Not identifying with postnatal depression: a qualitative study of women’s postnatal symptoms of distress and need for support

Abstract

Introduction: Diagnoses and symptoms of postnatal mental health problems are associated with adverse outcomes for women and their families. Current classification and assessment of postnatal mental health problems may not adequately address the range or combination of emotional distress experienced by mothers. This study aims to explore symptoms of mental health problems reported by new mothers and their experiences of being assessed for these.

Methods: In-depth interviews with 17 women in southeast England with a baby under 1-year old who experienced a postnatal mental health problem. Data were analyzed using inductive thematic analysis.

Results: Women described a lack of identification with the concept of postnatal depression and felt that other forms of emotional distress were not recognized by the healthcare system. Women felt that support seeking for postnatal mental health problems needed to be normalized and that support should be available whether or not women were diagnosed. Assessment needs to be well timed and caringly implemented.

Discussion: Identification and recognition of symptoms and disorders other than postnatal depression need to be improved. Awareness of multiple types of distress needs to be raised both for women experiencing such distress, and for healthcare professionals, to enable them to support women at this time. Different approaches to assessment that include the range of symptoms reported should be piloted.

• Assessment
• postnatal anxiety
• postnatal depression
• postnatal mental health
• screening

Current knowledge on the subject

• Anxiety and adjustment disorders in the postnatal period may be as prevalent as postnatal depression.

• Screening and assessment of postnatal mental health largely focuses on postnatal depression.

What this study adds

• We provide an in-depth exploration of women’s feelings of postnatal distress beyond symptoms of depression.

• We consider assessment of multiple types of distress in postnatal women needs to be improved through evaluating different approaches to assessment and their acceptability to women.

Acknowledgements

We are grateful to all the women who dedicated time to talk to us about their experience of distress.

Declaration of interest

The authors report no conflict of interest.