Dr Lynne Roberts
St George Hospital


Title: Hypertension In Pregnancy: Gaining Insight Into Women’s Mental Health And Birth Experience 6-12 Months Postpartum.

Authors: LM Roberts1,2, SB Harvey3, CSE Homer2, GK Davis1,2

1 Department of Women’s and Children’s Health, St George Hospital, Sydney, Australia
2 Faculty of Health, UTS, Sydney, Australia
3 School of Psychiatry, UNSW, Sydney, Australia

Abstract Text: 

Pregnancy and childbirth are usually joyful experiences. However, when complications occur, it can be traumatic. There is limited research reporting on women’s mental health after hypertension in pregnancy (HIP) and their perspective of the experience.

To compare depression, anxiety and PTSD symptoms amongst women who were normotensive and hypertensive in pregnancy and to gain insight into women’s experiences of HIP.

A mixed methods study using prospective observational and qualitative descriptive approaches was undertaken. Women who were normotensive or hypertensive (gestational hypertension or preeclampsia) in pregnancy completed the Edinburgh Postnatal Depression (EPDS), General Anxiety Disorder (GAD) and Posttraumatic Stress Diagnostic Scales six months postpartum. Independent t-tests were used to compare scores; chi squared tests to compare thresholds for caseness. 20 women who experienced HIP were interviewed 12 months postpartum. Thematic analysis was used to analyse interview data.  

Of 210 participants, 49 had HIP. Mean EPDS and GAD scores were similar in both groups. The proportion of women scoring above established thresholds for depression and anxiety was not significant (p=0.47 depression, p=0.74 anxiety). Of the HIP group, 10% reported their birth experience as traumatic compared to 1% of normotensive group (p=0.003). Mean PTSD symptom scores were not significantly different between the groups (p=0.7). Women’s experiences included Reacting to the diagnosis, Being a mother in adversity, and ‘Moving on’. Factors that helped improve her experience were Feeling safe, Trust, Continuity of care and Support.

By six months postpartum, psychological morbidity is not significantly different. Women who experienced HIP reported that they could process the experience and move on with being a mother. The care of women with HIP often focusses on their physical health but their care should also include emotional and social support. Trust and continuity of care are important factors for improving the woman’s birth experience.