A qualitative study of women's views on the acceptability of being asked about mental health problems at antenatal booking appointments

Midwifery. 2019 Jul:74:126-133. doi: 10.1016/j.midw.2019.03.021. Epub 2019 Mar 29.

Abstract

Objective: To explore women's views on the acceptability of being asked about mental health problems at antenatal booking.

Design: Qualitative study.

Setting: Brief semi-structured qualitative interviews were conducted with women in a private setting at a hospital, or at women's homes. Interview discussions centered around three key questions: "What was it like for you answering the questions about your mood?", "Were there any questions you found upsetting, distressing or confronting?" and "Did the midwife give you some feedback about your answers?"

Measurements: Interviews were audio-recorded, transcribed verbatim, and analysed using thematic and framework approaches.

Participants: An ethnically diverse sample [32% white British/Irish, 68% non-white, non-British] of 52 women living in the study area.

Findings: Most women found mental health enquiry acceptable. A smaller proportion reported difficulties and many of these women had a past or current mental health problem and/or a history of abuse. These women reported difficulty due to the emotional responses triggered by the questions and the way disclosures were handled. In general, women wanted to be asked clear questions about mental health problems, to have sufficient time to discuss issues, and to receive responses from midwives which were normalising and well-informed about mental health.

Conclusions: This study highlights that women want midwives to ask clearly-framed questions about mental health problems [addressing past and current mental health concerns], and value responses from midwives that are normalising, well-informed and allow for discussion.

Implications for practice: Training should be provided to midwives on how to appropriately respond to women's distress during mental health enquiry, and on referral to support services.

Keywords: Depressive symptoms; Mental health; Midwifery; Prenatal care; Qualitative research.

MeSH terms

  • Adult
  • Appointments and Schedules
  • Female
  • Humans
  • Interviews as Topic / methods
  • London
  • Mental Disorders / complications
  • Mental Disorders / psychology*
  • Patient Acceptance of Health Care / psychology*
  • Pregnancy
  • Prenatal Care / methods
  • Prenatal Care / standards*
  • Qualitative Research
  • Truth Disclosure*