Postpartum maternal distress: a multidimensional illness requiring a multilevel, multidiscipline response
Angela E. Elliott A , Peter C. Elliott B C and Roger Cook AA School of Health Sciences, Swinburne University of Technology, PO Box 218, H29, Hawthorn, Vic. 3122, Australia.
B Phoenix Australia Centre for Posttraumatic Mental Health, The University of Melbourne, Level 3, 161 Barry Street, Carlton, Vic. 3053, Australia.
C Corresponding author. Email: peter.elliott94@gmail.com, pelliott@unimelb.edu.au
Australian Journal of Primary Health 26(3) 222-226 https://doi.org/10.1071/PY19180
Submitted: 18 September 2019 Accepted: 11 February 2020 Published: 28 April 2020
Abstract
Australia’s federal, state, territory and local governments all have responsibilities, often overlapping, for policy and delivery of primary mental health care to postpartum women. Identification and treatment of postpartum distress is carried out by a broad range of professionals from diverse disciplines. Although there is evidence to show that anxiety and stress are important aspects of postpartum distress, substantially greater emphasis has been given to identification and treatment of depression. In addition, relatively little attention has been given to incorporating positive and negative social experiences in healthcare policy and practice. This study aimed to extend the postpartum literature by: (1) comparing the levels of depression, anxiety and stress (i.e. distress indicators) in a non-clinical sample of postpartum mothers to those in the general non-clinical population; (2) comparing the prevalence of anxiety and stress to that of depression in postpartum mothers; and (3) examining the consequences of negative social exchange, alongside perceived social support, on postpartum distress indicators. A self-report survey was completed by 242 postpartum women assessing levels of perceived social support, frequency of negative social exchange and distress indicators. Postpartum mothers were found to have significantly higher depression, anxiety and stress than the general population, and had anxiety and stress levels that were similar in severity to depression. In addition, both negative social exchanges and perceived social support were found to be important for postpartum depression, anxiety and stress. These findings suggest that Australia’s primary postpartum mental health care policy and practice guidelines, delivered through a broad range of professionals, may benefit from giving anxiety and stress equal weight to depression and by embracing the important effects, for good and for ill, of positive and negative social interactions.
Additional keywords: anxiety, depression, negative social exchange, perceived social support, stress.
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