Assessing mental health during pregnancy: An exploratory qualitative study of midwives’ perceptions
Abstract
BACKGROUND: Mental health disorders are estimated to affect between 10% and 20% of women who access maternity services and can be defined as a public health issue due to the potential consequences for women, children and families. Detecting problems early in pregnancy can significantly improve outcomes for women and their families. However, mental health problems are not being consistently identified in routine midwifery practice and little is known from current literature about midwives' practice in relation to current national guidelines or the impact models of care have on assessing maternal mental health. OBJECTIVE: To identify midwives' views about barriers and facilitators to screening for mental health in pregnancy using current UK guidelines. DESIGN: Nine community midwives from a single district general hospital in the south of England were recruited to take part in focus groups. Thematic analysis was used to extract key themes from the data. FINDINGS: Three key themes were identified from the focus groups and included system factors, social factors and trust. Barriers and facilitators to screening maternal mental health were associated with the initial 'booking' appointment' and differences in models of care. Barriers to screening were defined as high workload, poor continuity, and a lack of trust between women and midwives. CONCLUSIONS: This study highlights key barriers and facilitators associated with mental health screening during pregnancy, including issues of trust and uncertainty about women's willingness to disclose mental health conditions. Further research is required to evaluate the relationship between women and midwives in contemporary practice and the influence this may have on maternal mental health.
Integrity signals
Registry
Cites
Statistics
Claims the paper makes
Cites
Using thematic analysis in psychology
Braun, V., & Clarke, V. (2006) · Qualitative Research in Psychology · doi:10.1191/1478088706qp063oa · Cited by 194,414 · see citing works
Case-finding instruments for depression: Two questions are as good as many
Whooley, M. A., Avins, A. L., Miranda, J., & Browner, W. S. (1997) · Journal of General Internal Medicine · doi:10.1046/j.1525-1497.1997.00076.x · Cited by 1,826 · see citing works
Midwife-led continuity models versus other models of care for childbearing women
Sandall, J., Soltani, H., Gates, S., Shennan, A. H., & Devane, D. (2013) · Cochrane Database of Systematic Reviews · doi:10.1002/14651858.cd004667.pub3 · Cited by 1,225 · see citing works
Barbour, R. S. (2008) · Medical Entomology and Zoology · Cited by 798 · see citing works
Midwife-led continuity models versus other models of care for childbearing women
Sandall, J., Soltani, H., Gates, S., Shennan, A., & Devane, D. (2015) · Cochrane Database of Systematic Reviews · doi:10.1002/14651858.cd004667.pub4 · Cited by 514 · see citing works
Knight, M. (2015) · Oxford University Research Archive (ORA) (University of Oxford) · doi:10.5287/ora-1axeqd96r · Cited by 267 · see citing works
Howard, L. M., Ryan, E., Trevillion, K., Anderson, F., Bick, D., Bye, A., Byford, S., O’Connor, S. J. M., Sands, P., Demilew, J., et al. (2018) · The British Journal of Psychiatry · doi:10.1192/bjp.2017.9 · Cited by 188 · see citing works
Barriers and facilitators of mental health screening in pregnancy
Kingston, D., Austin, M.-P., Heaman, M., McDonald, S., Lasiuk, G., Sword, W., Giallo, R., Hegadoren, K., Vermeyden, L., van Zanten, S. V., et al. (2015) · Journal of Affective Disorders · doi:10.1016/j.jad.2015.06.029 · Cited by 128 · see citing works
Midwives and assessment of perinatal mental health
McCauley, K., Elsom, S., Muir‐Cochrane, E., & Lyneham, J. (2011) · Journal of Psychiatric and Mental Health Nursing · doi:10.1111/j.1365-2850.2011.01727.x · Cited by 102 · see citing works
Multicenter Collaboration in Observational Research: Improving Generalizability and Efficiency
on Behalf of the Anterior Total Hip Arthroplasty Collaborative (ATHAC) Investigators*, Sprague, S., Matta, J. M., & Bhandari, M. (2009) · Journal of Bone and Joint Surgery · doi:10.2106/jbjs.h.01623 · Cited by 80 · see citing works
A public health role in perinatal mental health: Are midwives ready?
