Prevention of postnatal mental health problems: a survey of Victorian Maternal and Child Health Nurses

Abstract

Objectives: To investigate Maternal and Child Health (MCH) nurses’ views on what contributes to mental health problems among new mothers, and their current practices regarding risk factors for maternal mental health problems that are potentially modifiable in primary care.

Design: Cross-sectional, online survey.

Setting: Universal MCH service offered free to all new parents in Victoria, Australia.

Subjects: All MCH nurses employed in full or part-time clinical practice were invited to participate.

Main outcome measures: MCH nurses’ views on risk factors for maternal mental health problems and for unsettled infant behaviour; and their current practice regarding addressing unsettled infant behaviour and inclusion of fathers in services.

Results: Surveys were completed by 343/1051 eligible MCH nurses (32.6%). Respondents identified social factors as major determinants of postnatal mental health problems among women, including: parents having limited knowledge about infant sleep needs and skills to manage unsettled infant behaviour; and lack of support, including from intimate partners. Respondents offered widely divergent advice to mothers about management of unsettled infant behaviour. They regarded the inclusion of fathers in routine services as valuable, but acknowledged practical barriers, including difficulties in offering services and programs outside conventional office hours.

Conclusions: MCH nurses identified risks to maternal mental health that are potentially modifiable in primary care, but face barriers in addressing these. To facilitate more consistent advice to new parents about management of unsettled infant behaviours, evidence-based guidelines and training programs should be developed. Inclusion of men in routine services would require practical barriers to be overcome.