Developing Specialist Perinatal Mental Health Services: the door of opportunity

The development of Specialist Perinatal Mental Health Services in Ireland in recent years (2018-2021) is described. The paper highlights the role of unexpected opportunity in advancing this much needed service for women, infants and their families. It also emphasises the need for funding combined with an implementation mechanism to ensure that the service emerging is true to the Model of Care designed and is available in a uniform manner to women nationally.

A retrospective audit of joint mother-baby admissions to the Werribee Mercy mother and baby unit (MBU) and of the severity of maternal depression over the course of admission

OBJECTIVES

This study examined (i) the demographic and illness profiles of mothers admitted to Werribee Mercy MBU in Victoria, Australia and (ii) the severity of maternal depressive symptoms over the course of admission.

METHOD

A retrospective audit was conducted on consecutively admitted mother-baby dyads between January 2011 and June 2015. Routinely collected maternal Beck Depression Inventory, second edition (BDI-II) scores were analysed for severity and change.

RESULTS

A total of 307 mother-baby dyads were admitted during the study period. The majority of mothers was partnered and educated young adults. The average length of stay was 4.4 weeks. The mean age of babies was 3.3 months. One-third of mothers met International Classification of Diseases, 10th edition criteria for two or more psychiatric diagnoses. Unipolar major depression was the commonest diagnosis. Of the 307 mothers, 125 mothers completed BDI-II on admission and on discharge, which showed a mean reduction of 16 points (p < 0.001) on discharge.

CONCLUSIONS

This study notes the similarities between the clinical profiles of the study population with mother-baby admissions to MBUs worldwide. Maternal depressive symptoms improved by 16 points on the BDI-II over the course of MBU admission, which shows the utility of MBU admission on maternal depressive symptoms.

Experiences of mothers with preterm babies at a Mother and Baby Unit of a tertiary hospital: A descriptive phenomenological study

Aim

To describe the lived experiences of mothers with preterm babies at a Mother and Baby Unit (MBU) of a tertiary hospital.

Design

A descriptive phenomenological approach.

Method

Ten mothers were purposively sampled during the month of May, 2017 to describe their experiences of having preterm babies. Recorded in-depth individual interviews were transcribed verbatim; codes were generated and inductively organised into themes.

Results

Four themes were actively generated: 'Emotional experiences of mothers', 'Mother-baby interaction', 'Perception on care and support' and 'Challenges within Mother and Baby Unit environment'. Mothers were anxious about the premature delivery and were afraid of possible infant's death. They cherished interactions with their babies during kangaroo mother care and breastfeeding. Mothers applauded the nurses for their professional competence. They expressed concerns about inadequate accommodation, high cost of care, the frequency and duration of mother-baby interactions.

Infant psychomotor development in cases of maternal postpartum depression: Observation of a mother and baby unit

Studies of the first year of infant psychomotor development in cases of maternal postpartum depression are lacking. The mother and baby unit (MBU) is a healthcare system available to infants and their mothers during the postpartum period in a psychiatric hospital, which provides support and preserves the parent’s role in the child’s daily care. The aim of the paper is to describe the developmental profile of babies of mothers with severe postpartum depression treated in an MBU through the developmental quotients. Using the Brunet-Lézine scale, we studied six-month-old infants whose mothers were hospitalized. The study population consisted of 15 infants. The mean global developmental quotient score was 96.7. A developmental quotient lower than 80 was not observed for any of the children. We found no global psychomotor developmental delays. Despite this, the posture subscore was the area in which we observed the most difficulties. It is possible that the tonic dialogue between the mother and infant is disrupted by maternal depression.

Men's experiences of having a partner who requires Mother and Baby Unit admission for first episode postpartum psychosis

AIMS

The aim of this study was to explore the experiences of men during their partner's admission to a Mother and Baby Unit for first episode postpartum psychosis.

BACKGROUND

Postpartum psychosis can be life-changing for women, however little is known about the impact on their partners or their partners' needs.

DESIGN

An Interpretative Phenomenological Analysis approach was used to analyse interview transcripts.

METHODS

Semi-structured interviews were conducted with seven participants. Interviews were conducted in 2014-2015.

FINDINGS

Two main themes were identified: 'What the f*** is going on?' and 'Time to figure out how your family works'. Partners experienced shock and confusion during postpartum psychosis onset. Most felt hospital admission was beneficial, although there were barriers to accessing help and involvement in their partner's care. A process of understanding changes to roles, relationships and family identity was described. Loss was a common experience, with a potentially lasting impact.

CONCLUSIONS

Men reported a range of challenging and positive experiences associated with their partner's postpartum psychosis. Improvements are needed in awareness of postpartum psychosis, access to appropriate services and support of partners.

Outcomes for women admitted to a mother and baby unit: a systematic review

Mother and baby units (MBUs) provide inpatient psychiatric care for mothers and their infants up to a year after childbirth. They are commissioned to support the mother–infant relationship as well as stabilize maternal mental health. As their efficacy at meeting these aims had not previously been systematically assessed, this paper reviewed the international literature relating to psychological outcomes following MBU admission. A systematic search of five databases identified 23 papers eligible for inclusion, reporting on a range of outcomes indicating positive effects on maternal mental health and the mother–infant relationship and an absence of adverse effects on child development. The review also highlighted specific groups responding less favorably to MBU admission, eg, mothers with a diagnosis of schizophrenia. Although the included studies were of variable methodological quality, the research findings consistently indicated positive effects. Implications for research and clinical practice are outlined in the discussion.