Ross–Davie, M., Elliott, S. A., Sarkar, A., & Green, L. (2006) · British Journal of Midwifery · doi:10.12968/bjom.2006.14.6.21181 · Cited by 64 · see citing works
Williams, C. J., Turner, K. M., Burns, A., J. Evans, M., & Bennert, K. (2016) · Midwifery · doi:10.1016/j.midw.2016.01.015 · Cited by 40 · see citing works
McGlone, C., Martin, C. J. H., & Furber, C. (2016) · Journal of Reproductive and Infant Psychology · doi:10.1080/02646838.2016.1188278 · Cited by 29 · see citing works
Johnsen, H. L., Clausen, J. A., Hvidtjørn, D., Juhl, M., & Hegaard, H. K. (2017) · Women and Birth · doi:10.1016/j.wombi.2017.07.013 · Cited by 23 · see citing works
Phillips, L., & Thomas, D. (2015) · Midwifery · doi:10.1016/j.midw.2015.04.004 · Cited by 17 · see citing works
The acceptability of case-finding questions to identify perinatal depression
Mann, R., Adamson, J., & Gilbody, S. M. (2015) · British Journal of Midwifery · doi:10.12968/bjom.2015.23.9.630 · Cited by 12 · see citing works
Flagged first, then by citations
3 of the 19 references couldn’t be matched to a known paper.
Cited by
Sorted by citations
Lau, Y., Cheng, J.-Y., Wong, S.-H., Yen, K.-Y., & Cheng, L.-J. (2021) · World Journal of Psychiatry · doi:10.5498/wjp.v11.i4.133 · Cited by 68 · see citing works
Runkle, J. D., Risley, K., Roy, M., & Sugg, M. M. (2022) · Women s Health Issues · doi:10.1016/j.whi.2022.12.001 · Cited by 58 · see citing works
Mental health service use among pregnant and early postpartum women
Lee-Carbon, L., Nath, S., Trevillion, K., Byford, S., Howard, L. M., Challacombe, F. L., & Heslin, M. (2022) · Social Psychiatry and Psychiatric Epidemiology · doi:10.1007/s00127-022-02331-w · Cited by 46 · see citing works
Neo, H. S., Tan, J. H., Ang, W. H. D., & Lau, Y. (2022) · Journal of Psychosomatic Research · doi:10.1016/j.jpsychores.2022.110790 · Cited by 32 · see citing works
Harrison, S., Pilkington, V., Li, Y., QUIGLEY, M. A., & Alderdice, F. A. (2023) · BMC Pregnancy and Childbirth · doi:10.1186/s12884-023-05518-4 · Cited by 16 · see citing works
Community midwives views of postnatal care in the UK; A descriptive qualitative study
Kokab, F., Jones, E., Goodwin, L., Taylor, B., & Kenyon, S. (2022) · Midwifery · doi:10.1016/j.midw.2021.103183 · Cited by 15 · see citing works
Preis, H., Djurić, P. M., Ajirak, M., Chen, T., Mane, V., Garry, D. J., Heiselman, C. J., Chappelle, J., & Lobel, M. (2022) · Archives of Women s Mental Health · doi:10.1007/s00737-022-01259-z · Cited by 12 · see citing works
Vik, K., Aass, I. M., Willumsen, A. B., & Hafting, M. (2021) · Midwifery · doi:10.1016/j.midw.2021.103017 · Cited by 11 · see citing works
Johnson, J., Hope, L., Jones, L. A., & Bradley, E. (2023) · Frontiers in Psychiatry · doi:10.3389/fpsyt.2023.1056987 · Cited by 10 · see citing works
Promotion and Prevention of Perinatal Mood and Anxiety Disorders: Doulas’ Roles and Challenges
Shklarski, L., & Kalogridis, L. (2022) · The Journal of Perinatal Education · doi:10.1891/jpe-2021-00058 · Cited by 9 · see citing works
Preis, H., Whitney, C., Kocis, C., & Lobel, M. (2022) · PEC Innovation · doi:10.1016/j.pecinn.2022.100030 · Cited by 6 · see citing works
Identify mental health needs of adolescent pregnant women: a qualitative study
Sarwinanti, Widyawati, W., Warsini, S., Hakimi, M., & Ramdani, W. F. (2024) · International Journal of Adolescent Medicine and Health · doi:10.1515/ijamh-2024-0028 · Cited by 6 · see citing works
Motofelea, N., Galiș, R., Szasz, F. A., Motofelea, A. C., Hoinoiu, T., Trinc, S., Papavă, I., Olaru, F., Berceanu, C., Pârvănescu, R., et al. (2026) · Journal of Clinical Medicine · doi:10.3390/jcm15031029 · Cited by 4 · see citing works
