This study provides valuable insight into women’s lived experiences and psychological needs with MHDP. It reinforces the importance of understanding and supporting themental health of pregnant women, which has implications for both mother and child.
pregnant woman
Key Points
Rationale
While perinatal mental health services in the UK are evolving, women’s subjective experiences of MHDP and their needs are less well understood (Smith et al., 2019).
Existingqualitative researchhas focused more on the postnatal period or specific diagnoses rather than gaining a holistic understanding of moderate-to-severe MHDP (Dolman et al., 2013; Megnin-Viggars et al., 2015).
Method
This qualitative study usedInterpretive Phenomenological Analysis(IPA) to explore the life experiences of participants and how they make sense of them.
Semi-structured interviews were conducted with 11 women recruited via a regional Perinatal Mental Health Service in Northern Scotland.
Analysis
Themes were developed and explored in relation to each participant’s narrative, then grouped to understand patterns across all transcripts.
The third researcher independently analyzed multiple transcripts, and the researchers discussed themes to establish consensus.
Areflective logwas used to identify and minimize the influence of biases on coding interpretations.
Reflexivity
The primary researcher, a white female trainee clinical psychologist, had experience supporting distressed individuals but not specifically during pregnancy.
She kept a reflective log to manage potential biases. The research team, including a female PhD researcher and a male clinical psychologist with perinatal mental health expertise, discussed themes and reflections throughout the analysis process.
The latter two researchers did not conduct interviews directly.
Sample
The 11 women had experienced moderate distress due to MHDP (e.g. depression, anxiety, eating disorders). Seven were from an urban setting and four from rural. Most (n=9) had given birth prior to the interview.
One was aged 18-25, four were 26-34, and six were 35-40. Further demographics were not collected to maintain anonymity.
Results
Five superordinate themes represented the women’s lived experiences of MHDP:
1. Feeling the ‘wrong’ feelings
This theme encapsulates the intense emotional experiences and daily impacts on functioning that the women faced during their pregnancies.
Participants described feeling out of control, exhausted, and as if their distressing feelings would never end.
They often felt disconnected from their pregnancy and experienced guilt and shame for having thoughts they perceived as wrong or abnormal.
The quote “It was awful, it was anxiety I had panic attacks… it was like drowning” (P3) powerfully conveys the overwhelming nature of these emotions.
2. Societal pressures and a desire for greater acceptance
The influence of societal expectations emerged strongly in this theme. Participants felt they did not live up to the idealized image of a happy, glowing pregnant woman and experienced stigma and judgment when they deviated from this norm.
This led to feelings of isolation and reluctance to disclose their true emotions.
The quote “You’re just meant to feel happy when you’re pregnant. People expect you to be um happy and glowing” (P1) illustrates the pressure women felt to conform to unrealistic standards.
Searching for answers despite a lack of resources
This theme highlights the women’s attempts to make sense of their experiences despite limited awareness and information about MHDP.
Participants often looked for biological or situational explanations and reflected on past mental health difficulties.
However, they found that MHDP was rarely discussed or acknowledged compared to postnatal depression, leaving them feeling lost and unsupported. The quote “Nobody had heard of it before.
Everybody’s heard of postnatal depression” (P1) captures this lack of recognition and resources.
What made a difference
While many participants felt they had few sources of alleviation for their distress, this theme outlines the factors they identified as helpful or potentially beneficial.
Peer support, self-compassion, and a non-judgmental space to share their feelings were key elements. Some women found short-term relief through coping strategies likemindfulnessor focusing on their children.
The quote “It was very, very helpful talking with them because I didn’t have to hide, I didn’t have to pretend that I’m happy” (P3) emphasizes the value of authentic, supportive connections.
Experiences and expectations of service provision
The final theme centers on women’s encounters with and perceptions of perinatal mental health services. Specialist services, when accessed, were generally appreciated for their understanding and normalizing approach.
However, participants highlighted the need for systemic changes, including earlier intervention, clearer pathways, and better integration between services.
The lack of open discussion and promotion of mental health support during pregnancy was also noted.
Insight and Depth
This study provides a rich understanding of the lived experiences of women with MHDP. It highlights thedissonancebetween expectations and realities of pregnancy that can compound distress, and the pervasive role of stigma as a barrier to seeking support.
The findings emphasize the importance of awareness, acceptance, and access to needs-matched care in the perinatal period.
Strengths
Limitations
Clinical Implications
The study has important implications for perinatal mental health services and wider society. It highlights the need for greater awareness and acceptance of MHDP, early access to needs-matched care, and more open discourse to normalize and destigmatize MHDP.
References
Primary reference
Reddish, A., Golds, L., & MacBeth, A. (2024). “It is not all glowing and kale smoothies”: An exploration of mental health difficulties during pregnancy through women’s voices.Psychology and Psychotherapy: Theory, Research and Practice, 00, 1–21.https://doi.org/10.1111/papt.12527
Other references
Dolman, C., Jones, I., & Howard, L. M. (2013). Pre-conception to parenting: A systematic review and meta-synthesis of the qualitative literature on motherhood for women with severe mental illness.Archives of Women’s Mental Health, 16(3), 173–196.
Grote, N. K., Bridge, J. A., Gavin, A. R., Melville, J. L., Iyengar, S., & Katon, W. J. (2010). A meta-analysis of depression during pregnancy and the risk of preterm birth, low birth weight, and intrauterine growth restriction.Archives of General Psychiatry, 67(10), 1012–1024.
Megnin-Viggars, O., Symington, I., Howard, L. M., & Pilling, S. (2015). Experience of care for mental health problems in the antenatal or postnatal period for women in the UK: A systematic review and meta-synthesis of qualitative research.Archives of Women’s Mental Health, 18(6), 745–759.
Smith, M. S., Lawrence, V., Sadler, E., & Easter, A. (2019). Barriers to accessing mental health services for women with perinatal mental illness: Systematic review and meta-synthesis of qualitative studies in the UK.BMJ Open, 9(1), e024803.
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Olivia Guy-Evans, MSc
BSc (Hons) Psychology, MSc Psychology of Education
Olivia Guy-Evans is a writer and associate editor for Simply Psychology. She has previously worked in healthcare and educational sectors.
Saul McLeod, PhD
BSc (Hons) Psychology, MRes, PhD, University of Manchester
Saul McLeod, PhD., is a qualified psychology teacher with over 18 years of experience in further and higher education. He has been published in peer-reviewed journals, including the Journal of Clinical Psychology.
