Advertisement

Maternal Emotional Health Before and After Birth Matters

  • Katherine BrightEmail author
  • Gisela Becker
Chapter

Abstract

In this chapter, the authors examine why emotional health during pregnancy matters. Stress, anxiety, and depression are the most common conditions that women face during pregnancy and the postpartum period. One in four women experience anxiety or depression during their pregnancy, making emotional health issues one of the top three pregnancy complications. These emotional factors influence the physiological stress response in women and may explain why maternal stress during pregnancy can have long-term effects on the unborn child. These include an increased risk of spontaneous abortion, preeclampsia in the later phase of pregnancy, preterm delivery including late preterm birth, reduced birth weight, and smaller head size.

Working with women, their partners, their families, and the wider community supports the reduction of stress, anxiety, and depression in expectant mothers. This promotes a healthy pregnancy and in utero environment that protects the development of the brain architect and function. Given the essential role that maternal emotional health during pregnancy plays in the long-term health of the unborn baby, it is important to identify emotional health concerns early. Referral to the most appropriate resources and providers and timely prenatal interventions aimed at reducing these symptoms are essential. A starting point for identifying emotional health concerns during pregnancy is to start prenatal visits with four questions: The Whooley Questions (two questions exploring depression) and the two-item Generalized Anxiety Disorder Scale (GAD-2) (two questions exploring anxiety).

Keywords

Emotional health Mental health Maternal Pregnancy Prenatal Preterm birth Postpartum Stress Anxiety Depression 

