‘No help’ for depressed pregnant women

ALMOST 90% of pregnant women who reported psychological problems such as depression failed to be referred to a mental health service, a study has found.

Figures revealed at the College of Psychiatry of Ireland’s inaugural conference have shown that despite the need to pay close attention to the wellbeing of an expectant mother, 432 women who reported some form of psychological distress in 2006 were not referred to a specialist.

According to the research conducted by Dr Aileen McCauliffe, of the South Lee Mental Health Service in Cork, during the period a total of 4,188 pregnant women who attended midwife booking clinics at the Dublin-based hospital underwent psychological assessment.

Some 499 pregnant women were found to be under some form of psychological distress, such as depression.

However, just 67 were referred to the mental health liaison clinic at the hospital — with almost a third of this figure not referred for psychological assistance.

Of the remaining figures, reported in the Irish Medical Times, 113 were later found to have had postnatal depression, despite 77 not having the condition referred to in their initial case notes and only 15 being referred to the hospital’s mental health liaison clinic.

In one case a pregnant woman was later found to have had puerperal psychosis, an acute mental illness which begins in the days after childbirth and is considered to be a psychiatric emergency as it can include hallucinations, delusions and deep depression. The condition, noted Dr McCauliffe, was not recorded in the patient’s initial medical notes.

“There appeared to be no system in place to flag up concerns for potential further episodes of postnatal depression,” explained the doctor.

“The use of the term postnatal depression needs to be amended to provide for a more meaningful assessment of the patient’s needs.

“Future service development should attempt to minimise this loss to follow-up,” Dr McCauliffe said.

Postnatal depression occurs in 10% of mothers. While similar to other forms of depression in other settings, it has the added impact of affecting the new mother’s coping skills and can cause feelings of inadequacy and guilt and create a barrier to bonding with her new baby.

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