Impact and Health Promotion Strategies

Introduction

Mental Health issues or mental illness refer to a wide range of mental health disorders which negatively impacts the mood, behaviour and thinking efficiency of individuals (Ducat et al. 2015). The well-being is referred to the state in which the individuals remain healthy and comfortable in their life (Watson et al. 2016). Perinatal mental health issues are those mental illnesses that are experienced by the mother within a short time before and after the birth of their babies (Hall et al. 2016). The perinatal mental health issues include antenatal depression, post-traumatic stress disorder, perinatal obsessive-compulsive disorder, postpartum psychosis and others (Roberts et al. 2019). In this report, the key perinatal mental issue to be focussed for discussion is antenatal depression. The report will be targeted towards pregnant mothers.In the report?, signs and symptoms of antenatal depression will be discussed and the impact of the health issues on the mother as well as their babies will be explained. The impact of the critical issues which arises as a result of antenatal depression such as lack of sleep, low emotional condition and others on the mother and babies will be explored. The health promotion strategies available regarding antenatal depression are also to be analysed to determine gaps and the facts which are working in hindered manner to develop recommendations for the parents, families, partners and general practitioners.

Rationale of topic and Prevalence of antenatal depression

In the UK, it is reported that nearly 10-15% of pregnant women experience antenatal depression along with anxiety (babycentre, 2019). The survey by the Baby Centre states that nearly 30% of pregnant women experience frequent indicators of antenatal depression and that more than ¼th of pregnant women in the UK are suffering from antenatal depression (babycentre, 2019). However, it is reported by the Baby Centre that 42% of the pregnant women experiencing antenatal depression avoid talking about their health issues with the professionals (babycentre, 2019). This suggests that antenatal depression is at large and many pregnant mothers are avoiding accessing proper care by consulting with health professionals due to various factors such as stigma, fear, embarrassment and others. In another survey by RCOG (Royal College of Obstetricians and Gynaecologists), it was highlighted that 37% of the 2323 respondents develop depression as a key perinatal mental health issue during and after pregnancy (RCOG, 2017). As per the reports published by NICE in 2014, it is reported that 12% of women during their pregnancy experiences antenatal depression (NICE, 2014). Thus, it indicates that antenatal depression is one of the key perinatal mental health issues being faced by pregnant mothers regarding which effective steps have to be taken. This is because 1.27 maternal deaths have occurred from 2006 to 2008 per 100,000 deliveries in the UK due to antenatal depression and other prenatal health issues as mentioned by NICE (NICE, 2014). In the study of Healey et al. (2013), it is mentioned that out of 73 women surveyed who had perinatal mental health condition it is revealed that 58% of them mentioned to be involved in episode of self-harm. Therefore, discussion regarding the topic of antenatal depression is essential so that depression among pregnant women can be prevented as well as they can be protected from causing harm to themselves out of depressionto ensure good health. Moreover, focus on the topic is required so that pregnant women understand the way it is impacting on their their health as well as developing awareness regarding the way they can avoid their fear related with the stigma regarding mental issues present in the community to promote their healthy living.

Critical analysis of the antenatal depression and its impact on mental health and well-being of mothers

The antenatal depression is referred to a nature of clinical depression which occurs among women during pregnancy and is regarded as the precursor to postpartum depression (Jarde et al. 2016). In general, pregnancy is considered as the happiest moment in the life of the women but various causes such as lack of sleep, concerns regarding the health of the babies, lack of money and others lead women to develop antenatal depression. As mentioned by Kumar (2016), lack of sleep leads hormones like oxytocin which plays the role of allowing people to execute effective social bonding, maintain proper childbirth, sexual reproduction and others to be released at low levels. This is because it is one of the key hormones which are released in the body during sleep. Thus, the lack of release of the hormone at the proper levels as a result of less sleeping time leads the mothers unable to form proper social bonding and maintain the normal functioning of the body leading them to develop depression. As argued by Lucena et al. (2018), proper sleep is required for the effective functioning of the brains cells in producing signals to control the mood and behaviour of individuals. This informs that lack of sleep among mothers leads them to develop antenatal depression as their brain cells are unable to function properly in managing their fear and anxiety to avoid developing depression.

