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Healthcare professionals failing to spot range of postnatal disorders

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Healthcare professionals are failing to investigate psychological disorders beyond postnatal depression in mothers leaving them feeling “alienated” and “discounted”, a study has found.

More must be done to identify a wider range of symptoms of distress following birth, with health visitors playing a greater role in assessment, it added.

The study, published in the Journal of Psychosomatic Obstetrics and Gynecology, looked at whether classification and assessment of postnatal mental health problems were adequate in addressing the range of emotional distress experienced by mothers.

“There was a perception that health professionals were focussed on postnatal depression”

Study on postnatal symptoms of distress

Researchers conducted in-depth interviews with 17 women in the south east of England aged 23 to 42 with a baby under one year old who experienced a postnatal mental health problem.

They found women did not identify with postnatal depression and felt other forms of emotional distress were not recognised by the healthcare system.

Feeling tearful and anxious were the most frequently reported symptoms, but tearfulness was not necessarily related to feeling low but with various emotions such as frustration and feeling unable to cope.

Nearly three quarters of the respondents said they were “bereft of information, advice and support about types of distress other than depression”.

“Additionally, there was a perception that health professionals were focussed on postnatal depression and once it had been ruled out there was no further investigation,” said the report.

“Incorporating a holistic approach… into recent initiatives such as the Healthy Child Programme could be timely and beneficial”

Study on postnatal symptoms of distress

Researchers noted the number of postnatal contacts health visitors are expected to make as part of the Healthy Child Programme in England could enable better identification of multiple symptoms and risk factors.

They also questioned whether the Edinburgh Postnatal Depression Scale, which is the most commonly used assessment for postnatal depression, should continue to omit many symptoms of other disorders.

“Although no assessment tool is going to include every symptom felt by every distressed mother, the absence of items relating to feeling stressed, angry and frustrated particularly warrants attention,” they said.

The researchers also suggested using one screening tool at a single point in time may not be effective and said multiple opportunities for women to discuss their emotions was necessary.

“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 mothers.

“Incorporating a holistic approach focussing on the birth, the mother and her relationships into recent initiatives such as the Healthy Child Programme could be timely and beneficial,” concluded the study.

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