MIDW215 - Perinatal Mental Health

Year

Credit points

Campus offering

Prerequisites

For Bachelor of Midwifery: MIDW113 Midwifery Care of the Pregnant Woman AND MIDW246 Midwifery Care of the Postnatal Woman and Family AND (MIDW100 Clinical Midwifery Practice 1 OR MIDW122 Midwifery Professional Practice 2 )

For Bachelor of Midwifery (Graduate Entry): MDGE101 Introduction to Midwifery Practice

Teaching organisation

Unit rationale, description and aim

This unit provides students with the opportunity to develop an understanding of mental health and mental illness in pregnancy, childbirth and the postnatal period. The impact of mental health disorders on attachment, early parenting, the baby and family will be explored. The unit is required by students to extend their midwifery knowledge on assessment and care planning, specifically in relation to childbearing women with mental illness.

The aim of this unit is to extend students' knowledge of contemporary midwifery practice to enable them to support women and families challenged by mental health issues.

We recognise that people who access maternity care may have diverse gender identities, that those who do can experience marginalisation and oppression, and that using appropriate terminology can help with these community members’ recognition and visibility, acknowledge the variety of pregnancy and birth experiences people may have, and respect individuals’ preferences. To reflect this, terms such as ‘pregnant person’, ‘birthing person’, ‘childbearing people’, ‘parent’ and ‘chestfeeding’ may be used in the midwifery courses at ACU in addition to ‘woman’, ‘mother’, ‘maternity’, ‘maternal’ and ‘breastfeeding’, which are used not to exclude those who do not identify as a woman, but in recognition that women continue to be marginalised and oppressed in many places around the world and to respect their own individual preferences.

Learning outcomes

To successfully complete this unit you will be able to demonstrate you have achieved the learning outcomes (LO) detailed in the below table.

Each outcome is informed by a number of graduate capabilities (GC) to ensure your work in this, and every unit, is part of a larger goal of graduating from ACU with the attributes of insight, empathy, imagination and impact.

Explore the graduate capabilities.

On successful completion of this unit, students should be able to:

LO1 - Describe effective therapeutic approaches to communication in caring for women vulnerable to or experiencing mental illness and their families during pregnancy, birth and early parenting in a culturally competent manner (GA7, GA9)

LO2 - Understand the theoretical and social constructs of parenting and how they impact mental health and wellbeing in childbearing (GA5)

LO3 - Apply the principles of teamwork and self-management when planning, implementing and evaluating woman centred care and/or clinical responsibilities (GA7)

LO4 - Explore how stigma and other personal beliefs create barriers for women vulnerable to or experiencing mental illness to accessing midwifery care (GA4)

LO5 - Apply theories of maternal infant attachment to promote infant family bonding, particularly in families at risk (GA2)

LO6 - Apply ethico-legal and professional frameworks to screen, assess, plan and provide safe, evidence–based midwifery care in collaboration with other health professionals for women experiencing mental illness and family violence (GA1, GA3)

Graduate attributes

Each unit in your course contributes in some way to the development of the ACU Graduate Attributes which you should demonstrate by the time you complete your course. All Australian universities have their expected graduate attributes. ACU’s Graduate Attributes have a greater emphasis on ethical behaviour and community responsibility than those of many other universities. All of your units will enable you to develop some attributes.

GA1 - demonstrate respect for the dignity of each individual and for human diversity 

GA2 - recognise their responsibility to the common good, the environment and society 

GA3 - apply ethical perspectives in informed decision making

GA4 - think critically and reflectively 

GA5 - demonstrate values, knowledge, skills and attitudes appropriate to the discipline and/or profession 

GA7 - work both autonomously and collaboratively 

GA9 - demonstrate effective communication in oral and written English language and visual media 

NMBA Midwife Standards for Practice 

NMBA (2018) Midwife Standards for Practice developed in this unit are: 

Content

Topics will include: 

Legal and professional practice 

• Legal frameworks and obligations 
• Mental health 
• Child protection 
• Family violence 
• Consultation and referral 
• Medication knowledge and administration 
• Assertive communication skills

