Midwives' perceptions and experiences of caring for women who experience perinatal mental health problems: An integrative review.

BACKGROUND: perinatal mental health is an important public health issue and consideration must be given to care provision for effective support and care of women in the perinatal period.

AIM: to synthesise primary research on midwives' perceived role in Perinatal Mental Health (PMH).

DESIGN: integrative review.

METHODS: Whittemore and Knafl's (2005) framework was employed. A systematic search of the literature was completed. Studies were included if they met the following criteria: primary qualitative, quantitative and mixed methods research studies published in peer reviewed journals between January 2006 to February 2016, where the population of interest were midwives and the outcomes of interest were their perceived role in the management of women with PMH problems. The methodological quality of studies was assessed using the relevant CASP (Critical Appraisal Skills Programmes, 2014) criteria for quantitative and qualitative research studies. Data extraction, quality assessment and thematic analysis were conducted.

FINDINGS: a total of 3323 articles were retrieved and 22 papers were included in the review (15 quantitative, 6 qualitative and one mixed method study). The quality of the studies included was good overall. Two overarching themes emerged relating to personal and professional engagement. Within personal engagement four sub themes are presented: knowledge, skills, decision making and attitude. Within professional engagement four themes are presented: continuous professional development, organisation of care, referral, and support.

CONCLUSIONS AND IMPLICATIONS FOR PRACTICE: the findings indicate midwives require continuous professional development opportunities that address knowledge, attitudes to PMH, communication and assessment skills. However educational and training support in the absence of appropriate referral pathways and support systems will have little benefit.