The impact of stigma in the care of women with perinatal mental illness

Background. Perinatal mental illness (PMI) is experienced by women during pregnancy and up to one year after giving birth. Despite the high prevalence and the resultant adverse outcomes if not treated, many women choose not to disclose symptoms of PMI or to access help. Research indicates that reluctance to access services in adult populations is often due to the stigma of mental illness. Aim. The aim of this study is to provide an in-depth examination of stigma in the care of women who experience PMI. Methods. A qualitative descriptive approach was used. Eight focus groups were conducted with 52 penultimate and final year student midwives attending one of five UK universities. The data were analysed twice, first, using a template developed from six components of stigma, secondly, using an inductive thematic approach which explored student’s experiences of providing care to women. Findings Perinatal mental health stigma occurs at both the individual and structural level. It is observed in a context of care where students perceive poor knowledge of PMI, institutional needs predominate and with some midwives uncaring towards the mental health needs of women. Conclusion. PMI stigma is exacerbated by the maternity care environment, therefore interventions to reduce stigma must address the culture in which it occurs