The line between depressive and anxiety disorders in perinatal as well as general
populations is often blurred; when the EPDS has been factor-analyzed, although there are
separate factors corresponding to depression and anxiety, several items have moderate
loadings on both factors (Swalm, et al., 2010). Some services refer to antenatal or postnatal
“distress” rather than attempt to differentiate depression from anxiety, and often women
report a mix of anxious and depressed symptoms.
Although most of the research and clinical attention has been on unipolar depression among
antenatal and postnatal women, there is evidence that women with bipolar disorders are at
increased risk of postnatal psychosis, and women who have depressive symptoms should
be screened for bipolar disorder and monitored for elevated mood. However, there is no
consensus on the most effective screening method, with a variety of possible tools but no
one well validated in antenatal women (Chessick & Dimidjian, 2010)....
In some countries, adolescents are less likely than adults to obtain skilled care
before, during and after childbirth.
WHO’s recommendations for increasing the use of skilled antenatal, childbirth and postpartum care are informed
by one graded study, one ungraded study, existing WHO guidelines and the collective experience and judgment of a
panel of experts. The studies were conducted in Chile and India. One intervention was a home visit programme for
adolescent mothers. Another was a cash transfer scheme contingent upon health facility births.
A student magazine asserts that a key action towards sustainability is ‘don’t
have kids’ (Anon. 2008: 29). Another ‘green’ magazine for parents points out
that ‘in the US, even having just one child creates a carbon legacy almost six
times greater than each parent’s own lifetime carbon emissions’ (McAleer
2009). Sustainability and birthing human children are figured as mutually
exclusive. So how do we get an edited collection of essays in a book with both
the words ‘sustainability’ and ‘birth’ in the title?...
Access to skilled birth attendance is one measure of inequity in maternal health.
Differences in socioeconomic aspects account for about two-thirds (61%) of inequalities in
skilled birth attendance, of which household wealth accounts for 24%, mother’s education
16% and living in rural areas 12%.
When examining the relationship between utilization patterns and offer of skilled care
during delivery, women who did not receive valid antenatal care (at least four visits to a
health professional during pregnancy) were more likely to deliver without professional care.
Advice from the Health Education Board for Scotland (now NHS Health Scotland) is that light,
occasional drinking during pregnancy (one or two units once or twice a week) is not likely to do
any harm.78 Heavy drinking is associated with miscarriage, and sometimes with serious effects
on the babys development.78 Some authorities recommend complete abstinence during
pregnancy (the US National Institute on Alcohol Abuse and Alcoholism:
Two studies have been identified which looked at brief interventions in the antenatal setting.