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Addressing the Unmet Need for Maternal Mental Health Services in Low‐ and Middle‐Income Countries: Integrating Mental Health Into Maternal Health Care
Author(s) -
Lasater Molly E.,
Beebe Madeleine,
Gresh Ashley,
Blomberg Kirsten,
Warren Nicole
Publication year - 2017
Publication title -
journal of midwifery and women's health
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.543
H-Index - 62
eISSN - 1542-2011
pISSN - 1526-9523
DOI - 10.1111/jmwh.12679
Subject(s) - mental health , low and middle income countries , mental health care , maternal health , environmental health , psychiatry , nursing , psychology , medicine , economic growth , health services , developing country , population , economics
Most initiatives to reduce global maternal morbidity and mortality address direct causes such as hypertensive disorders and hemorrhage. But other, more subtle but serious threats to childbearing women often go unaddressed, such as common perinatal mental health disorders. These include nonpsychotic mental disorders, such as depression, anxiety, and somatoform disorders, which are commonly found in community and primary care settings and are responsible for increased morbidity and mortality among childbearing women worldwide.1,2 Perinatal depression, defined here as a depressive episode beginning during pregnancy or up to one year postpartum, is the most common perinatal mental disorder and the second leading contributing factor to the disease burden of childbearing women globally.1,3,4 Despite their high prevalence, common perinatal mental disorders often go undiagnosed and untreated due to a lack of or limited mental health infrastructure. This is particularly true in lowand middle-income countries where scarce resources limit the ability of the health system to address even the most pressing needs. A key approach to addressing this gap in need and care is to integrate mental health into existing maternal care services. This approach is consistent with midwifery core competencies5 and situatesmidwives as critical partners in efforts to address women’s mental health in lowand middleincome countries. But, as with any other threat to women’s well-being, midwives can appropriately intervene only if they have the tools they need. In the case of common perinatal mental disorders, all midwives should have the tools to screen for and provide appropriate care and referrals.6 In this commentary, we argue for the integration of mental health into maternal health services and for the use of locally relevant screening tools to identify women who may need support, particularly at the community level.