Unplanned Pregnancy and Depressive Symptoms during the COVID-19 Pandemic
Júnior, G. A. C., Rêgo, A. S., Brito, A. P., Furtado, P. D. S. R., Pereira, T. T. J., Beckman, L. F., Silva, Y. A. A. M., da Cruz, C. N., Nitz, M. K., Batista, M. R. V., et al. (2022) · International Journal of Environmental Research and Public Health · doi:10.3390/ijerph20010652 · Cited by 4 · see citing works
Brito, A. P. A., Silva, C. M., Riesco, M. L. G., Lima, M. D. O. P., & McArthur, A. (2025) · JBI Evidence Synthesis · doi:10.11124/jbies-24-00166 · Cited by 4 · see citing works
Women’s mental health during late pregnancy: A survey conducted in Shandong Province, China
Li, Y., Yu, H., Shen, K., & Long, J. (2024) · Fortschritte der Neurologie · Psychiatrie · doi:10.1055/a-2337-4336 · Cited by 2 · see citing works
Tarlazzi, E., Sacco, N., Branchini, L., Simonazzi, G., & Parma, D. (2025) · Midwifery · doi:10.1016/j.midw.2025.104572 · Cited by 1 · see citing works
Amador, K. S., & Ortiz, N. L. V. (2024) · Medicina UPB · doi:10.18566/medupb.v43n1.a07 · Cited by 1 · see citing works
Snow, M. E., Salmon, A., Banjo, J., Morrow, M., & Varcoe, C. (2026) · PLOS One · doi:10.1371/journal.pone.0329049
“It allows researchers to examine how factors such as personal or cultural beliefs, health-related practices, and individual and collective values influence health behaviours and perceptions of care [33–35].”
Isohata, H., Miura, S., Yamazaki, Y., Goto, H., Yoshimura, Y., Hattori, K., Shimaoka, T., Sekiguchi, K., Nakanishi, H., Inada, K., et al. (2025) · Scientific Reports · doi:10.1038/s41598-025-16886-6
Fabiyi, F., Darwin, Z., Sah, R. K., & Firth, A. (2025) · PLoS ONE · doi:10.1371/journal.pone.0331547
Harrison, S., Pilkington, V., Li, Y., Quigley, M. A., & Alderdice, F. (2023) · Figshare · doi:10.6084/m9.figshare.22705851
Vieira, G. T. B., Loyola, C. M. D., Barbosa, J. M. A., Batista, M. R. V., Silva, Y. A. A. M., Sevinhago, R., Diniz, D. M., Pinto, N. V. R., Carvalhêdo, G. B., & Silva, F. D. M. A. M. (2026) · Derecho y cambio social. · doi:10.54899/dcs.v23i87.4469
- Authors
- Baker, N., Gillman, L., & Coxon, K.
- Affiliations
- Royal Berkshire NHS Foundation Trust (GB)
- St George's, University of London (GB)
- Corresponding author
- Baker, Natasha
- Venue
- Midwifery
- Publisher
- Elsevier BV
- Published
- 2020-07
- Volume
- 86
- Pages
- 102690
- ISSN
- 0266-6138 (ISSN-L)
- OpenAlex
- W3011794163
- Cited by
- 23
- References
- 19
- Citations by year
- 2026: 2 · 2025: 4 · 2024: 3 · 2023: 4 · 2022: 7 · 2021: 3
- FWCI
- 2.62
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Midwifery (publishedVersion)
- PubMed (publishedVersion)
- Research Repository (Kingston University London) (acceptedVersion)
- Funders
- National Institute for Health Research
- Topics
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Maternal Mental Health During Pregnancy and Postpartum
- Health Sciences › Medicine › Obstetrics and Gynecology › Maternal and Perinatal Health Interventions
- Health Sciences › Health Professions › General Health Professions › Maternal and Neonatal Healthcare
- Keywords
- maternal mental health, midwives' perceptions, barriers and facilitators, midwifery practice, continuity of care, workload, models of care, obstetric care
- MeSH terms
- Adult, England, Female, Humans, Maternal Health Services, Mental Health, Mental Health Services, Nurse Midwives, Perception, Focus Groups, Qualitative Research, Pregnant People
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
Are you an author, or do you see a problem with this page? Request a review