References

  1. 1.
    Milgrom J, Gemmill AW, Bilszta JL, Hayes B, Barnett B, Brooks J, et al. Antenatal risk factors for postnatal depression: a large prospective study. J Affect Disord. 2008;108(1–2):147–57.CrossRefPubMedGoogle Scholar
  2. 2.
    Kingston D, Heaman M, Fell D, Dzakpasu S, Chalmers B. Factors associated with perceived stress and stressful life events in pregnant women: findings from the Canadian Maternity Experiences Survey. Matern Child Health J. 2012;16(1):158–68.CrossRefPubMedGoogle Scholar
  3. 3.
    Priest SR, Austin MP, Barnett BB, Buist A. A psychosocial risk assessment model (PRAM) for use with pregnant and postpartum women in primary care settings. Arch Womens Mental Health. 2008;11(5–6):307–17.CrossRefGoogle Scholar
  4. 4.
    Hawes K, McGowan E, O’donnell M, Tucker R, Vohr B. Social emotional factors increase risk of postpartum depression in mothers of preterm infants. J Pediatr. 2016;179:61–7.CrossRefPubMedGoogle Scholar
  5. 5.
    Tahirkheli NN, Cherry AS, Tackett AP, McCaffree MA, Gillaspy SR. Postpartum depression on the neonatal intensive care unit: current perspectives. Int J Womens Health. 2014;6:975.PubMedPubMedCentralGoogle Scholar
  6. 6.
    Samra HA, Dutcher J, McGrath JM, Foster M, Klein L, Djira G, et al. Effect of skin-to-skin holding on stress in mothers of late-preterm infants: a randomized controlled trial. Adv Neonatal Care. 2015;15(5):354–64.CrossRefPubMedGoogle Scholar
  7. 7.
    Isgut M, Smith AK, Reimann ES, Kucuk O, Ryan J. The impact of psychological distress during pregnancy on the developing fetus: biological mechanisms and the potential benefits of mindfulness interventions. J Perinat Med. 2017;31:31.Google Scholar
  8. 8.
    Mulder E, de Medinaa PR, Huizink A, Van den Bergh B, Buitelaar J, Visser G. Prenatal maternal stress: effects on pregnancy and the (unborn) child. Early Hum Dev. 2002;70:3–14.CrossRefPubMedGoogle Scholar
  9. 9.
    Huizink AC. Prenatal stress and its effect on infant development. Utrecht: Utrecht University Repository; 2001.Google Scholar
  10. 10.
    Andersson L, Sundström-Poromaa I, Wulff M, Åström M, Bixo M. Neonatal outcome following maternal antenatal depression and anxiety: a population-based study. Am J Epidemiol. 2004;159(9):872–81.CrossRefPubMedGoogle Scholar
  11. 11.
    McDonald SW, Kingston D, Bayrampour H, Dolan SM, Tough SC. Cumulative psychosocial stress, coping resources, and preterm birth. Arch Womens Ment Health. 2014;17(6):559–68.CrossRefPubMedGoogle Scholar
  12. 12.
    Challis J, Matthews S, Van Meir C, Ramirez M. Current topic: the placental corticotrophin-releasing hormone-adrenocorticotrophin axis. Placenta. 1995;16(6):481–502.CrossRefPubMedGoogle Scholar
  13. 13.
    Goldenberg RL, Culhane JF, Iams JD, Romero R. Epidemiology and causes of preterm birth. Lancet. 2008;371(9606):75–84.CrossRefPubMedPubMedCentralGoogle Scholar
  14. 14.
    McCormick MC, Litt JS, Smith VC, Zupancic JA. Prematurity: an overview and public health implications. Annu Rev Public Health. 2011;32:367–79.CrossRefPubMedGoogle Scholar
  15. 15.
    Kramer MS, Demissie K, Yang H, Platt RW, Sauvé R, Liston R, et al. The contribution of mild and moderate preterm birth to infant mortality. JAMA. 2000;284(7):843–9.CrossRefPubMedGoogle Scholar
  16. 16.
    Martin JA, Kirmeyer S, Osterman M, Shepherd RA. Born a bit too early: recent trends in “late preterm” births. NCHS Data Brief. 2009;24:1–8.Google Scholar
  17. 17.
    Richards JL, Kramer MS, Deb-Rinker P, Rouleau J, Mortensen L, Gissler M, et al. Temporal trends in late preterm and early term birth rates in 6 high-income countries in North America and Europe and association with clinician-initiated obstetric interventions. JAMA. 2016;316(4):410–9.CrossRefPubMedPubMedCentralGoogle Scholar
