Exploring women’s experiences of perinatal anxiety: a qualitative study.

Problem

Perinatal Anxiety (PNA) is anxiety that occurs during pregnancy or up to 12 months post-partum. Global prevalence PNA is estimated to be over 15% and at least as common as depression over this time period. PNA can adversely impact both mother and child, with potential implications for long-term health such as negative obstetric, foetal and neonatal outcomes. Despite this, research into PNA has received less attention than depression during this period and, as such, has been identified as a priority by the National Institute for Health and Care Excellence. This study aimed to explore the views and experiences of women who had experienced PNA.

Approach

A qualitative study utilising semi-structured interviews to explore lived experiences of PNA. NHS ethical approval obtained. Women with self-reported experience of PNA were recruited via social media, local parent support groups, children’s centres and NHS services (primary and secondary care) and invited to participate in a semi-structured interview (face-to-face, telephone or Skype). The interview topic guide was informed by existing literature, findings from a previous study exploring healthcare professional (HCP) perspectives, and was modified iteratively to explore emerging themes during analysis. Interviews were digitally recorded with consent, transcribed and anonymised prior to analysis. Thematic analysis using principles of constant comparison is underway. Emerging themes are to be agreed through discussion within the research team. Data collection will continue until data saturation is achieved.A Patient and Public Involvement and Engagement (PPIE) group informed development of the research idea, helped to draft the initial topic guide, a lay summary and other public facing study documents for the ethics application. We will meet with the PPIE team again to discuss findings.

Findings

Initial analysis highlights three emerging themes: women’s experiences of PNA are highly individualised (experiences were linked to prior expectations, pregnancy journeys, and support networks), coping and management strategies, and the value of establishing relationships with HCPs. Fear of disclosing symptoms to others due to stigma and potential loss of control was apparent across all themes.

Consequences

Women report experiencing anxiety at different times in the perinatal period with a range of contributing factors described. Becoming a mother had implications for self-identity which contributed to anxiety, along with societal expectations around parenthood. Coping strategies and ways to manage PNA were discussed with positive support from partner, family and friends being identified as being important. However, familial support networks also inadvertently contributed to anxiety. Women’s access to and satisfaction with encounters with HCPs were varied. Fear and stigma presented major barriers to disclosure and management of maternal mental health problems.