The importance of assessing psychological status during pregnancy, childbirth and the postnatal period as a multidimensional construct: A literature review

This paper presents a comprehensive review of the literature surrounding women’s psychological health in pregnancy, childbirth and the postnatal periods. The content will provide clinically useful information to midwives and health care professionals involved in caring for women during the antenatal, intranatal and postnatal periods. The impact of psychological health status in pregnancy on clinical outcomes such as preterm labour, pre-eclampsia, epidural use, caesarean section, instrumental deliveries and increased rates of admission to neonatal intensive care, alongside the cognitive and social development of the infant and child are well documented. Less research to date has considered the impact of psychological well-being on the mother throughout pregnancy, the peripartum, postpartum and beyond. Psychological status for these women has traditionally been characterised by anxiety and depression, largely ignoring the complex psychological interrelations that characterise pregnancy. Psychological status in pregnancy cannot be defined within a unidimensional framework but must include a comprehensive assessment of all the dimensions that attribute to mood and emotional status for women during pregnancy, childbirth and the postnatal period. This paper intends to address the constructs of anxiety and depression, worry, control, quality of life, sleep and self-esteem. Screening for, and identification of, maternal psychological distress from a multidimensional perspective enables healthcare professionals to recognise and acknowledge normal and abnormal adjustment and offer interventions, strategies and support to facilitate a woman’s transition to motherhood.