  18. 18.
    Bilgin A, Wolke D. Maternal sensitivity in parenting preterm children: a meta-analysis. Pediatrics. 2015;136:1–17.CrossRefGoogle Scholar
  19. 19.
    Feldman R, Rosenthal Z, Eidelman AI. Maternal-preterm skin-to-skin contact enhances child physiologic organization and cognitive control across the first 10 years of life. Biol Psychiatry. 2014;75(1):56–64.CrossRefPubMedGoogle Scholar
  20. 20.
    Anderson C, Cacola P. Implications of preterm birth for maternal mental health and infant development. MCN Am J Matern Child Nurs. 2017;42(2):108–14.CrossRefPubMedGoogle Scholar
  21. 21.
    Fisk NM, Glover V. Association between maternal anxiety in pregnancy and increased uterine artery resistance index: cohort based study. BMJ. 1999;318(7177):153–7.CrossRefPubMedPubMedCentralGoogle Scholar
  22. 22.
    Weaver IC, Cervoni N, Champagne FA, D’Alessio AC, Sharma S, Seckl JR, et al. Epigenetic programming by maternal behavior. Nat Neurosci. 2004;7(8):847–54.CrossRefPubMedGoogle Scholar
  23. 23.
    Glover V. Prenatal stress and its effects on the fetus and the child: possible underlying biological mechanisms. Adv Neurobiol. 2015;10:269–83.CrossRefPubMedGoogle Scholar
  24. 24.
    Glover V. Maternal depression, anxiety and stress during pregnancy and child outcome; what needs to be done. Best Pract Res Clin Obstet Gynaecol. 2014;28(1):25–35.CrossRefPubMedGoogle Scholar
  25. 25.
    Jaekel J, Wolke D, Chernova J. Mother and child behaviour in very preterm and term dyads at 6 and 8 years. Dev Med Child Neurol. 2012;54(8):716–23.CrossRefPubMedGoogle Scholar
  26. 26.
    Beckwith L, Rodning C. Dyadic processes between mothers and preterm infants: Development at ages 2 to 5 years. Infant Ment Health J. 1996;17(4):322–33.CrossRefGoogle Scholar
  27. 27.
    Meyer EC, Coll CTG, Seifer R, Ramos A, Kilis E, Oh W. Psychological distress in mothers of preterm infants. J Dev Behav Pediatr. 1995;16(6):412–7.CrossRefPubMedGoogle Scholar
  28. 28.
    Pierrehumbert B, Brisch K, Nicole A, Fava-Vizziello G, Wolke D. The processes of parenting and attachment with premature infants: implications for intervention. Infant Mental Health J. 2000: Michigan ASSN Infant Mental Health Michigan State Univ Dept Psychology, East Lansing, MI, USAGoogle Scholar
  29. 29.
    Muller-Nix C, Forcada-Guex M, Pierrehumbert B, Jaunin L, Borghini A, Ansermet F. Prematurity, maternal stress and mother–child interactions. Early Hum Dev. 2004;79(2):145–58.CrossRefPubMedGoogle Scholar
  30. 30.
    Landry SH, Smith KE, Swank PR. Responsive parenting: establishing early foundations for social, communication, and independent problem-solving skills. DP. 2006;42(4):627.Google Scholar
  31. 31.
    Lyons-Ruth K, Bureau J-F, Holmes B, Easterbrooks A, Brooks NH. Borderline symptoms and suicidality/self-injury in late adolescence: prospectively observed relationship correlates in infancy and childhood. Psychiatry Res. 2013;206(2):273–81.CrossRefPubMedGoogle Scholar
  32. 32.
    Jaekel J, Pluess M, Belsky J, Wolke D. Effects of maternal sensitivity on low birth weight children’s academic achievement: a test of differential susceptibility versus diathesis stress. J Child Psychol Psychiatry. 2015;56(6):693–701.CrossRefPubMedGoogle Scholar
  33. 33.
    Engle WA, Tomashek KM, Wallman C. “Late-preterm” infants: a population at risk. Pediatrics. 2007;120(6):1390–401.CrossRefGoogle Scholar
  34. 34.
