Responding to maternal distress: from needs assessment to effective intervention

Yvonne Fontein-Kuipers, Evelien van Limbeek, Marlein Ausems, Raymond de Vries, Marianne Nieuwenhuijze

To perform a needs assessment of maternal distress to plan the development of an intervention for the prevention and reduction of antenatal maternal distress. We searched PubMed, OVID and EBSCO and applied the PRECEDE logic model to select the data. Experts in the field validated the findings. We identified 45 studies. Maternal distress was associated with diminished maternal and child's quality of life. Aetiological factors of maternal distress included past and present circumstances related to obstetric factors and to a woman's context of living, coping behaviour, and support mechanisms. Lacking knowledge of coping with (maternal) distress was identified as a predisposing factor. Reinforcing factors were relaxation, partner support, counselling experiences and positive interaction with the midwife. Enabling factors were the availability of a support network. When planning the development of an antenatal intervention for maternal distress, it is advisable to focus on assessment of antenatal emotional wellbeing, the context of the woman's past and present circumstances, her coping behaviour and her environment. The identified predisposing factors, enabling and reinforcing factors should also be taken into consideration.