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Call for midwives to tackle depression during pregnancy
By Judith Duffy, Health Correspondent
10 July 2005

MIDWIVES should undergo training to help increase the detection of depression in women during pregnancy, according to a new report.
Antenatal depression is thought to be even more prevalent than postnatal depression, with experts estimating it can affect between 10% and 25% of mothers-to-be.

Risk factors include marital disharmony, unemployment, previous depression and an unplanned or unwanted pregnancy. Yet a study has revealed a lack of awareness about the condition among both women and health professionals.

Unlike postnatal depression, which has received widespread attention - with high-profile sufferers such as Gail Porter - depression during pregnancy is rarely talked about.

Researchers asked mothers, health visitors and community midwives in one health trust area about their experiences of antenatal depression.

Nicky Stanley, professor of social work at the University of Central Lancashire, said: Antenatal depression has not been given the attention that postnatal depression has attracted.

What we found when we talked to mothers was that they felt unprepared for the possibility of being depressed in the antenatal period.

They all knew about post natal depression, but they felt there was very little available to them to alert them to the possibility of depression antenatally.

Some women said they experienced a "rollercoaster" of emotions during pregnancy and said it was difficult to know if they were unusual, especially during their first pregnancy.

One first-time mother said: "I assumed that was how pregnant women felt, it wasn't until after my baby was born and I talked it through with a midwife - who said it sounded like I'd been depressed. Why didn't anyone pick it up?"

Nearly three-quarters of the health professionals questioned thought they had looked after at least one women they believed to be suffering from the condition in the past two years.

Over 40% indicated that they had worked with six or more women who were depressed in pregnancy during that time.

Stanley said: "When we talked to the practitioners we found quite a few of them had come across antenatal depression in the last couple of years.

So they felt they were coming across it fairly regularly, more regularly than we would have expected really."

The study recommends that training should be given to all staff involved in caring for pregnant women to develop their knowledge of antenatal depression.

In particular it says midwives' awareness of and ability to detect the condition needs to be increased, given their key role in antenatal care.

Stanley highlighted a lack of specialist services to help mothers with antenatal depression, as most focus only on the postnatal period.

But she warned that the problem had to be addressed: "When depression takes a very severe form, there can be a risk of suicide.

Ultimately it is about saving the lives of women in the perinatal period."
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