    Voegtline KM, Stifter CA, Investigators FLP. Late-preterm birth, maternal symptomatology, and infant negativity. Infant Behav Dev. 2010;33(4):545–54.CrossRefPubMedPubMedCentralGoogle Scholar
  35. 35.
    Holditch-Davis D, Schwartz T, Black B, Scher M. Correlates of mother–premature infant interactions. Res Nurs Health. 2007;30(3):333–46.CrossRefPubMedGoogle Scholar
  36. 36.
    Braungart-Rieker JM, Garwood MM, Powers BP, Wang X. Parental sensitivity, infant affect, and affect regulation: predictors of later attachment. Child Dev. 2001;72(1):252–70.CrossRefPubMedGoogle Scholar
  37. 37.
    Amir M, Horesh N, Lin-Stein T. Infertility and adjustment in women: the effects of attachment style and social support. J Clin Psychol Med Settings. 1999;6(4):463–79.CrossRefGoogle Scholar
  38. 38.
    Bowlby J. Attachment and loss: separation. 2nd ed. New York, NY: Basic Books; 1973.Google Scholar
  39. 39.
    Stuart S, Robertson M. Interpersonal psychotherapy 2E a clinician’s guide. Boca Raton, FL: CRC Press; 2012.CrossRefGoogle Scholar
  40. 40.
    Collins NL. Working models of attachment: Implications for explanation, emotion, and behavior. JPSP. 1996;71(4):810.Google Scholar
  41. 41.
    Simpson JA, Rholes WS. Adult attachment, stress, and romantic relationships. Curr Opin Psychol. 2017;13:19–24.CrossRefPubMedPubMedCentralGoogle Scholar
  42. 42.
    Dunkel-Schetter C, Tanner L. Anxiety, depression and stress in pregnancy: implications for mothers, children, research, and practice. Curr Opin Psychiatry. 2012;25(2):141.CrossRefPubMedPubMedCentralGoogle Scholar
  43. 43.
    Lou HC, Hansen D, Nordentoft M, Pryds O, Jensen F, Nim J, et al. Prenatal stressors of human life affect fetal brain development. Dev Med Child Neurol. 1994;36(9):826–32.CrossRefPubMedGoogle Scholar
  44. 44.
    Chaplin TM, Aldao A. Gender differences in emotion expression in children: a meta-analytic review. Psychol Bull. 2013;139(4):735–65.CrossRefPubMedGoogle Scholar
  45. 45.
    Aarnoudse-Moens CSH, Weisglas-Kuperus N, van Goudoever JB, Oosterlaan J. Meta-analysis of neurobehavioral outcomes in very preterm and/or very low birth weight children. Pediatrics. 2009;124(2):717–28.CrossRefPubMedGoogle Scholar
  46. 46.
    Wenzel A, Stuart SC. Anxiety in childbearing women: diagnosis and treatment. Washington, DC: American Psychological Association; 2011.CrossRefGoogle Scholar
  47. 47.
    Davies J, Slade P, Wright I, Stewart P. Posttraumatic stress symptoms following childbirth and mothers’ perceptions of their infants. Infant Ment Health J. 2008;29(6):537–54.CrossRefPubMedGoogle Scholar
  48. 48.
    Ferber SG, Feldman R. Delivery pain and the development of mother—infant interaction. Infancy. 2005;8(1):43–62.CrossRefGoogle Scholar
  49. 49.
    Grant KA, McMahon C, Austin MP. Maternal anxiety during the transition to parenthood: a prospective study. J Affect Disord. 2008;108(1–2):101–11.CrossRefPubMedGoogle Scholar
  50. 50.
    Hildingsson I, Nilsson C, Karlström A, Lundgren I. A longitudinal survey of childbirth-related fear and associated factors. J Obstet Gynecol Neonatal Nurs. 2011;40(5):532–43.CrossRefPubMedGoogle Scholar
  51. 51.
    Giallo R, Woolhouse H, Gartland D, Hiscock H, Brown S. The emotional–behavioural functioning of children exposed to maternal depressive symptoms across pregnancy and early childhood: a prospective Australian pregnancy cohort study. Eur Child Adolesc Psychiatry. 2015;24(10):1233–44.CrossRefPubMedGoogle Scholar
  52. 52.
    van der Waerden J, Galera C, Saurel-Cubizolles MJ, Sutter-Dallay AL, Melchior M. Predictors of persistent maternal depression trajectories in early childhood: results from the EDEN mother-child cohort study in France. Psychol Med. 2015;45(9):1999–2012.CrossRefPubMedGoogle Scholar
