'Creating a safety net': Women's experiences of antenatal depression and their identification of helpful community support and services during pregnancy.

OBJECTIVE

to explore the feelings of depression during pregnancy of a local sample of women living in an area of socio-economic deprivation, and to identify the support mechanisms that they report as personally or potentially helpful for antenatal depression.

DESIGN

a retrospective study using a qualitative approach, informed by constructivism, to explore the participants' individual experiences of depression during pregnancy. Data were collected via tape-recorded semi-structured interviews.

SETTING

a socio-economically deprived area in North London, UK, identified as a Sure Start Local Programme providing local services specifically designed for socially disadvantaged families with children aged 0-4 years.

PARTICIPANTS

a self-selected sample of nine women aged 23-40 years, from a variety of ethnic backgrounds, who retrospectively admitted to feeling low or depressed during pregnancy. All the participants had had a baby more than 6 weeks previously and less than 1 year before the start of the study.

FINDINGS

despite different cultural and ethnic backgrounds, the participants shared similar feelings of emotional isolation that seemed to contribute largely to their experience of antenatal depression. Partner support (or lack of it) seemed to be crucial to the women's psychological well-being during pregnancy. For some of these women, the research interview was the first opportunity to talk about their needs and feelings during pregnancy. Potentially helpful mechanisms for support were identified by the participants and were judged to be relatively simple to introduce, involving connecting with other women via peer support and having 'somewhere to go' to meet others during pregnancy.

IMPLICATIONS FOR PRACTICE

some women do not disclose their feelings of depression during pregnancy, with potentially damaging effects on both the family and the baby. Feelings of loss and emotional isolation may occur, which could be partly alleviated by providing models of midwifery care that offer continuity of carer. Isolated and vulnerable women require increased midwifery resources, and partners may also have particular needs for support and adjustment, which currently remain unmet and need further research. Many 'low tech' interventions aimed at supporting women with antenatal depression could be developed, including peer support, which may offer realistic models of social capital and community empowerment in the new Children's Centres in England and Wales.