title: Women's care-seeking experiences after referral for postpartum depression.
abstract: This qualitative descriptive study explored women's care-seeking experiences after referral for postpartum depression. Interviews with 18 participants revealed individual-, social network-, and health system-related factors that hindered and facilitated care seeking. Women's normalizing of symptoms, limited understanding of postpartum depression, waiting for symptom improvement, discomfort discussing mental health concerns, and fears deterred care seeking; symptom awareness and not feeling like oneself were facilitating influences. Family and friends sometimes hindered care seeking because they, too, normalized symptoms or had limited understanding of postpartum depression. Care seeking was facilitated when women encouraged a health professional visit or expressed worry and concern. Health system barriers included normalizing of symptoms, offering of unacceptable interventions, and disconnected care pathways. Care seeking was facilitated by having established and supportive relationships, outreach and follow-up, legitimization of postpartum depression, and timeliness of care. These findings can be used to guide clinical practice and service provision.
authors.affiliation: McMaster University, 1200 Main Street West, Hamilton, Ontario, Canada. sword@mcmaster.ca
authors.forename: Wendy
authors.initials: W
authors.lastname: Sword
authors.forename: Dianne
authors.initials: D
authors.lastname: Busser
authors.forename: Rebecca
authors.initials: R
authors.lastname: Ganann
authors.forename: Theresa
authors.initials: T
authors.lastname: McMillan
authors.forename: Marilyn
authors.initials: M
authors.lastname: Swinton
mesh_terms: D000328:Adult; D019052:Depression, Postpartum / Q000175:diagnosis* / Q000628:therapy*; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D008605:Mental Health Services / Q000706:statistics & numerical data*; D010342:Patient Acceptance of Health Care / Q000523:psychology*; D011369:Professional-Patient Relations; D036301:Qualitative Research; D012017:Referral and Consultation; D012944:Social Support; D016387:Women's Health