Psychological well-being and depression from pregnancy to postpartum among primiparous and multiparous women.

BACKGROUND: The bulk of research on motherhood has focused on perinatal depression, largely overlooking indicators of women's positive mental health which can likewise have pervasive consequences on family functioning. OBJECTIVE: The aim of the present study was to address this issue by exploring the impact of parity and childbirth on both women's perinatal depression and psychological well-being. METHODS: A convenience sample of 81 women was followed during pregnancy (Time 1) and postpartum (Time 2). At both times, participants completed the Edinburgh Depression Scale and the Psychological Well-being Scales, measuring perceived autonomy, environmental mastery, personal growth, positive relations, purpose in life, and self-acceptance. RESULTS: Significant negative correlations were observed between depression and psychological well-being dimensions. ANCOVA and mixed ANOVA analyses showed that depression levels did not differ between primiparous and multiparous women, or between pre- and postpartum assessments. By contrast, after childbirth, primiparous women reported higher values of environmental mastery and self-acceptance than multiparous women. In addition, levels of self-acceptance and personal growth increased from pregnancy to postpartum among primiparous women, while no differences were detected over time in the scores of all the psychological well-being dimensions among multiparous women. CONCLUSIONS: This study highlighted some dimensions of positive psychological functioning that specifically contribute to women's well-being in the transition to motherhood, and their different relevance for primiparous and multiparous mothers. Future trials are needed to integrate this information in tailored intervention for the promotion of mothers' complete mental health.

Un estudio longitudinal sobre maternidad y bienestar: Implicaciones evolutivas y clínicas / A Longitudinal Study on Motherhood and Well-Being: Developmental and Clinical Implications

Pregnancy and puerperium are crucial periods at both the biological and psychological levels. The aim of this longitudinal study was to investigate women's perceived health and illness during pregnancy and puerperium through the assessment of hedonic and eudaimonic components of well-being, symptoms of peripartum depression, and their relationship. Nineteen women recruited at the Unit of Obstetrics and Gy-necology of a university hospital in Northern Italy were enrolled and answered a set of questionnaires at two time points: 20-22 weeks of gestation and 6 months after childbirth. Results showed a substantial lack of correlation between the dimensions of mental illness and mental health. The analysis of the well- and ill-being components showed low levels of depression as well as good levels of mental health, especially concerning the eudaimonic components of well-being, both during and after pregnancy. Overall, findings attested to a general stability of well-being over pregnancy and puerperium. Key words: positive psychology, hedonic and eudaimonic well-being, peripartum depression.

El embarazo y el puerperio son periodos cruciales tanto a nivel biológico como psicológico. El objetivo de este estudio longitudinal fue investigar la percepción de las mujeres sobre su salud y enfermedad durante el embarazo y el puerperio mediante la evaluación de componentes hedónicos y eudaimónicos del bienestar, síntomas de depresión, y sus relaciones. Participaron 19 mujeres contactadas en la Unidad de Obstetricia y Ginecología de un hospital italiano, quienes respondieron a unos cuestionarios a las 20-22 semanas de la gestación y a los 6 meses tras el parto. Los resultados mostraron una sustancial falta de correlación entre dimensiones de salud y de enfermedad mental. El análisis del bienestar y malestar mostraron bajos niveles de depresión así como buenos niveles de salud mental, especialmente en los componentes eudaimónicos del bienestar, tanto durante como después del embarazo. Globalmente nuestros hallazgos indican una estabilidad general del bienestar en el embarazo y el puerperio.

Clinical relationship and psychological experience of hospitalization in "high-risk" pregnancy.

OBJECTIVE: To explore, in a systemic view, the reciprocal perceived relationship between hospitalized "high-risk" pregnant women with uncertain fetal prognosis and the multidisciplinary prenatal care team, by the use of specifically developed questionnaires. STUDY DESIGN: A pilot study in a high-risk pregnancy department. We enrolled 52 pregnant hospitalized women and 17 clinical operators and we interviewed them by the use of open-ended and close-ended question questionnaires. RESULTS: We described patients' perception of doctors and staff communication, patients' feelings and emotions relating to "high-risk" pregnancy and hospitalization, operators' emotions, perceived facilitating factors, difficulties and resources. In a "high-risk" pregnancy condition, some difficulties in the relationship between hospitalized women and health operators occur. For inpatients the emotional difficulties were mostly connected to the pathologic situation and the contingent loneliness. Although the majority of women said that they understood staff communication and that they established a basic trust towards the entire clinical staff, there was a request for greater outspokenness. For clinical operators the relational and communication difficulties specifically concerned the overall management of the relationship with the patients studied. In particular, they perceived themselves to be called to a greater clearness and clinical reliability. CONCLUSIONS: Overcoming the dyadic model of the doctor-patient relationship (in a systemic view) by incorporating clinical operators' and inpatients' points of view, seems a useful tool to highlight critical and facilitating factors about the relationship and communication in "high-risk" conditions. Condensation Overcoming the dyadic vision of the doctor-patient relationship, by crossing clinical operator's and inpatient's points of view, seems a useful tool to highlight critical and facilitating factors about the relationship and communication in "high-risk" pregnancy conditions.