Emotional distress and depressive mood in pregnant and new mothers : women’s and men’s perceptions of parenthood during the first year after childbirth

The overall aim of this thesis was to study the prevalence of maternal emotional distress and depressive mood in pregnant and new mothers and the consequences for women’s and men’s perceptions of the unborn and newborn infant, parenthood and everyday life during the first year after childbirth.

Method: Project A. A total of 232 women in Stockholm filled out three screening instruments for depression after the birth of their first baby: Beck Depression Inventory (BDI), Edinburgh Postnatal Depression Scale (EPDS) Postpartum and Depression Symptoms Rating Scale (PDRS) as well as to complete various background data. Project B. A total of 298 women and their partners (n=282) were recruited from antenatal clinics in Stockholm to participate in a longitudinal study, including assessment at two months before, two months after, and one year after childbirth. The following questionnaires were used: Demographic and psychosocial background data, EPDS and Maternal/ Paternal Fetal Attachment Scale (MFA/PFA); EPDS and Infant Characteristic Questionnaire (ICQ); EPDS and Experiences of Motherhood/Fatherhood Questionnaire (EMQ/EFQ).

Results: Background data were compared with the outcome of the screening scales at 4-6 weeks and 10-12 weeks after the birth of the first child. EPDS measured during the last 2 months of pregnancy showed a stronger prediction of depressed mood at one year (r=0.45, p<0.05) compared to EPDS measured two months after childbirth (r=0.26, p<0.05), correlating with the MFA and PFA. Physical aspects of pregnancy and the perception of fetal movements were assessed differently by women with and without signs of depression (p=0.03 and p=0.01 respectively). Parents’ perceptions of their infant’s temperament were assessed at two months after childbirth; families where the mother was possibly depressed (EPDS≥13) both fathers (p=0.05) and mothers (p=0.03) perceived their infant as fussier compared to families with a non-depressed mother. No difference emerged on the other ICQ-subscales. Depressed mood in women cast a long shadow over the mothers’ view of life one year after childbirth; both women and men were less satisfied with their sex life. The findings are discussed in relation to the midwife’s professional responsibility for maternal care and reproductive health for women, their partner’s and their children.

List of scientific papers

I. Seimyr L, Welles-Nyström B, Nissen E. (2011). A history of mental health problems may predict maternal distress in women postpartum. [Submitted]

II. Seimyr L, Edhborg M, Lundh W, Sjögren B. (2004). In the shadow of maternal depressed mood: Experiences of parenthood during the first year after childbirth. J Psychosom Obstet Gynecol. 25:23-34.
https://doi.org/10.1080/01674820410001737414

III. Seimyr L, Sjögren B, Welles-Nyström B, Nissen E. (2009). Antenatal depressive mood and parental-fetal attachment at the end of pregnancy. Arch Womens Ment Health. 12:269-279.
https://doi.org/10.1007/s00737-009-0079-0

IV. Edhborg M, Seimyr L, Lundh W, Widström A-M. (2000). Fussy child – difficult parenthood? Comparisons between families with a ‘depressed’ mother and a non-depressed mother 2 months postpartum. J Reprod Infant Psychol. 18(3):225-238.
https://doi.org/10.1080/713683036