Abstract
Access to treatment for postnatal anxiety and depression is dependant on women seeking help for psychological symptoms. The aim of this paper was to investigate what women themselves say about seeking help for emotional difficulties after childbirth. The Maternal Health Study is a prospective pregnancy cohort study investigating the physical and psychological health of 1,507 nulliparous women during pregnancy and after birth. One thousand, three hundred eighty-five women completed a computer-assisted telephone interview at 9 months postpartum; 8.5% of women reported intense anxiety or panic attacks occasionally or often, and 9.5% reported depressed mood, between 6 and 9 months postpartum. Of those experiencing anxiety symptoms alone 44.4% had spoken to a health professional, compared with 65.5% of women experiencing depressive symptoms alone (RR = 0.68, 95% CI—0.5 to 0.9). Measures of anxiety and depressive symptoms at 9 months postpartum were not validated against diagnostic criteria. Anxiety is a common experience in the perinatal period. More research is needed into this area to determine what levels of anxiety are ‘normal’ and acceptable to women during this period. Public health campaigns may have been more effective in encouraging women to seek help for depression than anxiety.
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References
Affonso DD, De AK, Horowitz JA, Nayberr LJ (2000) An international study exploring levels of postnatal depressive symptomatology. J Psychosom Res 49:207–216
Anderson CM, Robins CS, Greeno CG, Cahalane H, Copeland VC, Andrews RM (2006) Why lower income mothers do no engage with the formal mental health care system: Perceived barriers to care. Qual Health Res 16(7):926–943
Astbury J, Brown S, Lumley J, Small R (1994) Birth events, birth experiences and social differences in postnatal depression. Aust J Public Health 18(2):176–184
Austin M-P, Tully L, Parker G (2007) Examining the relationship between antenatal anxiety and postnatal depression. J Affect Disord 101:169–174
Bennett HA, Boon HS, Romans SE, Grootendorst P (2007) Becoming the best mom that I can: women’s experiences of managing depression during pregnancy—a qualitative study. BMC Women’s Health 7(13):1–14
Brown S, Lumley J (1998) Maternal health after childbirth: results of an Australian population based survey. Br J Obstet Gynaecol 105(2):156–161
Brown S, Lumley J (2000) Physical health problems after childbirth and maternal depression at six to seven months postpartum. Br J Obstet Gynaecol 107(10):1194–1201
Brown S, Lumley J, Small R, Astbury J (1994) Missing Voices: The Experience of Motherhood. Oxford University Press, Melbourne
Brown S, Bruinsma F, Darcy M-A, Small R, & Lumley J (2004). Early discharge: no evidence of adverse outcomes in three consecutive population-based Australian surveys of recent mothers, conducted in 1989, 1994 and 2000. Paediatr Perinat Epidemiol 18:202–213
Brown SJ, Lumley JM, McDonald EA, Krastev AH, group, i. c. w. t. M. H. S. c. (2006) Maternal Health Study: a prospective cohort study of nulliparous women recruited in early pregnancy. BMC Pregnancy and Childbirth 6:12
Buist A, Austin M-P, Hayes B, Speelman C, Bilstza J, Gemmill AW et al (2008) Postnatal mental health of women giving birth in Australia 2002–2004: findings from the beyondblue national postnatal depression program. Aust N Z J Psychiatry 42(1):66–73
Cox JL, Holden JM, Sagovsky R (1987) Detection of postnatal depression. Development of the 10-item Edinburgh Postnatal Depression Scale. Br J Psychiatry 150:782–786
Dennis CL (2004) Can we identify mothers at risk for postpartum depression in the immediate postpartum period using the Edinburgh Postnatal Depression Scale? J Affect Disord 78:163–169
Dennis C-L, Chung-Lee L (2006) Postpartum depression help-seeking barriers and maternal treatment preferences: A qualitative systematic review. Birth 33(4):323–331
Goldfield SR, Wright M, Oberklaid F (2003) Parents, infants and health care: Utilization of health services in the first 12 months of life. J Pediatr Child Health 39:249–253
Halliday J, Ellis I, Stone C (1999) WUDWAW Report on models of antenatal care. VPDCU, Melbourne
Harris B, Huckle P, Thomas R, John S, Fung H (1989) The use of rating scales to identify postnatal depression. Br J Psychiatry 154:813–817
Heron J, O’Connor TG, Evans J, Golding J, Glover V (2004) The course of anxiety and depression through pregnancy and the postpartum in a community sample. J Affect Disord 80:65–73
Holopainen D (2002) The experience of seeking help for postnatal depression. Aust J Adv Nurs 19(3):39–44
