Promoting positive parenthood: emotional health in pregnancy

Depression is a common problem in the general population and is projected to be one of the major health issues facing the world in 2020 (WHO). Serious consequences exist for the sufferer, and the family. Given that women are twice as likely to suffer from depression, and are at particular risk in the child bearing years, children from infancy may be affected, with long term ramifications. Postnatal depression (PND) occurs in 14% of women, and there may be a similar number affected antenatally. The perinatal period thus is a crucial time to identify depression, and offers an excellent opportunity to screen women due to their increased contact with health services. In order to do so, services need to reevaluate their priorities, and assess barriers to screening. These barriers include attitudes to mental illness, anxiety about how to deal with mental illness in health professionals who are not trained in this area, and--most importantly--resource implications. It is argued that without attempting to address this, identify and remedy the deficiencies, change will not occur. This paper looks to examine the prevalence of depression in the perinatal period, the associated concerns and the difficulties of identification at this time through a review of key relevant papers in this area, and proposes a framework to approach the problem.