Support preferences among women with and without postpartum depression and anxiety disorder

Some women struggle with mental health problems such as postpartum depression (PPD) or postpartum anxiety disorder (PAD) after giving birth. This can have a negative impact on the new mother, the infant, and the whole family. However, many women experiencing PPD and/or PAD go unrecognized and untreated. Since appropriate support is essential, efforts should be made to facilitate women's help-seeking behavior. The purpose of this study was to improve the mental health of postpartum women by understanding their specific support preferences. To this end, the preferences for counseling and treatment services, as well as the service delivery mode among women with PPD, PAD, comorbid PPD and PAD, and women with neither PPD nor PAD were examined.

In the cross-sectional study INVITE, mothers (n = 2,031) were interviewed via telephone about three to four months after birth. PPD was assessed using the Edinburgh Postnatal Depression Scale (EPDS), PAD was assessed using the anxiety scale of the Symptom-Checklist-90-Revised (SCL-90-R), and preferences for services and delivery modes were assessed using self-generated questionnaires. Analyses of covariance were performed to examine differences between the symptom groups.

All women preferred the support of (family) midwives and family, friends, or colleagues and to talk to someone in person. Analysis of covariance showed that, overall, women with PPD preferred all services less than women with neither PPD nor PAD. Furthermore, women with PPD preferred psychotherapeutic services (e.g., inpatient clinic and outpatient clinic/treatment) less, and women with comorbid PPD and PAD preferred professional and personal confidants (e.g., midwife and women in the same situation) less than all other women. Women did not differ in their preferences for service delivery mode.

This study provides unique insight into postpartum women's preferences for various services and delivery modes. Results showed that women differ in their preferences for services depending on their symptoms. This should be considered when making referrals, and postpartum support should be better tailored to mothers' wishes and needs to improve help-seeking behavior and ultimately postpartum mental health.