Lumley J, Austin M-P, Mitchell C (2004) Intervening to reduce depression after birth: A systematic review of the randomized trials. Int J Technol Assess Health Care 20(2):128–144
McIntosh J (1993) Postpartum depression: women’s help-seeking behaviour and perceptions of cause. J Adv Nurs 18:178–184
Milgrom J, Gemmill AW, Bilstza JL, Hayes B, Barnett B, Brooks J et al (2008) Antenatal risk factors for postnatal depression: A large prospective study. J Affect Disord 108:147–157
Murray L, Carothers AD (1990) The validation of the postnatal depression scale on a community sample. Br J Psychiatry 157:288–290
Murray D, Cox JL (1990) Screening for depression during pregnancy with the Edinburgh Postnatal Depression Scale (EPDS). J Reproductive Infant Psychol 8:99–106
Murray C, Lopez A (1996) The Global Burden of Disease. World Health Organization and Harvard University Press, Boston
O’Connor TG, Heron J, Glover V, Team TAS (2002) Antenatal anxiety predicts child behavioural/emotional problems independently of postnatal depression. J Am Acad Child Adolesc Psychiatry 41(12):1470–1477
O’Hara M, Swain AM (1996) Rates and risk of postpartum depression—meta-analysis. Int Rev Psychaitry 8:37–54
Ross LE, McLean LM (2006) Anxiety disorders during pregnancy and the postpartum period: A systematic review. J Clin Psychiatry 67(8):1285–1298
Ross LE, Gilbert Evans SE, Sellers EM, Romach MK (2003) Measurement issues in postpartum depression part I: Anxiety as a feature of postpartum depression. Arch Womens Ment Health 6:51–57
Small R, Lumley J (2007) Reduction of maternal depression: much remains to be done (letter). Lancet 370(10):1593–1595
Small R, Brown S, Lumley J (1994) Depression: Women’s Voices. In: Brown S, Lumley J, Small R, Astbury J (eds) Missing Voices: The Experience of Motherhood. Oxford Univeristy Press, Melbourne
Statacorp (2007) Stata Statistical Software Release 10. college station. Statacorp LP, College Station
Stewart S, Couser G, Schilder K, O’Hara MW, Gorman L (1998) Post-partum anxiety and depression: Onset and comorbidity in a community sample. J Nerv Dis 186:420–424
Wenzel A, Gorman LL, O’Hara MW, Stuart S (2001) The occurence of panic and obsessive compulsive disorder symptoms in women with postpartum dysphoria: a prospective study. Arch Womens Ment Health 4:5–12
Wenzel A, Haugen EN, Jackson LC, Robinson K (2003) Prevalence of generalized anxiety at eight weeks postpartum. Arch Womens Ment Health 6:43–49
Wenzel A, Haugen E, Jackson L, Brendle J (2005) Anxiety symptoms and disorders at eight weeks postpartum. Anxiety Disord 19:295–311
Whitton A, Warner R, Appleby L (1996) The pathway to care in post-natal depression: women’s attitudes to post-natal depression and its treatment. Br J Gen Pract 46:427–428
Youth and Family Services Division, Department of Human Services (1997) Maternal and Child Health Consumer Survey: Project Report. Youth and Family Services Division, Department of Human Services, Melbourne
Acknowledgments
We are extremely grateful to all of the women taking part in the study; to members of the Maternal Health Study Collaborative Group (Christine MacArthur, Kelsey Hegarty, Shaun Brennecke, Peter Wein, and Jane Yelland) who contributed to the design of study instruments and/or interpretation of data presented in the paper; to Judith Lumley and Lyn Watson who contributed to the development of the study protocol; to Creina Mitchell who assisted us in the early stage of planning recruitment methods; and to members of the Maternal Health Study research team who have contributed to data collection and coding (Marita Baum, Liesje Brice, Mary Conellan, Maggie Flood, Kay Paton, Renee Paxton, and Martine Spaull).
The National Health and Medical Research Council (NHMRC) funded the establishment of the cohort with a 5 year epidemiology grant (2002–2006). SB held a 5 year VicHealth Public Health Research Fellowship (2001–2005) and currently holds an NHMRC Career Development Award (2008–2010). Additional funding for the study has been awarded by the Medical Research and Technology in Victoria Fund (ANZ Trustees), and the William Buckland Foundation.
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The authors of this paper declare that they have no Conflicts of Interest.
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Woolhouse, H., Brown, S., Krastev, A. et al. Seeking help for anxiety and depression after childbirth: results of the Maternal Health Study. Arch Womens Ment Health 12, 75–83 (2009). https://doi.org/10.1007/s00737-009-0049-6
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DOI: https://doi.org/10.1007/s00737-009-0049-6