The transition to motherhood: Towards a broader understanding of perinatal distress (original) (raw)

The perinatal period, which includes pregnancy and the first year post birth, is recognised as a period of major transition that can be exceedingly emotional, 1 and associated with considerable distress. 2,3 Consequently, elevated symptoms of depression and anxiety are experienced by a substantial number of women during this time, with prevalence studies suggesting that perinatal depression affects approximately 10-25% of women, 4-6 and perinatal anxiety affecting approximately 25-45% of women. 4-7 Research has also demonstrated that depressive and anxiety symptoms are often co-morbid throughout the perinatal period 3,8,9 and that an interrelationship exists between the two. Furthermore, the negative consequences of depression and anxiety extend not only to the woman herself, but also to her foetus, and baby. 10-15 Given these consequences, theoretical advances that will inform intervention strategies designed to prevent perinatal depression and anxiety are warranted. Researchers to date have predominantly defined perinatal distress as the psychological disorders of depression and anxiety that occur both during pregnancy and post birth. 1 However, it is unclear if these two affective states alone comprehensively describe the broad range of negative emotional experiences that can occur during the transition to motherhood. In this paper we argue that stress should be included in the definition of perinatal distress as a distinct affective state. The existing literature, albeit limited, that supports this premise is outlined. We also argue that further research is needed in order to assess whether maternal stress is part of a normal continuum associated with the range of physical, social, and emotional changes that accompany the transition to parenthood, or whether it is linked to a depressed mood state, or a precursor to clinical presentations. Fig. 1 depicts a proposed continuum model whereby emotional health and