Continuity of midwifery carer moderates the effects of prenatal maternal stress on postnatal maternal wellbeing

the Queensland flood study

Sue Kildea, Gabrielle Simcock, Aihua Liu, Guillaume Elgbeili, David P. Laplante, Adele Kahler, Marie Paule Austin, Sally Tracy, Sue Kruske, Mark Tracy, Michael W. O’Hara, Suzanne King

Research output: Contribution to journalArticleResearchpeer-review

Abstract

Poor postnatal mental health is a major public health issue, and risk factors include experiencing adverse life events during pregnancy. We assessed whether midwifery group practice, compared to standard hospital care, would protect women from the negative impact of a sudden-onset flood on postnatal depression and anxiety. Women either received midwifery group practice care in pregnancy, in which they were allocated a primary midwife who provided continuity of care, or they received standard hospital care provided by various on-call and rostered medical staff. Women were pregnant when a sudden-onset flood severely affected Queensland, Australia, in January 2011. Women completed questionnaires on their flood-related hardship (objective stress), emotional reactions (subjective stress), and cognitive appraisal of the impact of the flood. Self-report assessments of the women’s depression and anxiety were obtained during pregnancy, at 6 weeks and 6 months postnatally. Controlling for all main effects, regression analyses at 6 weeks postpartum showed a significant interaction between maternity care type and objective flood-related hardship and subjective stress, such that depression scores increased with increasing objective and subjective stress with standard care, but not with midwifery group practice (continuity), indicating a buffering effect of continuity of midwifery carer. Similar results were found for anxiety scores at 6 weeks, but only with subjective stress. The benefits of midwifery continuity of carer in pregnancy extend beyond a more positive birth experience and better birthing and infant outcomes, to mitigating the effects of high levels of stress experienced by women in the context of a natural disaster on postnatal mental health.

Original languageEnglish
Pages (from-to)203-214
Number of pages12
JournalArchives of Women's Mental Health
Volume21
Issue number2
Early online date27 Sep 2017
DOIs
Publication statusPublished - 1 Apr 2018
Externally publishedYes

Fingerprint

Queensland
Midwifery
Caregivers
Mothers
Group Practice
Pregnancy
Anxiety
Mental Health
Depression
Postpartum Depression
Continuity of Patient Care
Medical Staff
Disasters
Psychological Stress
Self Report
Postpartum Period
Pregnant Women
Public Health
Regression Analysis
Parturition

Cite this

Kildea, Sue ; Simcock, Gabrielle ; Liu, Aihua ; Elgbeili, Guillaume ; Laplante, David P. ; Kahler, Adele ; Austin, Marie Paule ; Tracy, Sally ; Kruske, Sue ; Tracy, Mark ; O’Hara, Michael W. ; King, Suzanne. / Continuity of midwifery carer moderates the effects of prenatal maternal stress on postnatal maternal wellbeing : the Queensland flood study. In: Archives of Women's Mental Health. 2018 ; Vol. 21, No. 2. pp. 203-214.
@article{4033cd470fc14b249257ba37d9b40142,
title = "Continuity of midwifery carer moderates the effects of prenatal maternal stress on postnatal maternal wellbeing: the Queensland flood study",
abstract = "Poor postnatal mental health is a major public health issue, and risk factors include experiencing adverse life events during pregnancy. We assessed whether midwifery group practice, compared to standard hospital care, would protect women from the negative impact of a sudden-onset flood on postnatal depression and anxiety. Women either received midwifery group practice care in pregnancy, in which they were allocated a primary midwife who provided continuity of care, or they received standard hospital care provided by various on-call and rostered medical staff. Women were pregnant when a sudden-onset flood severely affected Queensland, Australia, in January 2011. Women completed questionnaires on their flood-related hardship (objective stress), emotional reactions (subjective stress), and cognitive appraisal of the impact of the flood. Self-report assessments of the women’s depression and anxiety were obtained during pregnancy, at 6 weeks and 6 months postnatally. Controlling for all main effects, regression analyses at 6 weeks postpartum showed a significant interaction between maternity care type and objective flood-related hardship and subjective stress, such that depression scores increased with increasing objective and subjective stress with standard care, but not with midwifery group practice (continuity), indicating a buffering effect of continuity of midwifery carer. Similar results were found for anxiety scores at 6 weeks, but only with subjective stress. The benefits of midwifery continuity of carer in pregnancy extend beyond a more positive birth experience and better birthing and infant outcomes, to mitigating the effects of high levels of stress experienced by women in the context of a natural disaster on postnatal mental health.",
keywords = "Anxiety, Continuity of carer, Midwifery group practice, Natural disaster, Postnatal depression, Prenatal maternal stress",
author = "Sue Kildea and Gabrielle Simcock and Aihua Liu and Guillaume Elgbeili and Laplante, {David P.} and Adele Kahler and Austin, {Marie Paule} and Sally Tracy and Sue Kruske and Mark Tracy and O’Hara, {Michael W.} and Suzanne King",
year = "2018",
month = "4",
day = "1",
doi = "10.1007/s00737-017-0781-2",
language = "English",
volume = "21",
pages = "203--214",
journal = "Archives of Women's Mental Health",
issn = "1434-1816",
publisher = "Springer Wien",
number = "2",

