GSBS Dissertations and Theses
ORCID ID
0000-0002-0026-7499
Publication Date
2019-01-31
Document Type
Doctoral Dissertation
Academic Program
Clinical and Population Health Research
Department
Population and Quantitative Health Sciences
First Thesis Advisor
Kristin M. Mattocks
Keywords
Women veterans, pregnancy, depression, mental health, Veterans Health Administration
Abstract
Background: 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.
Repository Citation
Kroll-Desrosiers, AR. Understanding the Experience and Evaluating the Occurrence of Depression in a Sample of Pregnant Veterans. (2019). University of Massachusetts Medical School. GSBS Dissertations and Theses. Paper 1006. DOI: 10.13028/07dz-4m58. https://escholarship.umassmed.edu/gsbs_diss/1006
DOI
10.13028/07dz-4m58
DOI Link
Rights and Permissions
Copyright is held by the author, with all rights reserved.
Included in
Clinical Epidemiology Commons, Epidemiology Commons, Female Urogenital Diseases and Pregnancy Complications Commons, Maternal and Child Health Commons, Mental and Social Health Commons, Military and Veterans Studies Commons, Obstetrics and Gynecology Commons, Psychiatry and Psychology Commons