Antenatal Depression: A Concept Analysis Using the Walker and Avant Method

Abstract

Antenatal depression is an important mental health problem of pregnancy whose symptoms are often masked by the physiological changes of pregnancy, and it can adversely affect both the mother and the baby. The concept is used inconsistently in the literature and is often interchanged with related terms such as prenatal, antepartum and perinatal depression. This concept analysis aimed to clarify antenatal depression, distinguish its common use from its scientific use, and develop an operational definition for future research. The method of Walker and Avant was followed. Dictionaries and the literature were reviewed to identify the uses of the concept and related concepts, and model, borderline and contrary cases were constructed to illustrate it. The defining attributes were depressed mood, loss of interest, feelings of guilt or worthlessness, disturbed sleep and appetite, fatigue, poor concentration, crying episodes and thoughts of death or suicide. Antecedents included a personal or family history of depression, unplanned pregnancy, lack of social and partner support and previous miscarriages, while consequences included low birth weight, preterm birth, postpartum depression and mental health disorders in the infant in later life. Prenatal and antepartum depression were the terms most closely related to the concept. Antenatal depression is operationalized as depression during pregnancy and before childbirth, characterized by sadness, worthlessness, inactivity, loss of appetite, disturbed sleep, crying spells, loss of interest and extreme fatigue lasting for almost two weeks. Further research is needed to separate antenatal from postpartum depression.