}

Kildea, S, Simcock, G, Liu, A, Elgbeili, G, Laplante, DP, Kahler, A, Austin, MP, Tracy, S, Kruske, S, Tracy, M, O’Hara, MW & King, S 2018, 'Continuity of midwifery carer moderates the effects of prenatal maternal stress on postnatal maternal wellbeing: the Queensland flood study', Archives of Women's Mental Health, vol. 21, no. 2, pp. 203-214. https://doi.org/10.1007/s00737-017-0781-2

Continuity of midwifery carer moderates the effects of prenatal maternal stress on postnatal maternal wellbeing : the Queensland flood study. / Kildea, Sue; Simcock, Gabrielle; Liu, Aihua; Elgbeili, Guillaume; Laplante, David P.; Kahler, Adele; Austin, Marie Paule; Tracy, Sally; Kruske, Sue; Tracy, Mark; O’Hara, Michael W.; King, Suzanne.

In: Archives of Women's Mental Health, Vol. 21, No. 2, 01.04.2018, p. 203-214.

Research output: Contribution to journalArticleResearchpeer-review

TY - JOUR

T1 - Continuity of midwifery carer moderates the effects of prenatal maternal stress on postnatal maternal wellbeing

T2 - the Queensland flood study

AU - Kildea, Sue

AU - Simcock, Gabrielle

AU - Liu, Aihua

AU - Elgbeili, Guillaume

AU - Laplante, David P.

AU - Kahler, Adele

AU - Austin, Marie Paule

AU - Tracy, Sally

AU - Kruske, Sue

AU - Tracy, Mark

AU - O’Hara, Michael W.

AU - King, Suzanne

PY - 2018/4/1

Y1 - 2018/4/1

N2 - Poor postnatal mental health is a major public health issue, and risk factors include experiencing adverse life events during pregnancy. We assessed whether midwifery group practice, compared to standard hospital care, would protect women from the negative impact of a sudden-onset flood on postnatal depression and anxiety. Women either received midwifery group practice care in pregnancy, in which they were allocated a primary midwife who provided continuity of care, or they received standard hospital care provided by various on-call and rostered medical staff. Women were pregnant when a sudden-onset flood severely affected Queensland, Australia, in January 2011. Women completed questionnaires on their flood-related hardship (objective stress), emotional reactions (subjective stress), and cognitive appraisal of the impact of the flood. Self-report assessments of the women’s depression and anxiety were obtained during pregnancy, at 6 weeks and 6 months postnatally. Controlling for all main effects, regression analyses at 6 weeks postpartum showed a significant interaction between maternity care type and objective flood-related hardship and subjective stress, such that depression scores increased with increasing objective and subjective stress with standard care, but not with midwifery group practice (continuity), indicating a buffering effect of continuity of midwifery carer. Similar results were found for anxiety scores at 6 weeks, but only with subjective stress. The benefits of midwifery continuity of carer in pregnancy extend beyond a more positive birth experience and better birthing and infant outcomes, to mitigating the effects of high levels of stress experienced by women in the context of a natural disaster on postnatal mental health.

AB - Poor postnatal mental health is a major public health issue, and risk factors include experiencing adverse life events during pregnancy. We assessed whether midwifery group practice, compared to standard hospital care, would protect women from the negative impact of a sudden-onset flood on postnatal depression and anxiety. Women either received midwifery group practice care in pregnancy, in which they were allocated a primary midwife who provided continuity of care, or they received standard hospital care provided by various on-call and rostered medical staff. Women were pregnant when a sudden-onset flood severely affected Queensland, Australia, in January 2011. Women completed questionnaires on their flood-related hardship (objective stress), emotional reactions (subjective stress), and cognitive appraisal of the impact of the flood. Self-report assessments of the women’s depression and anxiety were obtained during pregnancy, at 6 weeks and 6 months postnatally. Controlling for all main effects, regression analyses at 6 weeks postpartum showed a significant interaction between maternity care type and objective flood-related hardship and subjective stress, such that depression scores increased with increasing objective and subjective stress with standard care, but not with midwifery group practice (continuity), indicating a buffering effect of continuity of midwifery carer. Similar results were found for anxiety scores at 6 weeks, but only with subjective stress. The benefits of midwifery continuity of carer in pregnancy extend beyond a more positive birth experience and better birthing and infant outcomes, to mitigating the effects of high levels of stress experienced by women in the context of a natural disaster on postnatal mental health.

KW - Anxiety

KW - Continuity of carer

KW - Midwifery group practice

KW - Natural disaster

KW - Postnatal depression

KW - Prenatal maternal stress

UR - http://www.scopus.com/inward/record.url?scp=85030088037&partnerID=8YFLogxK

U2 - 10.1007/s00737-017-0781-2

DO - 10.1007/s00737-017-0781-2

M3 - Article

VL - 21

SP - 203

EP - 214

JO - Archives of Women's Mental Health

JF - Archives of Women's Mental Health

SN - 1434-1816

IS - 2

ER -