Experience of women with perinatal mood and anxiety disorder and the supportive role of obstetric and gynecologic nurses
DOI:
https://doi.org/10.18203/2349-3291.ijcp20260836Keywords:
Perinatal mood and anxiety disorders, Postpartum depression, Perinatal anxiety, Women’s experiences, Obstetric nurses, Gynecologic nurses, Nursing support, Maternal mental healthAbstract
Perinatal mood and anxiety disorders (PMADs) represent a significant public health concern affecting women during pregnancy and up to one year postpartum, with substantial consequences for maternal well-being, obstetric outcomes, and infant development. Despite their high prevalence, PMADs remain under-recognized and under-treated, largely due to stigma, limited awareness, and fragmented healthcare services. This comprehensive review synthesizes current evidence on women’s lived experiences of PMADs and examines the supportive role of obstetric and gynecologic nurses in identification, intervention, and continuity of care. A systematic search of major biomedical, nursing, and psychological databases was conducted, incorporating quantitative, qualitative, and mixed-methods studies, systematic reviews, and clinical practice guidelines. Findings indicate that women commonly experience emotional distress, anxiety, guilt, and fear of judgment, which contribute to delayed help-seeking and reduced engagement with mental health services. Obstetric and gynecologic nurses emerged as key facilitators of perinatal mental health care due to their sustained contact with women across the perinatal continuum. Evidence supports the effectiveness of nurse-led screening, psychoeducation, emotional support, and brief psychological interventions in reducing depressive and anxiety symptoms, particularly for mild to moderate PMADs. However, gaps in training, time constraints, and inadequate referral pathways limit optimal nursing involvement. Strengthening nurse education, integrating mental health services within obstetric care, and implementing structured care pathways are essential to improving outcomes. Enhancing the role of obstetric and gynecologic nurses offers a feasible and effective strategy to address the burden of PMADs and improve maternal and infant health outcomes.
Metrics
References
Howard LM, Khalifeh H. Perinatal mental health: a review of progress and challenges. World Psychiatry. 2020;19(3):313-27. DOI: https://doi.org/10.1002/wps.20769
Stein A, Pearson RM, Goodman SH, Elizabeth R, Atif R, Meaghan McC, et al. Effects of perinatal mental disorders on the fetus and child. Lancet. 2014;384(9956):1800-19. DOI: https://doi.org/10.1016/S0140-6736(14)61277-0
Wang Z, Liu J, Shuai H, Zhongxiang C, Xia F, Yang L, et al. Mapping global prevalence of depression among postpartum women. Transl Psychiatry. 2021;11(1):543. DOI: https://doi.org/10.1038/s41398-021-01692-1
Fisher J, Cabral de Mello M, Patel V, Atif R, Thach T, Sara H, et al. Prevalence and determinants of common perinatal mental disorders in women in low- and lower-middle-income countries. Bull World Health Organ. 2012;90(2):139-49. DOI: https://doi.org/10.2471/BLT.11.091850
Biaggi A, Conroy S, Pawlby S, Pariante CM. Identifying the women at risk of antenatal anxiety and depression. BJOG. 2016;123(6):1045-56.
Dennis CL, Falah-Hassani K, Shiri R. Prevalence of antenatal and postnatal anxiety. Br J Psychiatry. 2017;210(5):315-23. DOI: https://doi.org/10.1192/bjp.bp.116.187179
O’Hara MW, McCabe JE. Postpartum depression: current status and future directions. Annu Rev Clin Psychol. 2013;9:379-407. DOI: https://doi.org/10.1146/annurev-clinpsy-050212-185612
Oates M. Suicide: the leading cause of maternal death. Br J Psychiatry. 2003;183:279-81. DOI: https://doi.org/10.1192/bjp.183.4.279
Beck CT. Postpartum depression: it isn’t just the blues. Am J Nurs. 2006;106(5):40-50. DOI: https://doi.org/10.1097/00000446-200605000-00020
Dennis CL, Chung-Lee L. Postpartum depression help-seeking barriers and maternal treatment preferences. J Adv Nurs. 2006;56(6):576-87.
Sword W, Busser D, Ganann R, Theresa McM, Marilyn S. Women’s care-seeking experiences after referral for postpartum depression. Birth. 2008;35(1):5-15.
Beck CT. Perinatal depression: a metasynthesis of qualitative research. MCN Am J Matern Child Nurs. 2002;27(4):214-9. DOI: https://doi.org/10.1097/00005721-200207000-00004
American College of Obstetricians and Gynecologists. Screening for perinatal depression. Obstet Gynecol. 2018;132(5):e208-12. DOI: https://doi.org/10.1097/AOG.0000000000002927
NICE. Antenatal and postnatal mental health: clinical management and service guidance. 2020.
Available at: https://www.nice.org.uk/guidance/cg192. Accessed on 15 January 2026.
Cox JL, Holden JM, Sagovsky R. Detection of postnatal depression: development of the EPDS. Br J Psychiatry. 1987;150:782-6. DOI: https://doi.org/10.1192/bjp.150.6.782
Gavin NI, Gaynes BN, Lohr KN, Samantha M-B, Gerald G, Tammeka S. Perinatal depression: a systematic review. Obstet Gynecol. 2005;106(5):1071-83. DOI: https://doi.org/10.1097/01.AOG.0000183597.31630.db
Fairbrother N, Janssen P, Antony MM, Patricia J, Martin MA. Perinatal anxiety disorder prevalence. Arch Womens Ment Health. 2016;19(2):103-14.
