Midwives and assessment of perinatal mental health

Childbirth is a significant life event in which women may experience emotional as well as physical changes. This study examined what midwives thought about their mental health skills and knowledge when they worked with women with a mental illness who had just had a baby. They reported feeling ill equipped to work with women with mental illness as well as not being aware of the resources available to them and the mothers. Midwives need to have appropriate education, knowledge and skills to work with this vulnerable group of women. Childbirth involves many psychological and emotional changes for women. The recent Commonwealth Government of Australia, National Perinatal Mental Health Action Plan (in 2008) recommends all pregnant and postnatal women have a psychosocial assessment including completion of the Edinburgh Postnatal Depression Scale. Midwives will assess all women at antenatal 'booking in' to maternity services. Currently, midwives receive little education regarding mental health assessment of women. This study explored the perceptions of midwives of their own mental health skills, knowledge and experiences, when working with women with mental illness in the perinatal period. An exploratory descriptive design was utilized to survey midwives across 19 maternity sites in Victoria, Australia. Clearly, midwives lack mental health skills and knowledge, describing their lack of confidence and feeling uncomfortable and unsafe when providing care for women with mental illness. They also report little knowledge of resources available to provide appropriate services for these women. The future direction for improving maternity care will require midwives to assess mental health needs of women, and refer them on, for timely intervention. It is critical midwives are prepared and able to make this kind of assessment.