Facilitators and Barriers to Disclosure of Postpartum Mood Disorder Symptoms to a Healthcare Provider
- 600 Downloads
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.
KeywordsPostpartum mood disorder Disclosure Maternal mental health Barriers Social support
Compliance with Ethical Standards
Conflict of interest
The authors declare that they have no conflict of interest.
- Bener, A., Gerber, L. M., & Sheikh, J. (2012). Prevalence of psychiatric disorders and associated risk factors in women during their postpartum period: A major public health problem and global comparison. International Journal of Women’s Health, 4(1), 191–200. doi: 10.2147/IJWH.S29380.CrossRefPubMedPubMedCentralGoogle Scholar
- Centers for Disease Control. (2008). Prevalence of self-reported postpartum depressive symptoms–17 states, 2004–2005. Morbidity and Mortality Weekly Report, 57(14), 361–366.Google Scholar
- Hansotte, E., Payne, S. I., & Babich, S. M. (2017). Positive postpartum depression screening practices and subsequent mental health treatment for low-income women in Western countries: A systematic literature review. Public Health Reviews, 38(1), 3. doi: 10.1186/s40985-017-0050-y.CrossRefGoogle Scholar
- Hutto, H. F., Kim-Godwin, Y., Pollard, D., & Kemppainen, J. (2011). Postpartum depression among White, African American, and Hispanic low-income mothers in rural Southeastern North Carolina. Journal of Community Health Nursing, 28(1), 41–53. doi: 10.1080/07370016.2011.539088.CrossRefPubMedGoogle Scholar
- Lovibond, S. H., & Lovibond, P. F. (1995). Manual for the depression anxiety stress scales (2nd edn.). Sydney: Psychology Foundation of Australia.Google Scholar
- Minkler, M., & Wallerstein, N. (Eds.). (2008). Community-based participatory research for health: From process to outcomes (2nd edn.). San Francisco: Jossey-Bass.Google Scholar
- Mohr, D. C., Hart, S. L., Howard, I., Julian, L., Vella, L., Catledge, C., & Feldman, M. D. (2006). Barriers to psychotherapy among depressed and nondepressed primary care patients. Annals of Behavioral Medicine: A Publication of the Society of Behavioral Medicine, 32, 254–258. doi: 10.1207/s15324796abm3203_12.CrossRefGoogle Scholar
- Myers, E. R., Aubuchon-Endsley, N., Bastian, L. A., Gierisch, J. M., Kemper, A. R., Swamy, G. K., … Sanders, G. D. (2013). Efficacy and safety of screening for postpartum depression. Comparative effectiveness review 106. Rockville, MD: Agency for Healthcare Research and Quality.Google Scholar
- Santora, K., & Peabody, H. (2010). Identifying and treating maternal depression: Strategies and considerations for health plans. Washington, DC: National Institute for Health Care Management Issue Brief.Google Scholar
- Siu, A. L., Bibbins-Domingo, K., Grossman, D. C., Baumann, L. C., Davidson, K. W., Ebell, M., … Pignone, M. P. (2016). Screening for depression in adults: US Preventive Services Task Force recommendation statement. Journal of the American Medical Association, 315(4), 380. doi: 10.1001/jama.2015.18392.CrossRefPubMedGoogle Scholar
- US Census Bureau. (2016). QuickFacts: Wake County North Carolina. Retrieved May 16, 2016 from http://www.census.gov/quickfacts/table/RHI105210/37183.
- Wright, A., Jorm, A. F., Harris, M. G., & McGorry, P. D. (2007). What’s in a name? Is accurate recognition and labelling of mental disorders by young people associated with better help-seeking and treatment preferences?. Social Psychiatry and Psychiatric Epidemiology, 42(3), 244–250. doi: 10.1007/s00127-006-0156-x.CrossRefPubMedGoogle Scholar