Understanding the Experience and Evaluating the Occurrence of Depression in a Sample of Pregnant Veterans
AuthorsKroll-Desrosiers, Aimee R.
Faculty AdvisorKristin M. Mattocks
Academic ProgramClinical and Population Health Research
UMass Chan AffiliationsPopulation and Quantitative Health Sciences
Document TypeDoctoral Dissertation
Veterans Health Administration
Female Urogenital Diseases and Pregnancy Complications
Maternal and Child Health
Mental and Social Health
Military and Veterans Studies
Obstetrics and Gynecology
Psychiatry and Psychology
MetadataShow full item record
AbstractBackground: The Veterans Health Administration (VHA) encourages depression screening and treatment for pregnant veterans; however, rates of depression symptoms and treatment utilization during pregnancy have not been well-studied. Methods: We used data from the Maternity Care Coordination for Women Veterans cohort study. Specifically, our aims were to: 1) examine rates and correlates of depression symptoms in a sample of pregnant veterans; 2) understand mental health care treatment utilization and explore the experiences of veterans accessing mental health care at the VHA during pregnancy; and 3) examine VHA mental health provider's perspectives on depression screening and treatment in the perinatal period. Findings: Depression symptoms were present in 28% of pregnant veterans in our sample. Social support and employment decreased odds of symptoms; history of anxiety, antidepressant use, and active duty service resulted in increased odds of symptoms. Nearly 70% of women veterans with prenatal depression symptoms received at least one mental health visit or antidepressant prescription during pregnancy. However, symptomatic pregnant women without a history of depression were less likely to receive care. Mental health providers identified absence of screening protocols and referral procedures and variability in risk/benefit conversations surrounding antidepressant use as areas of weakness for VHA mental health care during the perinatal period. Conclusions: Depression symptoms were present in nearly one in every three pregnant veterans. Depression treatment during pregnancy is complex, requiring individualized care. Policies for depression screening, referrals to providers, and medication review could be better encouraged to improve standardized care across the VHA.
Permanent Link to this Itemhttp://hdl.handle.net/20.500.14038/31223
RightsCopyright is held by the author, with all rights reserved.