The concerns regarding baby’s health lead pregnant mothers to develop depression because they feel they would be unable to provide the required care for the healthy development of the baby which would lead the baby to develop uncertain illness and reduced growth that may result them to die (Gravensteen et al. 2018). Thus, the pregnant women having the fear of failure to provide care to the going to be newborn makes them depressed. As asserted by Amarante et al. (2016), proper money and social condition are required for the healthy development of the babies. This is because the effective amount of money is required to fulfil the medical needs of the babies on their birth. Therefore, lack of money leads pregnant women to develop antenatal depression out of their insecurity to ensure meeting the needs of the babies on birth. The symptoms regarding antenatal depression include fatigue or less energy to execute everyday chores, trouble with attachment formation, change in appetite, increased anxiety and mood swings, less enjoyment in pleasured activity and trouble with sleeping. It also mentioned that frequent weepiness or crying is also indication that pregnant women are suffering from antenatal depression (Coll et al. 2017).

The persistent antenatal depression leads pregnant women to avoid taking their own care by eating less and not getting enough rest (Hu et al. 2015). The lack of having proper meals leads the pregnant mother to be unable to have the required nutrients and minerals needed for proper growth of the baby within their womb. Moreover, lack of sleep also interferes with the normal development of the baby (Zeng et al. 2015). Thus, it indicates that antenatal depression not only negatively affects the health of the mothers but also have a negative impact on the baby by making them unable to have proper nutrients and body management of the body to develop in a healthy way. As mentioned by Sahile et al. (2017), antenatal depression may lead pregnant women to experience miscarriage or having premature babies with less body weight. This indicates that antenatal depression impacts the mother to experience negative health issues. As argued by Mohamad Yusuf et al. (2016), the lack of proper management of antenatal depression during pregnancy leads the women to develop postpartum depression. This condition creates worst situation for the mother as they are unable to offer care and develop proper bonds with the babies as required.

The pregnant women are found to be suffering from the risk of antenatal depression because many of them due to various reasons are avoiding to access proper care from health professionals. This is evident as the report by Baby Centre mentions that permanent women out of feeling guilty (74%), embarrassed (62%), fear of stigma (58%) and others avoid consulting their mental health issues with the health professional and nurses (babycentre, 2019). The pregnant women feel guilty because they think that it is their duty to remain happy and ensure proper mental health and by not doing so they are deteriorating the health of the child. Thus, revealing regarding their antenatal depression would indicate they would fail as a mother, in turn, making them avoid accessing care regarding the health issue. In the UK, it is reported that 9 out of 10 people due to mental health issues have experienced stigma in society. The experienced of stigma in society due to mental health leads the individuals to face social isolation as well as abuse from society (NICE, 2014). Thus, pregnant women out of fear of being isolated and stigmatised for their mental health avoided accessing mental health services.

The RCOG report mentions that only 7% of women they surveyed in the UK experiencing any form of perinatal mental health issue were only referred to specialists care. In addition, 38% of the women who were referred to mental health professionals for antenatal depression and other perinatal mental health issues have to want more than 4 weeks and at times one year to access care (babycentre, 2019; RCOG, 2017). Thus, it indicates that there is lack of proper management in regard to the management of antenatal depression and other perinatal mental health issues among women. Moreover, it can be deduced that there is lack of proper amount of awareness and resources to support healthcare regarding antenatal depression to pregnant women due to which their waiting time to receive care for the health issue is extended. In regard to the cost of perinatal mental health issue, it is reported that NHS has to spend nearly £8.1 billion each year to offer care to the pregnant women and mothers who have just given birth (RCOG, 2017). This indicates a huge amount of money is being spent by the NHS to cope with mental health issues among mothers and pregnant women.

Health promotion strategies regarding antenatal depression

The health promotion strategies are referred to as the actions that are taken by individuals or organisation for empowering patients to have improved health in living a better life (Place et al. 2016). In respect to antenatal depression and postnatal depression, it is seen that NICE have mentioned few guidelines that are to be followed in promoting the health of the mothers and pregnant women. The NICE guidelines mention that women are to be provided with culturally relevant information regarding mental health during pregnancy and with her agreement to her family and carer. This ensures that the women have detailed understanding regarding mental health issue and is not comfortable to consider antenatal depression as normal and goes for proper treatment (NICE, 2018; Baron et al. 2016). It is effective to promote the health of the pregnant women as with better awareness they would be able to avoid fear and confusion for accessing care and orienting to take effective intervention at the right time to avoid negative impact of antenatal depression on them and the baby.

