title: The first antenatal appointment: An exploratory study of the experiences of women with a diagnosis of mental illness.
abstract: OBJECTIVE
  to explore and gain insight into the expectations and experiences of women with a pre-existing diagnosis of mental illness, of their first booking appointment; to make recommendations for practice development and collaborative partnership working between healthcare professionals.
  
  
  METHODS
  a qualitative design using semi structured interviews and thematic analysis of the data. QSR NVivo 10 software is used to organise the data into themes.
  
  
  METHODS
  the interviews took place either at the women׳s homes, or within the antenatal service with the consent of the woman and relevant practitioners.
  
  
  METHODS
  twelve participants were selected from one antenatal clinic and one perinatal mental health service.
  
  
  RESULTS
  the themes identified within the data included the lack of information prior to the initial midwife booking appointment; the perception of too much information at the initial booking appointment and women not being clear about their mental health needs at this time; a general positivity about disclosing mental illness diagnoses; overall positive thoughts about midwives although some midwives appeared less knowledgeable about bipolar disorder, and perceptions about a lack of joined up working between antenatal and perinatal mental health services.
  
  
  CONCLUSIONS
  it is recommended that GPs receive adequate training in order to equip them with the skills needed to discuss sensitive issues around perinatal mental illness and the impact on pregnancy and childbirth. Women require more information about their booking appointment, and it would be beneficial for their emotional and physical health needs to be assessed at each follow-up antenatal appointment. Midwives need to be facilitated to receive up-to-date knowledge of antenatal and postnatal mental illness and treatments, and the referral process to perinatal mental health services.
authors.affiliation: School of Health Sciences, Nursing Division, Myddelton Building, City University, Northampton Square, London EC1V OHB, UK. Electronic address: L.A.Phillips@city.ac.uk.
authors.forename: Louise
authors.initials: L
authors.lastname: Phillips
authors.affiliation: Homerton University Hospital NHS Foundation Trust, Specialist Midwifery Office 5 1st Floor, 46 - 48 Clifden Road, Homerton Row, London E5 0LJ, UK. Electronic address: Dona.Thomas@homerton.nhs.uk.
authors.forename: Dona
authors.initials: D
authors.lastname: Thomas
mesh_terms: D000293:Adolescent; D000328:Adult; D005260:Female; D006801:Humans; D007407:Interviews as Topic; D008131:London; D008427:Maternal Health Services; D001523:Mental Disorders / Q000175:diagnosis* / Q000451:nursing; D008875:Middle Aged; D008880:Midwifery; D024802:Nurse's Role; D009819:Office Visits; D010348:Patient Care Team; D011247:Pregnancy; D011248:Pregnancy Complications / Q000175:diagnosis* / Q000451:nursing; D011295:Prenatal Care; D013222:State Medicine; D055815:Young Adult
keywords: Antenatal; Booking appointment; Disclosure; Midwifery; Perinatal; Pre-existing mental illness