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Depression During Pregnancy

OUT OF SILENCE - WOMEN'S MENTAL HEALTH IN IRELAND from NationalWomensCouncilofIreland on Vimeo.

The Well Before Birth project

Principal Investigator

Veronica O’Keane

Funders

Health Research Board

Partners

Persuasion Republic

The problem that was addressed…

Depression during pregnancy is a common problem but frequently overlooked at the cost of long term adverse consequences and suffering for Mother and Baby.  The problems associated with untreated antenatal depression include poorer attendance for obstetric care, more obstetric complications, shorter gestation length and poorer mental and medical health trajectories for Baby. The specific problem that we wanted to address was the lack of data on the rates of depression during pregnancy in the Irish obstetric services. A more general problem was to address the poor level of awareness about this common and serious problem. The overall aim of the project was to use the findings from the prevalence study as an evidential springboard to raise consciousness about perinatal depression in Ireland.  In addition to the general public we wished to raise awareness amongst key audiences – obstetric staff, policy makers and women particularly – that properly caring for the mental health of a woman during pregnancy protects the longer-term mental health of both mother and infant.

What we did…

The Well Before Birth was a KEDS-funded project awarded to the REDEEM Research Group (Research in Depression: Endocrinology, Epigenetics and neuroimaging) based in the Trinity College Institute of Neurosciences (TCIN). The REDEEM group is a multi disciplinary research group led by Veronica O’Keane, consultant psychiatrist in Tallaght, Dublin and clinical professor of psychiatry in the School of Medicine. This KEDS grant was part of a larger HRB funded project looking at the effects of depression during pregnancy on Baby’s stress systems, neurodevelopment and emotional state during the first year of life. The KEDS award funded a part-time Research Assistant to conduct a survey within Obstetric/Maternity hospitals in Ireland to examine rates of depression among pregnant women. We also had a small budget for a PR company to disseminate the findings to the public.

Our study involved screening over 5,000 pregnant women attending six maternity services in Ireland- the National Maternity Hospital, Dublin; the Rotunda Hospital, Dublin; Cork University Hospital; Mayo General Hospital, Castlebar; University Hospital Limerick; and Community Antenatal Clinics, Tallaght. Consultants and midwives from all these services came on board to collaborate with what they saw to be an important study that could form an evidence base for perinatal psychiatry service development.

Outcomes

We found high rates of antenatal depression, approximately 16%. These rates are higher than EU averages. In association with Persuasion Republic, an Irish PR company, we developed a campaign brand and a set of simple, compelling messages that captured the essence of the research.The launch of the research document Well before Birth, attached, took place in November 2016. The launch was very well covered by national and local media. The media coverage, included the following:

RTE: Morning Ireland, News, On-line and Drivetime
Newstalk:  News, On-line and Drive
Today FM: News, Lunchtime news feature, The Last Word
UTV:   News, feature, on-line
Thejournal.ie News and voices feature
Irish Times: News and colour piece, On-line
Irish Examiner:  News and colour piece, On-line
Irish Independent:   News and colour piece, On-line

The research was also covered in the medical media.  In addition, the story was covered in local newspapers and on local radio in the areas surrounding the survey sites. Evidence by experience given by Bethann Linkstra-Klein was particularly impactful. She and VO’K did a number of in-depth interviews together, including an Irish Times podcast (27th Feb, 2017), and PatKenny live (27th Feb, 2017). All have received excellent feedback. The findings were presented at the World Congress on Women’s Mental Health, March 2017: a biennial congress that was being hosted in Dublin jointly by the National Women’s Council of Ireland and Trinity College Dublin, led by Veronica O’Keane (http://iawmh2017.org/wp/).

Impact

Well before Birth has been widely circulated and the REDEEM team still receives requests for the document. VO’K was subsequent requested to advise on these issues directly with key Ministers and policy makers. Planning for perinatal psychiatry services commenced within six months of the document launch. The Well Before Birth study was heavily referenced. This modest study has had a direct influence not only on the public, and particularly women, but also on the medical profession and health policy makers.