The impact of antenatal mental distress on functioning and capabilities: views of health care providers and service users in Cape Town, South Africa

Abstract

Purpose: Antenatal mental distress has disabling consequences. It affects functioning and participation in daily activities and can lead to postnatal depression. This study employs the International Classification of Functioning Disability and Health (ICF), to explore the experiences of pregnant women with mental distress attending the Perinatal Mental Health Project (PMHP). The analysis also adopts Amartya Sen’s capabilities approach to provide suggestions for appropriate interventions. Methods: We conducted in-depth interviews with seven pregnant women experiencing antenatal mental distress, three postnatal women who had experienced antenatal mental distress and seven health care providers all affiliated with the PMHP. We used an open-ended interview guide employing domains from the ICF as well as from the capabilities approach. Findings: Participants attributed their antenatal mental distress to a range of environmental factors. Difficulties in functioning were reported by participants including difficulties at work and caring for children. Participants stated that services provided by the PMHP have a positive impact on functioning and capabilities. Conclusion: The study suggests that the ICF is useful for exploring the impact of antenatal mental distress on functioning. It is well complemented by the capabilities approach to inform interventions.

Implications for Rehabilitation

• Antenatal mental distress is a significant public health issue that impacts on women’s functioning and participation exacerbated by social factors such as poverty and exposure to violence.

• This study explored restrictions in functioning and participation faced by women with antenatal mental distress including the ability to care for children, find meaningful employment and sustain relationships.

• Counselling services can play a role in restoring functioning and capabilities for women experiencing antenatal mental distress.

• Counselling services have the ability to discuss restrictions in functioning caused by antenatal mental distress with their clients and to offer support for creating capabilities once functioning has improved.

• Antenatal mental distress
• capabilities
• ICF
• South Africa

Acknowledgements

We wish to acknowledge the staff at the facilities where the research was conducted for accommodating and assisting the researcher. We also wish to acknowledge the PMHP staff for their assistance and support with the research.