Factors influencing postnatal emotional distress and barriers to help seeking
Introduction: Historically, postnatal depression (PND) has been the main focus for maternal mental health. However, there is evidence that women experience other emotional difficulties in this period. Mental health is particularly important in the postnatal period as maternal morbidity has far reaching consequences for mother, child and partner. Despite effective treatments being available a large number of women do not seek help for postnatal mental health problems. This study aims to explore emotional distress in the postnatal period and examine factors influencing postnatal emotional distress, in order to facilitate detection and prevention. It aims to gain a better understanding of what the perceived barriers to seeking help in the postnatal period may be, and explore what interventions may be acceptable to women at this time in their lives. Method: A review of the literature failed to find a measure suitable to assess barriers to help-seeking. A questionnaire was developed based on qualitative literature, interviews with postnatal women and expert opinion. This questionnaire was piloted in a pack of questionnaires including: a measure of distress (DASS-21), social support (SOS) and life events (adapted form of the LTE). The study used a cross-sectional survey design to investigate the symptomatology of depression, anxiety and stress in a group of postnatal women in West Lothian. A between subjects design was adopted to look at differences between women with and without significant levels of symptomatology. Results: The responses to questionnaires were entered into SPSS. 16.7 per cent of the sample was identified as suffering from depressive symptomatology, 9.1per cent anxiety and 18.2 per cent stress symptomatology (as identified by the DASS-21). Multiple regression revealed that stressful life events and lack of social support were predictive of postnatal emotional distress. In addition parity was predictive of depressive symptomatology. Barriers to help-seeking were influenced by social support and level of distress, suggesting that vulnerable women may be less likely to seek help. In addition information was gathered about women’s preferences for support with postnatal emotional distress. Discussion: Evidence was presented for widening the focus of PND to look at postnatal emotional distress. Risk factors predictive of distress were highlighted and interventions suggested based on these and women’s treatment preferences. Barriers to help-seeking appear to be more salient for vulnerable women, who are most in need of support. The implications of this research are relevant for policy makers and further research in aspects of perinatal and postnatal mental health.