  53. 53.
    Kingston D, Tough S. Prenatal and postnatal maternal mental health and school-age child development: a systematic review. Matern Child Health J. 2014;18(7):1728–41.CrossRefPubMedGoogle Scholar
  54. 54.
    Nilsson C, Lundgren I, Karlström A, Hildingsson I. Self reported fear of childbirth and its association with women’s birth experience and mode of delivery: a longitudinal population-based study. Women Birth. 2012;25(3):114–21.CrossRefPubMedGoogle Scholar
  55. 55.
    Waldenström U, Hildingsson I, Ryding E-L. Antenatal fear of childbirth and its association with subsequent caesarean section and experience of childbirth. BJOG. 2006;113(6):638–46.CrossRefPubMedGoogle Scholar
  56. 56.
    Mughal MK, Ginn CS, Magill-Evans J, Benzies KM. Parenting stress and development of late preterm infants at 4 months corrected age. Res Nurs Health. 2017;40(5):414–23.CrossRefPubMedGoogle Scholar
  57. 57.
    Baker BJ. Understanding mothers of late preterm infants. Richmond, VA: Virginia Commonwealth University; 2011.Google Scholar
  58. 58.
    Røsand G-MB, Slinning K, Eberhard-Gran M, Røysamb E, Tambs K. Partner relationship satisfaction and maternal emotional distress in early pregnancy. BMC Public Health. 2011;11(1):161.CrossRefPubMedPubMedCentralGoogle Scholar
  59. 59.
    Letourneau NL, Dennis C-L, Benzies K, Duffett-Leger L, Stewart M, Tryphonopoulos PD, et al. Postpartum depression is a family affair: addressing the impact on mothers, fathers, and children. Issues Ment Health Nurs. 2012;33(7):445–57.CrossRefPubMedGoogle Scholar
  60. 60.
    Meighan M, Davis MW, Thomas SP, Droppleman PG. Living with postpartum depression: the father’s experience. MCN Am J Matern Child Nurs. 1999;24(4):202–8.CrossRefPubMedGoogle Scholar
  61. 61.
    Sayers SL, Kohn CS, Fresco DM, Bellack AS, Sarwer DB. Marital cognitions and depression in the context of marital discord. Cognit Ther Res. 2001;25(6):713–32.CrossRefGoogle Scholar
  62. 62.
    Paulson JF, Bazemore SD. Prenatal and postpartum depression in fathers and its association with maternal depression: a meta-analysis. JAMA. 2010;303(19):1961–9.CrossRefPubMedGoogle Scholar
  63. 63.
    Lee TY, Miles MS, Holditch-Davis D. Fathers’ support to mothers of medically fragile infants. J Obstet Gynecol Neonatal Nurs. 2006;35(1):46–55.CrossRefPubMedGoogle Scholar
  64. 64.
    Fox SE, Levitt P, Nelson CA III. How the timing and quality of early experiences influence the development of brain architecture. Child Dev. 2010;81(1):28–40.CrossRefPubMedPubMedCentralGoogle Scholar
  65. 65.
    Ulrich-Lai YM, Herman JP. Neural regulation of endocrine and autonomic stress responses. Nat Rev Neurosci. 2009;10(6):397.CrossRefPubMedPubMedCentralGoogle Scholar
  66. 66.
    Saisto T, Halmesmäki E. Fear of childbirth: a neglected dilemma. Acta Obstet Gynecol Scand. 2003;82(3):201–8.CrossRefPubMedGoogle Scholar
  67. 67.
    American Psychiatric Association. Diagnostic and statistical manual of mental disorders (DSM-5®). Washington, DC: American Psychiatric Pub; 2013.CrossRefGoogle Scholar
  68. 68.
    Kleiman K, Wenzel A. Dropping the baby and other scary thoughts: breaking the cycle of unwanted thoughts in motherhood. London: Routledge; 2011.CrossRefGoogle Scholar
  69. 69.
    Matthey S, Ross-Hamid C. The validity of DSM symptoms for depression and anxiety disorders during pregnancy. J Affect Disord. 2011;133(3):546–52.CrossRefPubMedGoogle Scholar
  70. 70.
    Huizink AC, Mulder EJ, de Medina PGR, Visser GH, Buitelaar JK. Is pregnancy anxiety a distinctive syndrome? Early Hum Dev. 2004;79(2):81–91.CrossRefPubMedGoogle Scholar
