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It is well established that expectant and new parents are most at risk of developing emotional and mental health conditions in pregnancy and the year following birth. Research was undertaken with 1,800 expectant and new parents to identify the key emotional and mental health challenges experienced, what were the compounding factors, and what could have prevented/alleviated the impact. 43% of respondents identified emotional and mental health challenges during their pregnancy and over a third (37%) experienced challenges at their birth. Expectant parents spoke of unmet expectations about what pregnancy was supposed to be like, the experience of anxiety, depression and hyperemesis – all of which were often not well understood by patients and/or health professionals. Body image, family violence, and the impacts of the pandemic were all seen to exacerbate mental health outcomes. Contrary to national guidelines, many parents came off their antidepressant medication, resulting in relapse at this already vulnerable life stage. Birth trauma featured prominently, exacerbated by poor treatment by front-line health professionals, lack of opportunity to debrief, and lack of continuity of care – all of which undermined new parents and further exacerbated their emotional and mental health vulnerability. The research emphasises the critical importance of education, prevention and early intervention approaches to support awareness and early detection and intervention. This presentation will equip midwives with insights, education and access to world-leading innovative solutions that are freely available to support best practice and reduce the significant levels of distress. All training and resources are freely available for practicing midwives and those in their care. [ABSTRACT FROM AUTHOR]

While there is awareness that multiple birth pregnancies and postnatal experiences are more challenging generally, little is known of the mental health impacts. To explore multiple birth mothers pregnancy experience and mental health outcomes during pregnancy, following delivery and postnatally. An open online anonymous survey was used to collect data from multiple birth parents, 1006 responses were collected. 713 completed the survey fully, providing very detailed responses to open-ended questions, whilst 293 provided high level responses only. The challenges of a multiple birth pregnancy was associated with high levels of mental distress and mental health problems. 73.3% of respondents noted that they experienced challenges during their pregnancy, and of these, 84.7% cited these challenges as directly impacting upon their emotional or mental health. Despite the challenges, 70% of these respondents did not seek treatment or a diagnosis. At birth, 73.7% of those surveyed had a caesarean delivery and another 2.3% had at least one baby delivered via caesarean. Almost 28% of respondents reporting experiencing a traumatic birth, with over 60% not seeking support or treatment. The heightened risk of postnatal mental health problems and emotional distress is indicated with 69% of respondents experiencing stress, anxiety and/or depression in the postnatal period. In addition, over three quarters (77.5%) experienced feelings of isolation. The results reveal the significantly higher risks of emotional and mental health distress for parents of multiple births. This begins in the antenatal period, and continues at birth and throughout the postnatal period. The results highlight the imperative need for information, screening and early detection, support and treatment. Given the high prevalence of emotional and mental health distress, low rates of help-seeking, and isolation, the need for continued advocacy to support the unique needs of this population group is urgently needed. [ABSTRACT FROM AUTHOR]

Background and aim Symptoms of perinatal depression and anxiety are usually described and understood from a nosological perspective. This research sought to gain insight into women's lived experience of postnatal depression and anxiety, the factors that contribute to these symptoms and the context in which they develop. Method Face to face and telephone interviews were conducted with 28 women from metropolitan and rural areas across Australia, who had experienced postnatal depression and/or anxiety within the last five years. Analysis was conducted from a grounded theory perspective. Findings Particular symptoms of anxiety and depression develop in the context of the numerous changes inherent to the transition to motherhood and contribute to a common experience of frustration and loss. Symptoms were also associated with feelings of dissatisfaction with the pregnancy and motherhood experience. Conclusions The findings provide useful insights into women's experiences of mental health symptoms during the perinatal period, how these symptoms present and the factors involved in their development and maintenance. The need to consider women's perspectives to develop resources and health promotions strategies, as well as within the context of relationships with health professionals is highlighted. The study emphasizes the need for greater, more accurate information surrounding perinatal depression and the need to increase the profile and awareness of anxiety disorders. [ABSTRACT FROM AUTHOR]

Abstract: Background: Mood disorders arising in the perinatal period (conception to the first postnatal year), occur in up to 13% of women. The adverse impact of mood disorders on mother, infant and family with potential long-term consequences are well documented. There is a need for clear, evidence-based, guidelines for midwives and other maternity care providers. Aim: To describe the process undertaken to develop the Australian Clinical Practice Guidelines for Depression and Related Disorders in the Perinatal Period and to highlight the key recommendations and their implications for the maternity sector. Method: Using NHMRC criteria, a rigorous systematic literature review was undertaken synthesising the evidence used to formulate graded guideline recommendations. Where there was insufficient evidence for recommendations, Good Practice Points were formulated. These are based on lower quality evidence and/or expert consensus. Findings: The quality of the evidence was good in regards to the use of the Edinburgh Postnatal Depression Scale and psychological interventions, but limited as regards medication use and safety perinatally. Recommendations were made for staff training in psychosocial assessment; universal screening for depression across the perinatal period; and the use of evidence based psychological interventions for mild to moderate depression postnatally. Good Practice Points addressed the use of comprehensive psychosocial assessment – including risk to mother and infant, and consideration of the mother–infant interaction – and gave advice around the use and safety of psychotropic medications in pregnancy and breastfeeding. In contrast to their international counterparts, the Australian guidelines emphasize a more holistic, woman and family centred approach to the management of mental health and mood disorders in the perinatal setting. Conclusion: The development of these Guidelines is a first step in translating evidence into practice and providing Australian midwives and other maternity care providers with clear guidance on the psychosocial management of women and families. [Copyright &y& Elsevier]

Abstract: Background: Current research activity has not focused adequately upon the experience of caring for a person with depression. This study aimed to explore the carer''s experience of living with a person with clinical depression. Specific focus was given to the detection and recognition of the disorder. Methods: A series of focus groups and in-depth interviews was conducted with carers living with a person with clinical depression in rural and metropolitan Australia. Participants were recruited via support agencies and local advertising of the research. Results: Signs and symptoms of depression were recognised by carers, generally in hindsight. Barriers to early detection were identified by carers and these were likely to contribute to the psychological reaction of carers and to the eventual diagnosis of the care recipient. Limitations: The study would be strengthened by a greater diversity of relationships between the carer and the care recipient. Conclusions: This research has important implications for clinical practice and health policy, which must evolve to facilitate early detection and intervention, and to address the experience and needs of carers. [Copyright &y& Elsevier]