Susan Cox

This thesis presents an interpretive description of twelve primary antenatal care providers’ (PACP) attitudes and perspectives towards anxiety and depression (AD) during pregnancy.In British Columbia (BC), pregnant people (PP) can choose to be cared for throughout the perinatal period by a Family Physician (FP), Registered Midwife (RM), and/or Obstetrician-Gynecologist (ObGyn). Each profession operates under different mandates and care modalities. Thus, a purposive sample of twelve English-speaking PACPs (n=12) participated in one-on-one semi-structured interviews, including five FPs, four RMs, and three ObGyns. Interviews were transcribed verbatim and analyzed inductively using thematic analysis. Current practices in identifying and managing AD with PP, existing resources to support mental health during pregnancy, PACP’s perceived capacity to address AD during pregnancy, what could help address AD, and considerations for implementation in perinatal care settings are described. The knowledge constructed throughout interviews, analysis, and reporting portrays complex phenomena with significant implications for research, practice and policy.Anxiety and depression in the antenatal period are associated with short and long-term morbidity for PP and families. As the main and most constant point of contact with the healthcare system, PACPs are instrumental in shaping healthy pregnancy outcomes. With increasing calls to integrate mental health in perinatal care, this thesis explores and describes the perspectives of those on the frontline of care and offers insights to how we can improve responsiveness to needs. The latter focuses on organizational and system-level supports needed to facilitate the integration of mental health in perinatal care in the interest of healthy pregnancy outcomes.

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