  71. 71.
    Lang AJ, Sorrell JT, Rodgers CS, Lebeck MM. Anxiety sensitivity as a predictor of labor pain. Eur J Pain. 2006;10(3):263.CrossRefPubMedGoogle Scholar
  72. 72.
    White T, Matthey S, Boyd K, Barnett B. Postnatal depression and post-traumatic stress after childbirth: prevalence, course and co-occurrence. J Reprod Infant Psychol. 2006;24(02):107–20.CrossRefGoogle Scholar
  73. 73.
    Kelly RH, Russo J, Katon W. Somatic complaints among pregnant women cared for in obstetrics: normal pregnancy or depressive and anxiety symptom amplification revisited? Gen Hosp Psychiatry. 2001;23(3):107–13.CrossRefPubMedGoogle Scholar
  74. 74.
    Austin MP, Priest SR. Clinical issues in perinatal mental health: new developments in the detection and treatment of perinatal mood and anxiety disorders. Acta Psychiatr Scand. 2005;112(2):97–104.CrossRefPubMedGoogle Scholar
  75. 75.
    Lee AM, Lam SK, Lau SMSM, Chong CSY, Chui HW, Fong DYT. Prevalence, course, and risk factors for antenatal anxiety and depression. Obstet Gynecol. 2007;110(5):1102–12.CrossRefPubMedGoogle Scholar
  76. 76.
    Kuo C, Chen G, Yang M, Lo H, Tsai Y. Biphasic changes in autonomic nervous activity during pregnancy. Br J Anaesth. 2000;84(3):323–9.CrossRefPubMedGoogle Scholar
  77. 77.
    Yonkers KA, Smith MV, Lin H, Howell HB, Shao L, Rosenheck RA. Depression screening of perinatal women: an evaluation of the healthy start depression initiative. Psychiatr Serv. 2009;60(3):322–8.CrossRefPubMedPubMedCentralGoogle Scholar
  78. 78.
    De Jesus Silva MM, Peres-Rocha-Carvalho-Leite E, Alves-Nogueira D, Clapis MJ. Depression in pregnancy. Prevalence and associated factors. Invest Educ Enferm. 2016;34(2):342–50.PubMedGoogle Scholar
  79. 79.
    Smith KF, Huber LRB, Issel LM, Warren-Findlow J. The association between maternal depression during pregnancy and adverse birth outcomes: a retrospective cohort study of PRAMS participants. J Community Health. 2015;40(5):984–92.CrossRefPubMedGoogle Scholar
  80. 80.
    Manikkam L, Burns JK. Antenatal depression and its risk factors: an urban prevalence study in KwaZulu-Natal. S Afr Med J. 2012;102(12):940–4.CrossRefPubMedGoogle Scholar
  81. 81.
    World Health Organization. Thinking healthy: a manual for psychosocial management of perinatal depression, WHO generic field-trial version 1.0, 2015. Geneva: WHO; 2015.Google Scholar
  82. 82.
    NICE. Antenatal and postnatal mental health: clinical management and service guidance (CG192). London: NICE – National Institute for Health and Care Excellence; 2014.Google Scholar
  83. 83.
    Somerville S, Dedman K, Hagan R, Oxnam E, Wettinger M, Byrne S, et al. The perinatal anxiety screening scale: development and preliminary validation. Arch Womens Ment Health. 2014;17(5):443–54.CrossRefPubMedGoogle Scholar
  84. 84.
    Somerville S, Byrne SL, Dedman K, Hagan R, Coo S, Oxnam E, et al. Detecting the severity of perinatal anxiety with the Perinatal Anxiety Screening Scale (PASS). J Affect Disord. 2015;186:18–25.CrossRefPubMedGoogle Scholar
  85. 85.
    Bayrampour H, McDonald S, Tough S. Risk factors of transient and persistent anxiety during pregnancy. Midwifery. 2015;31(6):582–9.CrossRefPubMedGoogle Scholar
  86. 86.
    Zigmond AS, Snaith RP. The hospital anxiety and depression scale. Acta Psychiatr Scand. 1983;67(6):361–70.CrossRefPubMedGoogle Scholar
  87. 87.
    Spielberger CD, Gorsuch RL, Lushene R, Vagg PR, Jacobs G. State-trait anxiety inventory for adults. Menlo Park, CA: Mind Garden; 1983.Google Scholar
  88. 88.
    Beck A, Steer R. Beck anxiety inventory manual. San Antonio, TX: The Psychological Corporation; 1993.Google Scholar
