The experience of psychological distress, depression, and anxiety during pregnancy: A meta-synthesis of qualitative research

Abstract

Objective: to systematically review qualitative research that explores the experience of maternal antenatal psychological distress, such as depression, anxiety and stress during pregnancy.

Method: a meta-synthesis was conducted to integrate the findings of qualitative studies. Eight final eligible studies were scrutinised, recurring themes were extracted and compared across studies, and core themes were identified.

Findings: five core themes of the experience of pregnancy distress were identified: Recognising that things are not right, Dealing with stigma, Negotiating the transformation, Spiralling down, and Regaining control. In the interpretation of these concepts the experience of maternal antenatal distress was depicted as a process similar to the one of grief and loss, as a result of women׳s inability to situate their experience within the 'perfect mother' discourse.

Key conclusions: women who experience psychological distress undergo a specific process of transformation towards motherhood that begins during pregnancy. This process is exacerbated by their interpretation of their experience as deviant and often as inadequate.

Implications for practice: this review will assist health professionals in translating and negotiating the transformation towards motherhood for women experiencing pregnancy distress, in a timely and meaningful manner.

Keywords: Antenatal depression; Anxiety; Distress; Meta-synthesis; Pregnancy; Qualitative.