Professor Anne Buist, Dr Justin Bilszta, Jennie Ericksen, Professor Jeanette Milgrom
beyondblue Victorian Centre of Excellence
Project completion year
Recent evidence suggests that although strategies exist to identify mothers with emotional distress, many women still face significant barriers when attempting to access appropriate services and support. This project aimed to gain an in-depth understanding of how women with perinatal depression access help and to evaluate the personal and community beliefs, attitudes and barriers that influence this process.
The project involved a series of focus groups with:
- women accessing treatment for perinatal depression and/or anxiety
- key stakeholders involved in the management and treatment of women – maternal child health nurses, psychologists/counsellors, mutual support groups and mental health specialists.
A number of themes emerged:
Coping and failure – One of the most often repeated comments from the women involved in this project was a need to be seen to be keeping up appearances. Many women felt that they entered a downward spiral and completely lost confidence in their ability to be a mother.
Lack of knowledge – Many women reported not knowing how to identify or distinguish between the normal emotional and psychological adjustment associated with parenthood and being “depressed”. Perinatal depression was often seen as not being “real depression” and was not perceived to be as serious as other forms of mental illness or other types of depression.
Fear, stigma and denial – Women who develop postnatal depression still feel a high level of stigma. Women report feeling “a failure as a mother” and are concerned about “how to be a good mother”. Depression is seen as a failure, not an illness.
Interpersonal support – For many women, once they began to experience emotional distress, it put significant strain on their relationship with their partner. Family background also had an impact on women’s acknowledgement of their emotional health needs and their help-seeking behaviour.
Baby management – A majority of women identified that feelings of parenting inadequacy were often precipitated by difficulties in baby management. Many women struggled to use the baby management advice they received – they were confused by conflicting advice and wanted practical as well as emotional help.
Expectations of motherhood – Almost all the women identified a major difference between their expectations of motherhood and the reality of becoming a parent.
Help-seeking and treatment experiences – Women felt confusion about whether they were experiencing depression or normal adjustment to becoming a parent, and consequently about when to seek help. Women experiencing depression find it difficult to reach out for assistance.
Relationship with health professionals – Every mother who participated in this research project believed maternal child health nurses played a vital role in identifying and managing perinatal emotional distress. Health professionals, family and friends play a key role in providing women with the motivation to seek assistance for their depression.
Implications for policy, practice and further research
The findings of this study reinforce the important role of maternal child health nurses in identifying mothers who are at risk or suffering emotional distress, and providing them with help and support. A change in practice involving a wider group of health professionals and organisations providing assistance in the perinatal period will allow many more women to be brought to attention. All women need to be provided with information about adjustment and the transition to parenthood. The role of partners and families also needs to be encouraged. Strategies are needed that emphasise a message that seeking support and accessing services are normal parts of the perinatal journey. A media campaign should be undertaken to deconstruct the “myths-of-motherhood”.