Diagnostic and preventive measures undertaken by midwives regarding mental health among women and men in the perinatal period – analysis of the results of a multicentre cross-sectional study

Introduction:
According to the Regulation of Polish Minister of Health of 16 August 2018 on the organisational standard of perinatal care, it is mandatory for the person providing care to the pregnant and postpartum woman to assess the risk and severity of depressive symptoms (at 11-14 and 33-37 weeks of pregnancy) and to assess the mental state of the postpartum woman, including the risk of post-partum depression.

Material and methods:
297 Polish midwives and 90 midwifery students were surveyed by paper or online questionnaire, and 98 Icelandic midwives and 10 midwifery students were surveyed in the same way. The questionnaire consisted of 32 questions on beliefs about difficulties in coping with antenatal health problems, 20 questions exploring participants’ knowledge of depression treatment in relation to the general population and pregnant women separately, and 9 questions on participants’ views on the stigma caused by the illness.

Results:
28.8% of the professionally active participants declared to examine each pregnant patient for depression. 75% of all participants strongly agreed that they would like to receive additional teaching on antenatal mental health. About 20% of the respondents conducted a standard screening for depression among their pregnant patients, about 30% – among women in the postnatal period. 62% of midwives and midwifery students in Poland and 83% of the Icelandic cohort strongly or partially disagreed with the statement that a psychiatrist or psychologist, rather than a midwife, should do the mood assessment.

Conclusions:
Midwives indicate that they do not think that perinatal mental health screening should be addressed exclusively by a psychologist or psychiatrist, but only a part of the care population undergoes a mood assessment performed by midwives. Midwives and midwifery students recognise the need for self-education about screening for perinatal mental health disorders and draw attention to the ever-present stigmatisation of those experiencing depression.