DOI
https://doi.org/10.25772/0MNA-5T52
Defense Date
2024
Document Type
Dissertation
Degree Name
Doctor of Philosophy
Department
Nursing
First Advisor
Patricia Kinser, PhD
Abstract
Introduction and Background: Perinatal mental health (PMH) symptoms are recognized as a leading contributor to maternal morbidity and mortality; therefore symptom screening is critical for identifying individuals who need escalation of care. However, initial studies suggest many people report lack of screening or appropriate resources for symptoms in the early postpartum (up to 6 weeks post-delivery), hence there is a gap in the literature about symptom prevalence and experiences, particularly with regard to sub-threshold symptoms and contributing factors.
Conceptual Framework: This study is driven by Comprehensive Conceptual Framework to Guide Clinical Practice and Research about Mental Health During the Perinatal Period, whose three key principles are integrated into the aims of this study: (1) a focus on well-being rather than solely disease; (2) that it is critical recognize the impact of experiences specifically related to becoming a parent; and, (3) a comprehensive approach to perinatal mental health is essential in order to create impactful change in clinical care.
Methods: This study used a convergent mixed-methods design of secondary data analysis of cross-sectional quantitative data from a nationwide sample of individuals during the early postpartum period (n=697) and qualitative data from a subset of the participants (n=15), in order to: (1) describe the presence of and factors associated with PMH symptoms; (2) gain a deeper understanding of participants’ lived experiences with PMH symptoms, the screening process, and contributing factors to these experiences; and, (3) understand how symptom endorsement, risk/ resilience factors, and lived experiences converge.
Results: Results revealed that new parents are longing to feel seen, heard, respected, and cared for. In this nationally representative sample, 22.8% (n=159) participants scored a 10 or higher on the Edinburgh Postnatal Depression Scale (EPDS), indicating current perinatal depression symptoms that should trigger clinical follow-up. Participants shared that current perinatal mental health screenings and associated processes do not capture the full breadth of their symptom experience, highlighted the impact of experiences of matrescence (including birth and infant feeding experiences) as being particularly meaningful and impactful on their mental health and emotional well-being, , and participants shared the importance of continuity of care and relational care that respects their personal preferences and boundaries. Together these results combine to point out areas of optimization related to perinatal mental health.
Discussion: The key findings of this study highlighted opportunities for optimization of mental health screening and care for postpartum individuals. Therefore, future work should identify symptom profiles within a broadened understanding of perinatal mental health symptom experiences and investigate in the relationships between symptoms, symptom profiles, and impactful experiences (e.g. birth, postpartum care, infant feeding) during the early postpartum period in order to identify focused areas for intervention. Finally, this work highlights the need to think outside our current system to care for and support new parents during the early postpartum period. Additional intervention development should focus on broadening care accessibility and the systems through which new parents can access that care and support, focusing on increasing continuity of care and designing support and care systems that acknowledge the realities of new parenthood while respecting new parent’s preferences and boundaries.
Rights
© The Author
Is Part Of
VCU University Archives
Is Part Of
VCU Theses and Dissertations
Date of Submission
5-9-2024