Antenatal Education

Education during pregnancy, the antenatal period, provides a valuable opportunity to raise expectant couples' awareness of mood changes related to childbirth.

Education about PND for expectant couples would significantly reduce the trauma this illness causes. Studies show that expectant couples are more receptive to parenting and PND education if information is presented in the early stages of pregnancy rather than towards the end.

Women who have learnt about PND in antenatal classes, and then go on to develop symptoms, may be less likely to panic and recall the topic being discussed and know where to go for help.

Information about PND during the antenatal period would:

• help to dispel the myths and misconceptions about PND, helping to de-stigmatise PND;
• give new mothers permission to ask for help if they do not feel the way they expect to feel after having a baby, encouraging women to take control over their own mental health; and
• inform expectant couples that the symptoms of PND are recognizable and that help is available, which aids in earlier recognition and interventions.

However, relatively few antenatal educators introduce women in their classes to the possibility that they might develop PND. Probably every woman attending antenatal classes, whether she is aware of it or not, knows someone - a relative, a friend or a neighbour - who has been affected by PND. It is likely that one woman from every antenatal class will develop PND.

Many women with PND, and their partners, question why their antenatal classes did not prepare them for the possibility of PND. Many complain that their classes emphasised preparation for delivery rather than preparation for parenthood. They feel that if they had been taught to recognise the early signs they would have sought help earlier and so minimised the distress their families experienced. One woman has told PANDA:

"We were told that one of us would need an emergency caesarean, but we were not warned that one of us would experience the nightmare that is PND. Nobody told us it could happen."

Some antenatal education programs now include an interview with the expectant couple that provides an opportunity for routine antenatal screening for some recognized contributing factors such as pre-existing trauma, child abuse, previous childbirth trauma, history of illness or previous hospitalization. Once identified the expectant mother and father can be encouraged to consider the possible impact of childbirth and to prepare them should PND develop, including communication, counseling and referral to services in preparation for the early postnatal period.