seventh to one-tenth of women. The aim of this study is to identify the demographic, obstetrics, social, and psychological risk factors of PPD among the eastern region of the United Arab Emirates. Method : A community-based cross-sectional study was performed on 200 women who had a recent singleton pregnancy and delivered newborn within past six months via convenience sampling and email snowballing. Several demographics, obstetrics, social, and psychological factors of the respondents were assessed using a survey form. The Edinburgh depression rating scale (EDRS) was used for the identification of women with possible PPD. Descriptive statistics were utilized for the representation of demographic variables, whereas Chi-square test was employed to assess categorical variables. Also, logistic regression was applied to evaluate the association of investigated variables and PPD. Results: The median EDRS score amongst the study participants was found to be 11 (0-26). The prevalence of PPD was found to be 57% in the studied population. Significant differences were observed in the adverse life events, emotional supports, marital conflicts and history of depression of the participants with and without PPD (P < 0.01). The risk factors significantly associated with PPD were age of the newborn (OR = 6.50, 95%CI: 1.17-19.91), marital relationship (OR = 4.15, 95%CI: 1.31-15.22), maternal educational level (OR = 5.10, 95%CI: 4.30-16.58), adverse life events (OR = 9.32, 95%CI: 1.33-35.32), and history of depression (OR = 5.24, 95%CI: 3.14-11.96). Conclusion: Given the findings, there is an urgent need for policy initiatives to address the identified risk factors, such as improving access to education, strengthening supportive marital relationships, and providing comprehensive mental health services for pregnant women.