Emotional Disturbances During Pregnancy & Postpartum: A National Survey of Australian Midwives & an Educational Resource
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Pregnancy and the postpartum are critical stages in women’s adjustment to motherhood and can have a significant impact on childbearing women’s overall psychological well-being (Chokka, 2002; Stocky & Lynch, 2000). According to the National Midwifery Guidelines for Consultation and Referral (ANMC, 2006), the physical, emotional, social and cultural aspects for both women and their infant(s) need to be addressed as part of best practice standards in maternity care. To accomplish this, midwives need to be well-educated, competent and resourced in these areas of practice. Midwives are reported to provide poor intrapartum and postpartum emotional care to childbearing women that could in part, be attributed to low self-efficacy and knowledge inadequacies in regards to the provision of emotional care (Brown, Davey & Bruinsma, 2005; Bruinsma, Brown, & Davey, 2003; Gamble, Creedy, & Moyle, 2004b; Rudman, El-Khouri, & Waldenström, 2007a, 2007b). However, very few studies have been undertaken to both determine and improve Australian midwives’ knowledge of emotional care issues and address their professional development needs (Eden, 1989; Buist et al., 2006). Therefore, the aims of this research study were to: 1. Determine knowledge levels, attitudes and self-reported practices of midwives in relation to emotional disorders (i.e. antenatal and postnatal depression and anxiety disorders) during pregnancy and postpartum. 2. Develop, implement and evaluate an educational resource to improve the knowledge, attitudes and practices of midwives in the provision of emotional care. In addressing these aims, two research phases were undertaken. The first phase was a scoping study in the form of a national survey to examine midwives’ knowledge of perinatal emotional disorders and their attitudes and self-reported practices in providing emotional care to childbearing women. Information gathered from the first phase informed the development of an online educational resource designed to enhance midwives’ knowledge and abilities in this neglected area of midwifery practice so as to improve childbearing women’s emotional health needs and overall well-being. Thus, the second phase was to examine the efficacy of this online educational resource which was piloted and evaluated with a small group of Master of Midwifery students. Results of the national survey identified that midwives acknowledged their role in the provision of emotional care and support to childbearing women with perinatal emotional disorders. However, knowledge deficits in relation to incidence rate, onset period, assessment and treatment options for both antenatal and postnatal depression as well as the use of the Edinburgh Postnatal Depression Scale in practice were also highlighted. Results from the Phase 2 study suggested that the online educational resource was useful in improving midwives’ knowledge of perinatal emotional disorders. Nevertheless, revisions are needed to further enhance the overall quality of the online educational resource with emphasis given to the translation of knowledge into practice and improving midwives’ self-efficacy in emotional care work. In view of the increasing importance on the provision of emotional care to childbearing women, it is essential that midwives develop their knowledge and understanding of perinatal emotional disorders and ways to assess and manage childbearing women affected by these disorders in order to provide better support and emotional care.
Thesis (PhD Doctorate)
Doctor of Philosophy (PhD)
School of Nursing and Midwifery
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