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Objective: Review primary research regarding PTSD Post-Childbirth (PTSD-PC) that focussed on Quality of Provider Interaction (QPI) from the perspective of women who developed PTSD-PC, or midwives. Background: Up to 45% of women find childbirth traumatic. PTSD-PC develops in 4% of women (18% in high-risk groups). Women's subjective experiences of childbirth are the most important risk factor in the development of PTSD-PC, with perceived QPI being key. Methods: A systematic search was performed for PTSD-PC literature. Reviewed papers focussed on either women's subjective childbirth experiences, particularly QPI, or midwives' perspectives on QPI. Study quality was assessed using the Critical Appraisal Skills Programme (CASP) tools, and a narrative synthesis of findings produced. Results: Fourteen studies were included. Three features of QPI contribute towards developing PTSD-PC: interpersonal factors; midwifery care factors; and lack of support. Conclusion: QPI is a significant factor in the development of PTSD-PC and the identified key features of QPI have potential to be modified by midwives. The development of guidelines for midwives should be grounded on evidence highlighted in this review, along with further high-quality qualitative research exploring QPI from the perspective of women with PTSD-PC, but also midwives' knowledge and needs regarding their role within QPI. [ABSTRACT FROM AUTHOR]

Objective: To describe a rapid review of major health-related, electronic bibliographic databases, to identify pregnancy-specific measures of health-related quality of life and well-being. This paper details the range of available instruments, rather than aiming to critique their psychometric properties or indicate problem prevalence. Background: While many instruments are used to measure health and well-being in pregnant women, most are primarily designed for use with a generic population to quantify the presence and magnitude of problems. Few instruments are designed to measure well-being specifically with pregnant women. Methods: A comprehensive search was undertaken to retrieve studies reporting the use of pregnancy-specific instruments to measure health-related quality of life or well-being. The search was conducted on Medline, Cochrane Library and Social Sciences Citation Indexes. Results: 1938 papers were identified and checked for inclusion at title and abstract stage. Eighty-four full papers were obtained for review against inclusion criteria. Thirty-nine papers were selected for inclusion, covering 30 instruments available for use solely with pregnant women. Most of the studies were conducted in Scandinavia or the USA, involved low-risk women, were of cross-sectional design or longitudinal design with data collected across more than one trimester. Conclusion: Most instruments identified in this review were developed for use in non-pregnancy contexts. Those specifically designed for use during pregnancy were infrequently used, apart from the Wijma Delivery Expectancy Questionnaire and the Cambridge Worry Scale. We found limited activity in assessing and measuring the health and well-being of pregnant women to capture positive psychological pregnancy outcomes. [ABSTRACT FROM AUTHOR]

Experiencing a miscarriage can be a traumatic event for a woman and her partner. The couple's perceptions of the miscarriage may be influenced by many factors. These include their contact with health care professionals, family, friends, previous experiences, and possibly even their partner's expectations. This paper examines the experience of a miscarriage, reporting results from six women and their partners, all of whom were from ethnic backgrounds. A qualitative approach, employing an in-depth interview technique was utilized to obtain the data. The paper focuses on the coping strategies, social support and satisfaction with health care among the women and their partners. Factors such as treatment by medical personnel and family and friends were identified as either helping or hindering the experience. Coping with pregnancy loss depends on individual women and their partners, as each couple has different ways of dealing with it. However, a good support network and positive contacts with health care professionals also impact on how well the women and their partners are able to cope with the loss. This needs to be recognized when providing care to women who have experienced a miscarriage so that sensitive health care can be achieved. [ABSTRACT FROM AUTHOR]

Objective:This study aimed to explore health visitors’ (HVs) experiences of the assessment of women with psychological distress and mental health problems across the perinatal period in clinical practice.Background:In international contexts, there is now a firm policy remit for the assessment of psychological and mental health disorder across the perinatal period. Women are in regular contact with health professionals across this time and consultations intuitively create an ideal and appropriate context in which to assess women’s psychological health. National reports and academic literature highlight that to prevent the escalation of perinatal mental illness, significant change is needed to support health professionals in detecting, discussing and dealing with mental illnesses.Methods:In a qualitative aspect of a larger mixed-method study, data were collected from two Focus Group Discussions with HVs pre and post a training session related to assessing and managing perinatal mental health problems in practice. For the purposes of this paper, the data were explicitly examined for references to recognition and assessment.Results:Four themes emerged from the data: recognising the problem; questioning and identification; so what do I do now; the importance of support to promote effective identification and assessment.Conclusion:Findings elucidate the complexities that practitioners face in assessing women’s psychological health in real world settings. HVs’ experiences highlight that the implementation of measures into practice needs to be workable and accompanied by contemporary and appropriately contextualised knowledge, adequate service provision and clear referral pathways to ensure effective assessment of women’s psychological health. [ABSTRACT FROM PUBLISHER]

