Perinatal mental health: how to improve midwives' training?
Supervisor :
Corinne DUPONT
Catherine MASSOUBRE
Summary of the thesis:
Background: Perinatal mental health problems (PMHPs) concern one in five women and one in ten men. PMHPs remains often undetected with negative consequences onparents-baby triads. Their central role in perinatal healthcare places midwives in a key position to improve the detection, referral and management of PMHPs. However,midwives consistently report feeling ill prepared to do so, with negative consequences across the care pathway. Improving midwives’ training in perinatal mental health and itstranslation into routine clinical practice is a complex intervention that requires the integration of the perspective of all relevant stakeholders. This work addresses twointerconnected research questions: 1) How to improve perinatal mental healthcare?; 2) How to improve midwives’ training in perinatal mental health? Methods: We used aparticipatory research design from the inception of this project, i.e. co-production by academic researchers and researchers with lived experience as equal partners. Weconducted two systematic reviews on how to improve perinatal mental healthcare (n=75 articles) and on midwives’ training needs in perinatal mental health and relatedinterventions (n=66 articles). The qualitative part of this project (n=84 participants including 24 persons with lived experience of PMHPs, obstetric providers, childcare healthproviders and mental health providers) aims to explore the experiences, views and priorities of persons with lived experience and various perinatal health providers onimproving: 1) perinatal mental healthcare; 2) education in perinatal mental health. Results: This work has identified key issues to improve midwives' training in perinatal mentalhealth and its effective translation into routine clinical practice: 1) meet the priorities identified by persons with lived experience; 2) clarify midwives’ and other providers’ role inperinatal mental healthcare and facilitate a meaningful engagement into perinatal mental healthcare; 3) taking into account the context in which the intervention will be delivered.Conclusion: Our findings allowed to elaborate an integrative model presenting the determinants of a meaningful engagement of midwives in perinatal mental healthcare. Basedon this model, we co-designed a blended education intervention on perinatal mental health with lived experience experts that will be evaluated in the future (e.g. feasibility,acceptability and preliminary effectiveness in immediate post-training and at 9 months.
