Asking women about mental health and social adversity in pregnancy: results of an Australian population-based survey.

BACKGROUND

Social adversity undermines health in pregnancy. The objective of this study was to examine the extent to which pregnant women were asked about their mental health and life circumstances in pregnancy checkups.

METHOD: Population-based postal survey of recent mothers in two Australian states.

FINDINGS: Around half of the 4,366 participants reported being asked about depression (45.9%) and whether they were anxious or worried about things happening in their life (49.6%); fewer reported being asked about relationship issues (29.6%), financial problems (16.6%), or family violence (14.1%). One in five women (18%) reported significant social adversity. These women were more likely to recall being asked about their mental health and broader social health issues. Far higher levels of inquiry were reported by women in the public maternity system with midwives more likely than doctors to ask about mental health, family violence, and other social hardships.

CONCLUSIONS

Routine pregnancy visits afford a window of opportunity for identifying and supporting women experiencing mental health problems and social adversity. Changing practice to take advantage of this opportunity will require concerted and coordinated efforts by practitioners and policy makers to build systems to support public health approaches to antenatal care.