Prevatt, Betty-Shannon, and Sarah L. Desmarais, “Facilitators and Barriers to Disclosure of Postpartum Mood Disorder Symptoms to a Healthcare Provider,” Maternal and Child Health Journal 22, no.1 (August 2017), doi:10.1007/s10995-017-2361-5

URL: link.springer.com/article/10.1007%2Fs10995-017-2361-5

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Abstract

Objectives: This study explored perceived barriers and facilitators to disclosure of postpartum mood disorder (PPMD) symptoms to healthcare professionals among a community-based sample.

Methods: A sample of predominantly white, middle class, partnered, adult women from an urban area in the southeast United States (n = 211) within 3 years postpartum participated in an online survey including the Perceived Barriers to Treatment Scale, the Maternity Social Support Scale, the Depression, Anxiety and Stress Scales-21, and items querying PPMD disclosure. Perceived barriers were operationalized as factors, from the patient’s perspective, that impede or reduce the likelihood of discussing her postpartum mood symptoms with a healthcare provider. Analyses examined: (1) characteristics associated with perceived barriers; (2) characteristics associated with perceived social support; and (3) characteristics, perceived barriers, and perceived social support as predictors of disclosure.

Results: Over half of the sample reported PPMD symptoms, but one in five did not disclose to a healthcare provider. Approximately half of women reported at least one barrier that made help-seeking “extremely difficult” or “impossible.” Over one-third indicated they had less than adequate social support. Social support and stress, but not barriers, were associated with disclosure in multivariable models.

Conclusions for Practice: Many women experiencing clinically-significant levels of distress did not disclose their symptoms of PPMD. Beyond universal screening, efforts to promote PPMD disclosure and help-seeking should target mothers’ social support networks.

While this study focused on a small portion of US postpartum women, it demonstrates the significant need for improved mental health for postpartum women in general. Barriers of stigma, time constraints, and lack of motivation must be addressed in order to provide quality healthcare for mothers, as well as their children and family.