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Mental health in pregnancy and postpartum period

Mental health in pregnancy and postpartum in period

Mental health survey among reproductive healthcare providers reveals particular areas of low awareness in terms of symptoms and treatment.

Mental health is important to everybody, and it’s a topic that deserves discussion and action all year round. World Mental Health Day aims to raise awareness of issues related to mental health and support global efforts toward making mental health care available to all.

In support of World Mental Health Day, we’re highlighting research around pregnancy and postpartum mental health. Mental illness related to pregnancy can have long-lasting consequences for both parent and child, so it is crucial that healthcare providers are aware of the issues that can affect pregnant people.

Pregnancy and the first year after birth is a time of emotional and physical stress, placing significant strain on the mental health of the parent. Given the potential risk to both parent and baby, early detection and intervention is vital - and increased attention on maternal mental health is needed in all settings.

A paper recently published in Journal of Pregnancy, entitled Mental Health Problems during Pregnancy and the Postpartum Period: A Multicenter Knowledge Assessment Survey among Healthcare Providers, assessed Sri Lankan healthcare workers’ knowledge of perinatal mental health problems. As well as the clear risks to the parent, mental health problems in pregnancy are also associated with low birth weight, delayed development, and malnutrition in the child in low- and middle-income countries. Despite this risk, and a higher incidence of maternal mental health problems, far less research has been done on maternal mental health in low- and middle-income countries compared to high-income countries.

In this study, a team of researchers, led by Malitha Patabendige (registrar in Obstetrics and Gynaecology based at North Colombo Teaching Hospital, Sri Lanka), invited 300 reproductive healthcare providers comprising nurses, midwives and obstetric ward medical officers to fill out a questionnaire. Reproductive healthcare providers tend to have the most contact with parents over the course of pregnancy and early childhood, so can be considered the medical professionals best-placed to assess parental mental health. Just over half of those contacted completed the survey. The 152 respondents were asked about their experience and knowledge of mental health problems related to pregnancy and the postpartum period, including risk factors, symptoms and potential consequences. 

Overall awareness of this issue was good, but the survey revealed particular areas of low awareness in terms of symptoms and treatment. For example, less than half of those surveyed knew about the Edinburgh Postnatal Depression Scale, which is the standard assessment for diagnosing postnatal depression, and only just over a third were aware that excessive worrying about the baby’s health can be a symptom of mental health problems. There was also a lack of awareness around the special medical attention needed and existence of specific treatments for these conditions.

The final part of the survey asked the healthcare professionals for their suggestions on how to improve maternal mental health care. As well as suggesting training programmes and workshops to improve their patient care, respondents also highlighted the need for improved health education in patients themselves, and their families. Improving awareness of maternal mental health problems in the whole community helps to ensure that pregnant people are aware of when and where to seek advice and medical attention, and that their families know what symptoms to look out for.

The results of this study provide a framework for improving perinatal mental health policy in Sri Lanka, revealing specific areas for improvement in staff training and supporting the widespread implementation of psychiatric units in maternity hospitals. Although this survey was only carried out across three hospitals, the questionnaire itself could be used in future qualitative studies as a basis for assessing mental health awareness in maternity hospitals in other low- and middle-income countries, thereby presenting an opportunity to improve knowledge of perinatal mental health around the world. 

Read the full study >> 


This blog post is distributed under the Creative Commons Attribution License (CC-BY). Illustration adapted from Adobe Stock by David Jury.

Article of the Year Award: Outstanding research contributions of 2021, as selected by our Chief Editors. Read the winning articles.