Milgrom J, Gemmill AW. Screening for perinatal depression. Best Pract Res Clin Obstet Gynaecol. 2014;28(1):13-23. DOI: https://doi.org/10.1016/j.bpobgyn.2013.08.014
Dennis CL, Hodnett E. Psychosocial and psychological interventions for postpartum depression. Cochrane Database Syst Rev. 2007;4:CD006116. DOI: https://doi.org/10.1002/14651858.CD006116.pub2
Wang TH, Pai LW, Tzeng YL, Tzu-Pei Y, Yu-Kuei T. Nurse-led psychological interventions for perinatal depression. Nurs Open. 2021;8(5):2117-30. DOI: https://doi.org/10.1002/nop2.764
Grote NK, Bridge JA, Gavin AR, Jennifer LM, Satish I, Wayne JK, et al. Effectiveness of depression treatment during pregnancy. Arch Gen Psychiatry. 2010;67(10):1012-24. DOI: https://doi.org/10.1001/archgenpsychiatry.2010.111
Tandon SD, Ward EA, Hamil JL, Cindy J, Mya C. Perinatal depression prevention. Am J Prev Med. 2018;55(3):325-36.
Slomian J, Honvo G, Emonts P, Jean-Yves R, Olivier B. Consequences of maternal postpartum depression. J Womens Health. 2019;28(2):174-83.
Letourneau NL, Dennis CL, Benzies K. Postpartum depression is a family affair. J Affect Disord. 2012;140(2):165-74.
Sockol LE. A systematic review of the efficacy of CBT for perinatal depression. J Affect Disord. 2015;177:7-21. DOI: https://doi.org/10.1016/j.jad.2015.01.052
Shorey S, Chan SWC, Chong YS. Nurse-led interventions on postpartum depression. J Adv Nurs. 2015;71(4):763-75.
McCarter-Spaulding D, Shea K. Effectiveness of postpartum depression interventions. J Obstet Gynecol Neonatal Nurs. 2016;45(2):217-28.
Fenwick J, Toohill J, Gamble J. Effects of midwifery continuity on perinatal mental health. Birth. 2015;42(2):154-64.
Austin MP, Highet N. Mental health care in the perinatal period. Aust N Z J Psychiatry. 2011;45(7):565-8. DOI: https://doi.org/10.3109/00048674.2010.547842
Hall H, Cramer H, Midwives’ perceptions of perinatal mental health care. Women Birth. 2019;32(6):e605-15. DOI: https://doi.org/10.1016/j.wombi.2018.11.010
Jones CJ, Creedy DK, Gamble JA. Australian midwives’ confidence in mental health care. Women Birth. 2012;25(4):e23-9. DOI: https://doi.org/10.1016/j.wombi.2011.03.001
Reay R, Matthey S, Ellwood D, Scott M. Long-term outcomes of nurse-delivered CBT. J Affect Disord. 2012;136(3):803-12.
WHO. Maternal mental health and child health outcomes. 2014. Available at: https://www.who.int/publications/i/item/WHO-MSD-MER-14.1. Accessed on 15 January 2026.
Slade P, et al. Post-traumatic stress symptoms following childbirth. BJOG. 2010;117(13):1619-27.
Shorey S, Chee CYI, Ng ED, Yiong HC, Wilson Wai ST, Yap SC, et al. Prevalence and incidence of postpartum depression. J Psychiatr Res. 2018;104:235-48. DOI: https://doi.org/10.1016/j.jpsychires.2018.08.001
Bauer A, Parsonage M, Knapp M. Costs of perinatal mental health problems. Lancet Psychiatry. 2014;1(6):395-403.
Yonkers KA, Vigod S, Ross LE. Diagnosis, pathophysiology, and management of mood disorders. BMJ. 2011;343:d5937.
Gelaye B, Rondon MB, Araya R, Williams MA. Epidemiology of maternal depression. Clin Obstet Gynecol. 2016;59(3):546-61. DOI: https://doi.org/10.1016/S2215-0366(16)30284-X
Muzik M, Borovska S. Perinatal depression: implications for child mental health. Ment Health Fam Med. 2010;7(4):239-47.
Shorey S, Chan SWC. Nurse-led mental health education programmes. J Clin Nurs. 2017;26(23-24):4583-96.
Kingston D, McDonald S, Austin MP, Tough S. Association between prenatal stress and anxiety. J Psychosom Obstet Gynaecol. 2015;36(2):56-66.
Woody CA, Ferrari AJ, Siskind DJ, Whiteford HA, Harris MG. A systematic review of postpartum depression prevalence. J Affect Disord. 2017;219:86-92. DOI: https://doi.org/10.1016/j.jad.2017.05.003
Leigh B, Milgrom J. Risk factors for antenatal depression. Depress Anxiety. 2008;25(7):567-78.
Misri S, Kendrick K. Perinatal depression, infant bonding. Can J Psychiatry. 2007;52(8):489-98. DOI: https://doi.org/10.1177/070674370705200803
Letourneau NL. Long-term effects of postpartum depression on child development. Arch Womens Ment Health. 2012;15(1):1-11.
Slomian J, Reginster JY, Bruyère O, Emonts P. The maternal postpartum experience. BMC Pregnancy Childbirth. 2019;19:184.
O’Hara MW, Wisner KL. Perinatal mental illness: definition, description and aetiology. Best Pract Res Clin Obstet Gynaecol. 2014;28(1):3-12. DOI: https://doi.org/10.1016/j.bpobgyn.2013.09.002
Austin MP, Priest SR. Clinical issues in perinatal mental health. J Affect Disord. 2005;88(2):155-64.
Bauer A, Knapp M. The economic case for perinatal mental health care. Curr Opin Psychiatry. 2017;30(4):257-62.
Shorey S, Chee CYI. Effectiveness of telehealth interventions on perinatal depression. J Med Internet Res. 2019;21(2):e12737. DOI: https://doi.org/10.2196/12410