Facilitators and Barriers to Disclosure of Postpartum Mood Disorder Symptoms to a Healthcare Provider

Matern Child Health J. 2018 Jan;22(1):120-129. doi: 10.1007/s10995-017-2361-5.


Objectives This study explored perceived barriers and facilitators to disclosure of postpartum mood disorder (PPMD) symptoms to healthcare professionals among a community-based sample. Methods A sample of predominantly white, middle class, partnered, adult women from an urban area in the southeast United States (n = 211) within 3 years postpartum participated in an online survey including the Perceived Barriers to Treatment Scale, the Maternity Social Support Scale, the Depression, Anxiety and Stress Scales-21, and items querying PPMD disclosure. Perceived barriers were operationalized as factors, from the patient's perspective, that impede or reduce the likelihood of discussing her postpartum mood symptoms with a healthcare provider. Analyses examined: (1) characteristics associated with perceived barriers; (2) characteristics associated with perceived social support; and (3) characteristics, perceived barriers, and perceived social support as predictors of disclosure. Results Over half of the sample reported PPMD symptoms, but one in five did not disclose to a healthcare provider. Approximately half of women reported at least one barrier that made help-seeking "extremely difficult" or "impossible." Over one-third indicated they had less than adequate social support. Social support and stress, but not barriers, were associated with disclosure in multivariable models. Conclusions for Practice Many women experiencing clinically-significant levels of distress did not disclose their symptoms of PPMD. Beyond universal screening, efforts to promote PPMD disclosure and help-seeking should target mothers' social support networks.

Keywords: Barriers; Disclosure; Maternal mental health; Postpartum mood disorder; Social support.

MeSH terms

  • Adult
  • Community-Based Participatory Research
  • Depression, Postpartum / psychology*
  • Female
  • Health Personnel
  • Help-Seeking Behavior*
  • Humans
  • Mood Disorders / psychology*
  • Mothers / psychology*
  • North Carolina
  • Patient Acceptance of Health Care / psychology*
  • Postpartum Period / psychology
  • Pregnancy
  • Professional-Patient Relations
  • Self Disclosure*
  • Social Support*
  • United States