The NICE guidelines inform that the family members are to be involved in supporting the mother to develop attachment and caring for the baby before and after the birth of the baby (NICE, 2018; Potvin et al. 2016). This is an effective health promotion strategy in resolving antenatal depression among women as it would able the mother to develop the assurance that they are going to get support in caring for the baby. The NICE guidelines mention that pregnant women who are at risk of facing mental illness are to be referred to specialist perinatal mental health services. This is because it would help to provide the women proper assistance and treatment required to maintain healthy mental health so that they are able to take effective care of their own as well as the baby (NICE, 2018). The NICE guidelines mention that mental health professionals are to provide information to the pregnant women who are referred to them regarding the risk of mental health issues during pregnancy and the significance of the treatment (NICE, 2018; Vikström and Barimani, 2016). This is an effective health promotion strategy as it would help the pregnant women to consider their mental health issues such as antenatal depression in serious manner and ensure proper treatment is received to resolve it so that the risk related with the issues for them and the baby can be avoided. It also leads pregnant women to maintain a healthy pregnancy to give birth to a proper baby without psychiatric health condition.

The NICE guidelines mention that by using proper resources such as Edinburgh Postnatal Depression Scale, 7-item Generalized Anxiety Disorder scale and others the mental health symptoms among pregnant women are to be properly monitored (NICE, 2018). This is required so that irrespective of revealing mental health issues by pregnant women or women who have provided recent birth to their child it is able to be determined if they are facing any nature of perinatal mental health issues such as antenatal depression or postnatal depression or not. It would lead the health professionals to act in promoting the health of pregnant women suffering from antenatal depression who do not disclose their health issues by offering them proper mental healthcare. The NICE guidelines mention that to screen and provide care to women suffering from perinatal mental health issues such as antenatal depression the health professionals required to avail consent from the patient, consider child protection issues and use guidance mentioned in the Mental Health Act 2007 (NICE, 2018). This is effective to promote legal as well as ethical care services for the better mental health condition of the pregnant women as well as women who have recently given birth.

The NHS England has developed Five Year Forward View for Mental Health according to which it plans to increase specialist perinatal mental health care within the areas in England by 2020/21. This is to be done so that an addition of 30,000 women who are pregnant or have recently given birth to their child is able to access evidence-based treatment near their homes and whenever they need the services (NHS, 2018). This is an effective national policy developed by the NHS England to promote preinatal mental health in leading pregnant mothers to get treatment for issues such as antenatal depression because the services would offer timely and immediate care without hindrance to the mothers.

Conclusion

The above discussion mentions that antenatal depression is one of the prenatal health issues experienced by pregnant women. Thus, the key audience selected for the report is pregnant women so that they can be made aware regarding the health issue and make them access treatment for resolving it. The antenatal depression is seen to mainly arise due to lack of sleep, the worry of being able to take care of the baby, lack of money and others. There is found to be lack of effective awareness regarding prenatal mental health issues like antenatal depression among pregnant women due to which many are unable to access proper care. In this purpose, the NICE, UK have developed national guidelines such as immediate mental care is to be offered to be offered to pregnant women, benefits of mental health treatment along with risk of not completing the treatment are to be mentioned, pregnant women mental health are to be screened and others for health promotion of the individuals. The NHS England has also developed Five Year Forward View for Mental Health plan for perinatal health promotion so that the mental health issues among pregnant women and mothers are resolved.

Recommendations

According to the information regarding antenatal depression as perinatal mental health issue identified in the UK, it is recommended that timely access and early access to care for mental health issues among pregnant women are to be created. The Health Commissioners are to reach all the local and national areas to promote awareness regarding perinatal mental health issues such as antenatal depression along with others to ensure apart from the women their families have information regarding the way to identify of any women during their pregnancy are suffering from depression or not. This is because it would help the family members to report and take actions for the pregnant women's mental health to be improved even if the women themselves are unable to identify if they are suffering from any mental health issues or not. The Health Commissioners are required to implement trained local peer-groups and clinical groups to monitor and identify which women those are pregnant require mental health services for resolving antenatal depression to have better mental health.

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