Kelly_whole_thesis.pdf (5.49 MB)
Midwifery and child health nursing : supporting early parenting mental wellbeing
thesisposted on 2023-05-27, 11:01 authored by Robyn KellyRobyn Kelly
Background: Midwives and child health nurses are the key providers of perinatal education to families. There is little research internationally that documents how these health professionals deliver and families obtain mental health promotion, as opposed to screening for mental illness, within the perinatal education arena. Aim: This PhD study critically analyses how early parenting mental health promotion is understood and implemented by midwives and child health nurses in early parenting services in the state of Tasmania, Australia. Method: A critical ethnographical study by an Australian registered midwife and child health nurse in which 13 public hospital registered midwives and 18 community child health nurses were interviewed in 2011-2012 using approximately hour long, semi-structured and co-constructed strategies. The interviews explored these health professionals' understanding and practice of mental health promotion and how the two services implemented this promotion. State-wide documents from these services pertaining to perinatal curricula, protocols and policies for parenting information were also collated in 2012 and 2013 and then analysed for mental health promotional content. Key Findings: Analysis of interviews and documents concluded contested understandings of mental health promotion and implementation in practice. Three key findings were: 1) mental health promotion was complex to understand and complex to implement, 2) mental health promotion was represented in perinatal educational practice as early detection and prevention of perinatal depression, and 3) there was a plethora of constraints within the Women's and Children's' Services (WACS) and Child Health and Parenting Service (CHAPS) that made detecting and preventing perinatal depression difficult and promoting mental health almost impossible. Overall, current practices of delivering care ‚Äö- specifically current policies and management strategies and practices ‚Äö- were clear barriers to supporting families in this significant area that contributes to the wellbeing of parent and baby. Implications for midwifery and child health nursing practice and policy: The implementation of mental health promotion is gaining ascendency internationally; these findings around how mental health promotion, as opposed to early detection and prevention of mental illness, is perceived and implemented by key parenting supporters are particularly timely for informing future perinatal parenting service policy and provision.
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