Midwifery knowledge and practice 

• Introduction to the theories underpinning mental health and illness  
• Behaviourist 
• Psychoanalytic  
• Cognitive 
• Humanistic 
• Biopsychosocial 
• Application to midwifery practice 
• Mental health and childbearing: 
• Perinatal anxiety and depression; 
• Bipolar and psychotic disorders, 
• Posttraumatic stress disorder,  
• Body image disturbance,  
• Personality disorders  
• Childhood sexual abuse 
• Screening, assessment and diagnosis of women with perinatal mental health issues  
• Edinburgh Post Natal Depression Scale, 
• Comprehensive mental health assessment 
• Diagnostic and Statistical Manual of Mental Disorders  
• Collaborative management of women with perinatal mental health issues 
• Therapeutic interventions and communication 
• Infant Mental Health 
• Attachment theory application 
• Women at risk 
• Social and economic disadvantage  
• Substance use 
• Family violence 

Midwifery as primary health care 

• Societal constructs  
• Motherhood/fatherhood 
• Mental health and illness  
• Impact on child bearing women and families 

Reflective and ethical practice 

• Ethical issues 
• Disclosure 
• Confidentiality 
• Personal beliefs 
• Evidence-based practice 

Learning and teaching strategy and rationale

Modes of delivery in this unit include online learning complemented by learner-centred tutorials and therapeutic communication practice. Consistent with adult learning principles, the teaching and learning strategies used within these modes of delivery will provide students with foundational knowledge and skills relevant to professional midwifery practice. These strategies will also support students in meeting the aim, learning outcomes and graduate attributes of the unit and the broader course learning outcomes. Learning and teaching strategies will reflect respect for the individual as an independent learner. Students will be expected to take responsibility for their learning and to participate actively with peers.  Scenario-based learning, case-based learning, problem-based learning and inquiry-based learning are all used to support the development of students' independent learning ability.

Students at university need to operate effectively as self-sufficient learners who drive their own learning and access the learning supports they require. To guide students in their learning, feedback is required to identify what is being done well, what requires additional work and to identify progress toward required learning outcomes. Located in the second year of the programme, this theory unit includes moderate face-to-face teaching hours and an increasing online component of learning to build life-long learning skills. Online modules are utilised to convey content and its central principles while tutorials deliver interactive and student-driven learning sessions including in a Yarning Circle format which require an increasing reliance on students to extend their community of learners and increase self-reliance. Online materials provide students with the opportunity to undertake  directed, self-motivated study and continue to transition to  independent study and life-long learning.  

Assessment strategy and rationale

A range of assessment procedures consistent with University assessment requirements will be used to meet the unit learning outcomes and develop graduate attributes.

Students will work in groups within the online learning platform to explore discipline specific knowledge and skills in relation to mental illness in childbearing women and their family. The group work enables students to experience and reflect on team and leadership skills relevant to their professional practice within midwifery and wider multidisciplinary teams. The written assignment provides students with the opportunity to explore the evidence base regarding assessment and care planning for women challenged by mental illness. The examination enables students to demonstrate a sound knowledge base in addressing content and process questions related to unit content.

These assessments are required to build student knowledge and skills which, by the conclusion of this programme, will enable the student to graduate as a safe and effective midwife. 

Overview of assessments

Representative texts and references

Austin M-P., Highet N., and the Expert Working Group (2017). Mental Health Care in the Perinatal Period: Australian Clinical Practice Guideline. Centre of Perinatal Excellence.

Dudgeon, P., Milroy, H., & Walker, R. (Eds.). (2014). Working Together: Aboriginal and Torres Strait Islander Mental Health and Wellbeing Principles and Practice (2nd ed.). Department of Health and Ageing.

Hanley, J. (2009). Perinatal Mental Health: A Guide for Health Professionals and Users. Wiley-Blackwell.

Henshaw, C., Cox, J., & Barton, J. (2017). Modern Management of Perinatal Psychiatric Disorders (2nd ed.). Cambridge University Press.

Kohen, D. (Ed). (2010). Oxford Textbook of Women and Mental Health. Oxford University Press.

Martin, C.R. (2012). Perinatal Mental Health: A Clinical Guide. M&K Update Ltd.

Milgrom, J., & Gemmill, A.W. (2015). Identifying Perinatal Depression and Anxiety: Evidence-Based Practice in Screening, Psychosocial Assessment and Management. Wiley-Blackwell.

Pairman, S., Tracey, S., Dahlen, H., & Dixon, L. (2018). Midwifery: Preparation for Practice (4th ed.). Elsevier. 

Raynor, M., & England, C., (2010). Psychology for midwives: pregnancy, childbirth and puerperium. Open University Press.

Thomson, G., & Schmied, V. (2017). Psychosocial Resilience and Risk in the Perinatal Period: Implications and Guidance for Professionals. Routledge.