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Background: Maternal mental health during pregnancy has been identified as a key factor in the future physiological, emotional and social development of both the mother and her baby. Yet little is known about the factors that contribute to increased levels of pregnancy-specific distress. The present study investigated the role of two psychosocial and personality-based constructs, namely women's sense of coherence (SoC) and their mothering orientations, on their pregnancy-specific distress., Design: During their second trimester of pregnancy, 293 Australian and New Zealand women participated in an online study. Hierarchical multiple regression analysis was used to determine the unique contribution of women's SoC (Sense of Coherence Scale, SoC 13) and their antenatal mothering orientation (Antenatal Mothering Orientation Measure-Revised, AMOM-R) to pregnancy-specific distress (Revised Prenatal Distress Questionnaire, NuPDQ)., Results: Low SoC was the best determinant of women's pregnancy-specific distress, accounting for over 45% of the variance (β = -0.33, p < 0.001, 95% CI [-0.43, -0.23]). A Regulator mothering orientation was correlated with distress but did not have a unique contribution in the final model., Conclusions: This study further highlights the importance of better understanding women's perceptions of emotional health and their mothering role while taking into consideration their wider social context.

Maternal psychological distress during pregnancy is a potential risk factor for various birth complications. This study aimed to explore psychological factors associated with adverse birth outcomes. Symptoms of psychological distress, individual characteristics, and medical complications were assessed at two time points antenatally in 285 women from Australia and New Zealand; birth outcomes were assessed postpartum, between January 2014 and September 2015. Hierarchical multiple regression analyses were conducted to examine the relation of psychological distress to adverse birth outcomes. Medical complications during pregnancy, such as serious infections, placental problems and preeclampsia, and antenatal cannabis use, were the factors most strongly associated with adverse birth outcomes, accounting for 22 percent of the total variance (p < .001). Symptoms of depression and/or anxiety, low social support, and low sense of coherence were not associated with birth complications. In unadjusted analyses, self-reported diagnosis of anxiety disorder during pregnancy and an orientation toward aRegulatormothering style were associated with adverse birth outcomes; however, after controlling for medical complications, these were no longer associated. Our study results indicate that antenatal depressive and/or anxiety symptoms were not independently associated with adverse birth outcomes, a reassuring finding for women who are already psychologically vulnerable during pregnancy. [ABSTRACT FROM PUBLISHER]

Advances in perinatal mental health research have provided valuable insights around risk factors for the overall development of maternal distress. However, there is still a limited understanding of the experience of women struggling emotionally during pregnancy. We explored how women view, experience, and interpret psychological distress antenatally. Eighteen Australian women participated in in-depth interviews that were analyzed thematically within a critical realist theoretical framework. We present and situate the current findings within the dominant discourse of thegood mother, which arguably promotes guilt and stigma and results in women self-labeling asbad mothers. [ABSTRACT FROM AUTHOR]

Objective: to systematically review qualitative research that explores the experience of maternal antenatal psychological distress, such as depression, anxiety and stress during pregnancy. Method: a meta-synthesis was conducted to integrate the findings of qualitative studies. Eight final eligible studies were scrutinised, recurring themes were extracted and compared across studies, and core themes were identified. Findings: five core themes of the experience of pregnancy distress were identified: Recognising that things are not right, Dealing with stigma, Negotiating the transformation, Spiralling down, and Regaining control. In the interpretation of these concepts the experience of maternal antenatal distress was depicted as a process similar to the one of grief and loss, as a result of women's inability to situate their experience within the 'perfect mother' discourse. Key conclusions: women who experience psychological distress undergo a specific process of transformation towards motherhood that begins during pregnancy. This process is exacerbated by their interpretation of their experience as deviant and often as inadequate. Implications for practice: this review will assist health professionals in translating and negotiating the transformation towards motherhood for women experiencing pregnancy distress, in a timely and meaningful manner. [ABSTRACT FROM AUTHOR]

Summary: Background: The cause of hypertension in pregnancy remains unknown and results in increased risk of complications for mother and baby. Symptoms of developing pre-eclampsia, such as an elevated blood pressure, can be vague and singular. The purpose of this literature review is to evaluate research investigating antenatal screening practices for hypertension which fall within the midwives scope of practice. Method: Inclusion criteria for this literature review were English language, peer reviewed primary research journal articles, published in the previous 20 years where the population under study was pregnant with reported outcomes of prevention, screening or prediction of hypertension in pregnancy. A large number of papers (n =201) were identified and these were screened and subsequently excluded if they addressed diagnostic testing, screening and interpretation that depended solely on a medical practitioner. Results: There was no single predictive factor found, however the relevant papers included in this review (n =33) found evidence of modifiable, non-modifiable and clinical assessment factors for inclusion in a midwifery screening model. Conclusions: Further research should be focused on the factors observed by midwives during history taking and the antenatal course in the second and third trimesters and whether or not these can be synthesised in to a hypertension-specific diagnostic tool for use in midwifery practice. [ABSTRACT FROM AUTHOR]

Abstract: Background: Gestational diabetes mellitus (GDM) affects almost 5% of pregnancies in Australia, and within 15 years, 25% of affected women will go on to develop Type 2 Diabetes Mellitus (T2DM). The adoption of preventive health behaviours may be influenced by women's experiences of GDM. Question: This review sought to understand women's beliefs, values, perceptions and experiences following diagnosis of GDM. Methods: Peer reviewed and professional journals were searched for primary research, published between January 1991 and December 2011 that explored the beliefs, values, perceptions and experiences of peripartum or postpartum women with a diagnosis or history of GDM. Findings: Nineteen studies met the inclusion criteria and the majority of these studies were qualitative (n =15). Each study was reviewed and synthesis revealed three emergent themes and core concepts related to each theme: Responses (initial reaction to GDM diagnosis, negative thoughts following diagnosis, struggle to manage GDM, feelings of ‘loss of control’, changes to identity and adapting to change), Focus of Concern (concern for baby's health, mother's concern for her own health, perceived seriousness of GDM, perceived fear of T2DM) and Influencing Factors (cultural roles and beliefs, social stigmas, social support, professional support, adequate and appropriate information, social roles and barriers to self-care). Conclusion: The experiences of women with GDM are unique and personal however this review highlights common experiences evident in the existing research. The proposed framework may be used by midwives in clinical assessment and care of women diagnosed with GDM. [Copyright &y& Elsevier]