Mothers’ accounts of the impact on emotional wellbeing of organised peer support in pregnancy and early parenthood: a qualitative study

Background The transition to parenthood is a potentially vulnerable time for mothers’ mental health and approximately 9–21% of women experience depression and/or anxiety at this time. Many more experience sub-clinical symptoms of depression and anxiety, as well as stress, low self-esteem and a loss of confidence. Women’s emotional wellbeing is more at risk if they have little social support, a low income, are single parents or have a poor relationship with their partner. Peer support can comprise emotional, affirmational, informational and practical support; evidence of its impact on emotional wellbeing during pregnancy and afterwards is mixed. Methods This was a descriptive qualitative study, informed by phenomenological social psychology, exploring women’s experiences of the impact of organised peer support on their emotional wellbeing during pregnancy and in early parenthood. Semi-structured qualitative interviews were undertaken with women who had received peer support provided by ten projects in different parts of England, including both projects offering ‘mental health’ peer support and others offering more broadly-based peer support. The majority of participants were disadvantaged Black and ethnic minority women, including recent migrants. Interviews were audio-recorded and transcripts were analysed using inductive thematic analysis. Results 47 mothers were interviewed. Two key themes emerged: (1) ‘mothers’ self-identified emotional needs’, containing the subthemes ‘emotional distress’, ‘stressful circumstances’, ‘lack of social support’, and ‘unwilling to be open with professionals’; and (2) ‘how peer support affects mothers’, containing the subthemes ‘social connection’, ‘being heard’, ‘building confidence’, ‘empowerment’, ‘feeling valued’, ‘reducing stress through practical support’ and ‘the significance of “mental health” peer experiences’. Women described how peer support contributed to reducing their low mood and anxiety by overcoming feelings of isolation, disempowerment and stress, and increasing feelings of self-esteem, self-efficacy and parenting competence. Conclusion One-to-one peer support during pregnancy and after birth can have a number of interrelated positive impacts on the emotional wellbeing of mothers. Peer support is a promising and valued intervention, and may have particular salience for ethnic minority women, those who are recent migrants and women experiencing multiple disadvantages

The expected child versus the actual child: implications for the mother-baby bond

The aim of this study was to examine whether women's perceptions of their infant remain stable between late pregnancy and the early postnatal period, and to examine the effect of women's expectations and evaluations of their infant on the mother-baby bond. Participants completed questionnaires at 39 weeks gestation and 3 weeks after birth. Questionnaires measured demographic details, expected/actual infant characteristics, symptoms of anxiety and depression and the mother-baby bond (postpartum only). It was found that there was a significant difference between expectations and evaluations, with infants being perceived as less fussy, more adaptable and dull than they were expected to be. Both expectations of the baby and evaluation of the baby had a significant effect on the mother-baby bond. Women who expected their infant to have a more difficult temperament and then evaluated them, similarly reported a poorer mother-baby bond postpartum. Symptoms of anxiety and depression in pregnancy were unrelated to expectations of the baby, or to the postnatal mother-baby bond. The effects of parity and postnatal anxiety and depression were also examined. The results are discussed, suggesting that a subgroup of women who have negative perceptions of their infant before and after birth may be at risk of mother-infant attachment problems and long-term mother-infant difficulties

Perinatal depression in adolescent mothers: for identifying vulnerabilities

Introduction and objectives Due to the high frequency and co-occurrence of vulnerabilities, mothers under 20 years are at higher risk of perinatal depression than adults mothers. We performed a review of the literature investigating the epidemiology of adolescents mothers’ depression, compared these data to adult mothers and listed associated factors, to develop a more preventive approach and specific follow-up. Methods The review is based on Pubmed and Sciencedirect research combining “adolescent” or “teenage” and “depression” as keywords. Results Seventeen international studies were included, evaluating both prenatal (6 studies) and postnatal (14 studies) depression with three different scales (CES-D, BDI, EPDS). Depression rate in adolescents mothers varies from 26 to 63% in the third trimester of pregnancy and from 26 to 61% in the first 3 months postpartum, with differences depending of studies designs, screening instruments and cut-offs. Depression rate declines with time, but still persists with a prevalence ranging from 21 to 32% at 4 to 5 years after delivery. Depression rate in adolescent mothers are globally twice higher than in adult mothers, both in prenatal and postnatal periods. Characteristics associated with adolescent mothers depression include sociodemographic factors (less education, low income), psychosocial factors (confidence, self-esteem), poor or inadequate social support and negative life events (violence exposure, history of abuse). Conclusion Perinatal depression in adolescent mothers is very high and can contribute negatively to child-mother interaction. It should be a priority to screen depression early during pregnancy and to offer appropriate support services during the first years of motherhood. Moreover, it could be of high interest to assess maternofoetal attachment during pregnancy using validated instruments combined with depression scales.Introduction Comparativement aux mères plus âgées, les mères de moins de 20 ans cumulent certains facteurs de vulnérabilité les exposant à un risque accru de dépression. Méthodes À travers une revue de la littérature, cet article fait le point sur la prévalence de la dépression chez les mères adolescentes et compare ces données à celles des mères plus âgées. Résultats La prévalence de la dépression chez les mères adolescentes varie de 26 à 68 % au troisième trimestre de la grossesse et de 26 à 61 % dans les trois mois du post-partum, selon les études, les instruments d’évaluation et les cut-offs associés. Les taux de dépression à quatre et cinq ans varient de 21 à 32 %. Globalement, les taux de dépression chez les mères adolescentes sont deux fois plus élevés que chez les mères plus âgées. Les caractéristiques associées à la dépression des mères adolescentes incluent des facteurs sociodémographiques et psychosociaux, un soutien social faible ou inadéquat et des événements de vie négatifs. Conclusion La dépression périnatale chez les mères adolescentes est très élevée et peut contribuer négativement aux interactions mère-enfant. Il est impératif de pouvoir détecter les situations de vulnérabilité chez les jeunes mères afin d’organiser une réponse préventive et un suivi spécifiques. -------------------------------------------------------------------------------