  89. 89.
    Levin JS. The factor structure of the pregnancy anxiety scale. J Health Soc Behav. 1991;32:368–81.CrossRefPubMedGoogle Scholar
  90. 90.
    Wadhwa PD, Sandman CA, Porto M, Dunkel-Schetter C, Garite TJ. The association between prenatal stress and infant birth weight and gestational age at birth: a prospective investigation. Am J Obstet Gynecol. 1993;169(4):858–65.CrossRefPubMedGoogle Scholar
  91. 91.
    Van den Bergh B. The influence of maternal emotions during pregnancy on fetal and neonatal behavior. Pre Perinat Psychol J. 1990;5(2):119–30.Google Scholar
  92. 92.
    Rwakarema M, Premji SS, Nyanza EC, Riziki P, Palacios-Derflingher L. Antenatal depression is associated with pregnancy-related anxiety, partner relations, and wealth in women in Northern Tanzania: a cross-sectional study. BMC Womens Health. 2015;15(1):68.CrossRefPubMedPubMedCentralGoogle Scholar
  93. 93.
    Rini CK, Dunkel-Schetter C, Wadhwa PD, Sandman CA. Psychological adaptation and birth outcomes: the role of personal resources, stress, and sociocultural context in pregnancy. Health Psychol. 1999;18(4):333–45.CrossRefPubMedGoogle Scholar
  94. 94.
    Cox JL, Holden JM, Sagovsky R. Detection of postnatal depression. Development of the 10-item Edinburgh Postnatal Depression Scale. Br J Psychiatry. 1987;150:782–6.CrossRefPubMedGoogle Scholar
  95. 95.
    Murray D, Cox JL. Screening for depression during pregnancy with the Edinburgh Depression Scale (EDDS). J Reprod Infant Psychol. 1990;8(2):99–107.CrossRefGoogle Scholar
  96. 96.
    Bambridge GA, Shaw EJ, Ishak M, Clarke SD, Baker C. Perinatal mental health: how to ask and how to help. Obstet Gynaecol. 2017;19(2):147–53.Google Scholar
  97. 97.
    Howard LM, Molyneaux E, Dennis C-L, Rochat T, Stein A, Milgrom J. Non-psychotic mental disorders in the perinatal period. Lancet. 2014;384(9956):1775–88.CrossRefPubMedGoogle Scholar
  98. 98.
    Dennis CL, Chung-Lee L. Postpartum depression help-seeking barriers and maternal treatment preferences: a qualitative systematic review. Birth. 2006;33(4):323–31.CrossRefPubMedGoogle Scholar
  99. 99.
    Schwarzer R, Knoll N. Functional roles of social support within the stress and coping process: a theoretical and empirical overview. Int J Psychol. 2007;42(4):243–52.CrossRefGoogle Scholar
  100. 100.
    Nurullah AS. Received and provided social support: a review of current evidence and future directions. Am J Health Stud. 2012;27(3):173–88.Google Scholar
  101. 101.
    Champion L. Social relationships and social roles. Clin Psychol Psychother. 2012;19(2):113–23.CrossRefPubMedGoogle Scholar
  102. 102.
    Cutrona CE, Russell DW. Autonomy promotion, responsiveness, and emotion regulation promote effective social support in times of stress. Curr Opin Psychol. 2017;13:126–30.CrossRefPubMedGoogle Scholar
  103. 103.
    Cohen S, McKay G. Social support, stress and the buffering hypothesis: a theoretical analysis. Handb Psychol Health. 1984;4:253–67.Google Scholar
  104. 104.
    Ozturk Z, Olmez E, Gurpinar T, Gok S, Vural K. Safety of psychotropic medications in pregnancy: an observational cohort study. Bull Clin Psychopharmacol. 2016;26(3):229–37.CrossRefGoogle Scholar

Copyright information

© Springer International Publishing AG, part of Springer Nature 2019

Authors and Affiliations

  1. 1.Faculty of NursingUniversity of CalgaryCalgaryCanada
  2. 2.Women’s Mental Health Clinic, Alberta Health ServicesCalgaryCanada
  3. 3.Department of Health and Community ServicesGovernment of Newfoundland and LabradorSt. John’sCanada

Personalised recommendations