Background:A theory is a set of ideas that attempt to explain phenomena and can provide guiding principles on which to base practice. Many theories from biological and social sciences are relevant to women’s health and well-being during pregnancy and after birth, yet theory is not commonly explicitly reported in perinatal research.Method:This paper outlines the importance of theory to perinatal research and provides a pragmatic overview of when and how to use theory in research. In particular, we consider (i) deciding when it is appropriate to use theory, (ii) choosing which theory to use and (iii) how to operationalise theory in research. We give examples that illustrate how four different theories have been used in perinatal research to increase understanding and inform the development of interventions.Conclusion:Even when it is not appropriate to use theory in our research, careful consideration of pertinent theories contributes to greater clarity of concepts and understanding of different explanations or perspectives on what we are studying. It also prompts us to consider where our research fits in terms of contribution to knowledge or the development and evaluation of treatments. However, it is important that a critical approach is taken so that theories continue to be developed. In this way we will systematically advance our understanding of general factors or processes that are relevant to perinatal health, as well as those factors that are unique to perinatal health. [ABSTRACT FROM PUBLISHER]

Objective: To conceptualise and review the literature pertaining to ‘perinatal well-being’. Background: Poor perinatal mental health can have detrimental consequences for women’s life-long health and the well-being of their children and family; however, the meaning of the term ‘perinatal well-being’ is unclear. This is an important concept to evaluate to better ascertain families requiring additional support; however, currently no validated assessment tool exists. In order to develop such a tool, it is necessary to first determine the meaning of this concept. Methods: The concept analysis framework of Walker and Avant was used. Electronic bibliographic databases were searched to find papers written in English and dated 1946–2012. These included: CINAHL, PubMed, Medline via OVID, Embase, PsycINFO, British Nursing Index, Web of Science, All EBM Reviews – Cochrane DSR, ACP Journal club, DARE and Global Health. From undertaking a detailed literature review the defining attributes were ascertained: model, borderline, related, contrary, invented and illegitimate cases were constructed. The antecedents and consequences were then identified and empirical referents determined. Results: The apparent attributes of ‘perinatal well-being’ are (a) the time period ranging from before and after childbirth; (b) multi-dimensional elements which include; physical, psychological, social, spiritual, economical and ecological; and (c) subjective cognitive and/or affective self-evaluation of life. Conclusion: ‘Perinatal well-being’ is a complex concept which involves self-evaluation of various inter-relating life dimensions during the perinatal period. Qualitative research to explore factors which effect self-evaluation is required to assist in the development of an effective assessment tool for use within clinical practice. [ABSTRACT FROM PUBLISHER]

The State Trait Anxiety Inventory (STAI) has been widely used in research with pregnant women. However, few studies have examined its validity for this group. In this paper the content validity of the STAI, the impact of location and consequences for further participation of higher STAI scores are investigated for 215 pregnant women who completed the STAI at hospital or community based clinics. The study participants answered the open ended question, 'How do you feel about your pregnancy?' and whether or not they would be willing to take part in further research. Results indicated that STAI state scores reflected the nature of women's spontaneous comments regarding their pregnancy, with lower anxiety related to more 'positive' comments. The state scores were also found to be sensitive to the risk level associated with the clinic where the inventory was completed; higher scores related to high-risk localities. Women with the highest levels of state or trait anxiety were also less likely to wish to take part in further research. The study concludes that the STAI does reflect the anxiety-related experiences of pregnant women and that its use with pregnant women is appropriate in this respect; however, we recommend that future research notes the issue of potential recruitment biases. [ABSTRACT FROM AUTHOR]

The aim of this paper was to evaluate the effect of using the Edinburgh Postnatal Depression Scale (EPDS) in routine antenatal care. More specifically, we wanted to study the impact on the management of depressive symptoms when midwives were aware of women's EPDS scores and given training about its potential impact and the ways in which it can be ameliorated. Sixteen midwives (study group) were informed of the woman's EPDS score in gestational week 25, and 16 midwives were not (comparison group). Women in the study group displayed a significant reduction in the within-group EPDS mean score from week 25 to week 36 compared with women in the comparison group. An analysis of change scores revealed that whilst there was no significant difference between the groups in number of visits to the midwife or the doctor, or in number of referrals to a mental health professional, there was a significant difference in change patterns for the two groups from the first to the second assessment. The results of this study suggest that midwives who are aware of pregnant women's depressive symptoms and are given training in how to ameliorate them, support these women more effectively than midwives who are not aware and have not been given additional training on its treatment. [ABSTRACT FROM AUTHOR]