Relation between perceived stress, social support, and coping strategies and maternal well-being: a review of the literature.
ABSTRACT The objective of this work was to review published articles on the impact of perinatal stress on mothers' medium- or long-term psychological health and the efficacy of coping strategies, to determine if social support plays a role in the interaction between birth events and mothers' psychological experiences, and to identify the tools used for these measurements. MEDLINE, PsycINFO, and CINAHL databases were searched for English and French language articles from 2000 through 2010 inclusive. Thirty-seven articles fulfilled the selection criteria. The results of this review highlight an association between perceived stress and postpartum depressive symptoms. However, because perceived stress has been evaluated in a general manner, it was not possible to identify events having more or less relation to postpartum depressive symptoms in mothers. Social support also appeared to be related to mothers' psychological health. Coping strategies were difficult to analyze because of the lack of homogeneity in their definition across studies. The comparison among studies of social support and coping strategies was also difficult due to the diversity of tools used and their lack of specificity. New tools should be specifically developed for the perinatal period, and further research should be performed to understand better the events and adequacy of social support.
SourceAvailable from: Susan Ayers[Show abstract] [Hide abstract]
ABSTRACT: Background: Women can experience a range of psychological problems after birth, including anxiety, depression and adjustment disorders. However, research has predominantly focused on depression. Qualitative work on women’s experiences of postnatal mental health problems has sampled women within particular diagnostic categories so not looked at the range of potential psychological problems. The aims of this study were to explore how women experienced and made sense of the range of emotional distress states in the first postnatal year. Methods: A qualitative study of 17 women who experienced psychological problems in the first year after having a baby. Semi-structured interviews took place in person (n = 15) or on the telephone (n = 2). Topics included women’s experiences of becoming distressed and their recovery. Data were analysed using Interpretative Phenomenological Analysis (IPA). Themes were developed within each interview before identifying similar themes for multiple participants across interviews, in order to retain an idiographic approach. Results: Psychological processes such as guilt, avoidance and adjustment difficulties were experienced across different types of distress. Women placed these in the context of defining moments of becoming a mother; giving birth and breastfeeding. Four superordinate themes were identified. Two concerned women’s unwanted emotions and difficulties adjusting to their new role. “Living with an unwelcome beginning” describes the way mothers’ new lives with their babies started out with unwelcome emotions, often in the context of birth and breastfeeding difficulties. All women spoke about the importance of their postnatal healthcare experiences in “Relationships in the healthcare system”. “The shock of the new” describes women’s difficulties adjusting to the demands of motherhood and women emphasised the importance of social support in “Meeting new support needs”. Conclusions: These findings emphasise the need for exploration of psychological processes such as distancing, guilt and self-blame across different types of emotional difficulties, as these may be viable target for therapeutic intervention. Breastfeeding and birth trauma were key areas with which women felt they needed support with but which was not easily available.BMC Pregnancy and Childbirth 10/2014; DOI:10.1186/1471-2393-14-359 · 2.15 Impact Factor
[Show abstract] [Hide abstract]
ABSTRACT: Objective The postnatal period represents a critical phase for mothers because of physiological hormonal changes, the increase of emotional reactions and a greater susceptibility for the onset/recrudescence of psychiatric disorders. Despite the evidence of an increasing utilization of antidepressant drugs during breastfeeding, there is still few reliable information on the neonatal safety of the selective serotonin reuptake inhibitors (SSRIs) and selective noradrenergic reuptake inhibitors (SNRIs) [serotonin reuptake inhibitors (SRIs)] in nursing mothers. The aim of this study is to provide a systematic review on the neonatal safety profile of these drugs during breastfeeding, also assessing the limits of available tools. Methods MEDLINE and PubMed databases were searched without any language restrictions by using the following set of keywords: ((SSRIs OR selective serotonin inhibitor reuptake OR SNRIs OR selective serotonin noradrenaline inhibitor reuptake) AND (breastfeeding OR lactation OR breast milk)). A separate search was also performed for each SSRIs (paroxetine, fluvoxamine, fluoxetine, sertraline, citalopram and escitalopram) and SNRIs (venlafaxine and duloxetine). Results Sertraline and paroxetine show a better neonatal safety profile during breastfeeding as compared with other SRIs. Less data are available for fluvoxamine, escitalopram and duloxetine. Few studies followed up infants breastfeed for assessing the neurodevelopmental outcomes. Conclusions Literature review clearly indicates paroxetine and sertraline as the drugs that should be preferred as first line choice in nursing women who need an antidepressant treatment.Human Psychopharmacology Clinical and Experimental 01/2015; 30(1):4-20. DOI:10.1002/hup.2451 · 1.85 Impact Factor
[Show abstract] [Hide abstract]
ABSTRACT: Examining women's stress and social support following denial and receipt of abortion furthers understanding of the effects of unwanted childbearing and abortion on women's well-being. This study investigated perceived stress and emotional social support over time among women who were denied wanted abortions and who received abortions, and compared outcomes between the groups.BMC Women's Health 06/2014; 14(1):76. DOI:10.1186/1472-6874-14-76 · 1.66 Impact Factor