Summers, Holly; (2021) "Magic happens when women come together": An exploration of perinatal mental health and the role of social relationships in supporting mothers. Doctoral thesis (D.Clin.Psy), UCL (University College London).

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Abstract

Perinatal mental health difficulties are considered a key global health concern and if undetected and untreated, can negatively affect maternal wellbeing and infant development. This thesis explores women’s experiences of perinatal mental health difficulties and what supports them in this period, both in the UK and in a range of Low- and Middle-Income Countries, along with accounts from clinicians working in perinatal services. Part one is a systematic review and meta-synthesis of qualitative studies which explore women’s experiences of perinatal psychological distress in Low- and Middle-Income Countries. A systematic search found 20 studies, the findings from which were synthesized using thematic analysis. The review discusses salient themes and how learning from these may be used to inform services providing support for women experiencing perinatal psychological distress both in Low- and Middle-Income Countries and potentially in other socio-cultural settings. Part two is a qualitative study seeking to understand mothers’ experiences of accessing, and clinicians’ experiences of providing, perinatal mental health services in the UK. Thirteen mothers and the same number of clinicians were interviewed about their experiences. The interview transcripts were analysed using thematic analysis. Themes relating to barriers and facilitators to mothers’ disclosing their mental health difficulties and concerns relating to the parent-infant relationship were derived, with a thread of the importance of social support and relationships being key. The findings support existing literature on mothers’ experiences of perinatal services as they highlight the social nature of the perinatal period, the role of relationships across system levels and the importance of compassionate, non-judgmental support in order to facilitate access to services. The findings have implications for service planning and delivery. 4 Part three is a critical appraisal of the research process, examining the researcher’s perspective through personal reflexivity and the impact of this on the research. Contextual factors of power and privilege, along with the context of the COVID-19 pandemic on the present thesis are discussed.

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