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Perinatal mental illness is an important public health issue. Conditions such as postnatal depression increase mothers' risk of suicide and can herald onset of recurrent and chronic mental health problems. Maternal mental illness can also adversely impact the cognitive, physical, and psychological health and development of children. In light of known psychosocial risks, there is concern that fewer than expected women from black and minority ethnic (BME) backgrounds access care and treatment. This paper aims to address this issue.

Responding to persistent reports of patchy service provision across the UK more generally and particular concerns about potentially unmet needs among BME women, mixed‐method research was undertaken between September 2009 and March 2010. Using survey questionnaires and telephone interviews, the study sought to explore professional stakeholders' perspectives on current perinatal mental health provision and the extent to which it meets the needs of BME women. Findings from the study were intended to inform policy and plans to improve provision by establishing managed care networks (MCNs) for perinatal mental healthcare.

In total, 45 questionnaires were returned from the national survey. One‐third of respondents (n=14) consented to follow‐up telephone interviews. There was evidence of multi‐agency working among the 27 professional groups which respondents reported as being directly involved in delivering perinatal mental healthcare across the country. However, there was also evidence of disjuncture and poor communication – particularly between statutory and voluntary sectors and NHS primary and secondary care. Some respondents had difficulty defining “BME” or identifying the women to whom the acronym might be applied. They also questioned the validity of providing “BME‐specific” services. Instead, they endorsed more ethnically “inclusive models” of provision and “signposting” women to appropriate “community” services.

Taken together, these findings suggests that whilst there might be a theoretical argument for perinatal mental health MCNs, considerable effort is required if policy‐makers' aspirations for more “joined‐up” services capable of meeting the needs of all women are to be fully realised. Furthermore, current proposals for public sector reform coupled with reduction in voluntary sector provision is likely to disproportionately affect women from BME and other marginalised communities as they provide significant amounts of “below the radar” care and support.

This paper is of particular relevance to policy makers and practitioners. Findings suggest that women from BME backgrounds might be particularly vulnerable to perinatal mental illness. Contraction of voluntary sector provision increases the likelihood that the needs of BME women will remain unmet with deleterious consequences for their health and wellbeing of their families. This has potentially serious public health implications. MCNs/clinical networks have the potential to reduce inequalities by providing more “joined up” care for all women. However, the evidence base for levels of need and appropriate service response to perinatal mental illness among BME women is weak. Further research is required to bridge the evidence gap and to evaluate the impact of health and social care reform on vulnerable groups.

This paper reports on insights from an evaluation of Birth Companions (BC) (a UK-based charity) perinatal support in two prison settings in England. The initiative involved the provision of group and/or one-to-one perinatal support and training women prisoners as peer supporters.

A mixed-methods study was undertaken that involved observations of support groups and peer support supervision sessions (n = 9); audio recorded interviews (n = 33) with prison and health-care staff, women in prison, peer supporters and BC staff; analysis of existing routinely collected data by BC and notes undertaken during regular meetings (n = 10) with the BC Project Manager. Thematic analysis was undertaken supported by MAXQDA qualitative data analysis software.

BC provided instrumental/practical support, emotional support, information support, signposting to services and advocating for women to the prison concerning their perinatal needs and rights. Key themes revealed that support had an impact on the lives of perinatal women by creating a safe place characterised by meaningful interactions and women-centred approaches that facilitated access to wider care and support. The service made a difference by empowering women and providing added value for peer supporters, prison, health-care and BC staff. Key enablers and strategies for the care of perinatal women and the delivery of perinatal support are also detailed.

Through longitudinal data and the involvement of a range of stakeholders, this study evidences the subtleties of support provided by BC and the potential it has to make a difference to perinatal women in prison and those volunteering or working within the prison system.

The purpose of this paper is to investigate inter-organizational designs for care–cure conditions in which low-risk patients are cared for in specialized care organizations and high-risk patients are cared for in specialized cure organizations. Performance impacts of increasing levels of integration between these organizations are analyzed.

Mixed methods were used in Dutch perinatal care: analysis of archival data, clinical research and system dynamics simulation modeling.

Inter-organizational design has an effect on inter-organizational dynamics such as collaboration and trust, and also on the operational aspects such as patient flows through the system. Solutions are found in integrating care and cure organizations. However, not all levels of integrated designs perform better than a design based on organizational separation of care and cure.

A clear split between midwifery practices (care) and obstetric departments (cure) will not work since all pregnant women need both care and cure. Having midwifery practices only works well when there are high levels of collaboration and trust with obstetric departments in hospitals. Integrated care designs are likely to exhibit superior performance. However, these designs will have an adverse effect on organizations that are not part of this integration, since integrating only a subset of organizations will feed distrust, low collaboration and hence low performance.

The originality of this research is derived from its multi-method approach. Archival data and clinical research revealed the dynamic relations between organizations. The caveat of some integrated care models was found through simulation.

This paper engaged in theory-building from social movement and knowledge management (KM) theories and applied the case study method to explore the role of knowledge complexity in administration–society collaborations on knowledge. Complex knowledge is a kind of knowledge that consists of many interdependent elements, some of which are tacit. Complex knowledge creates challenges when external social groups attempt to transfer their knowledge to public organizations. Thus, the purpose of this paper is to investigate the following question: how do social groups acting as knowledge agents transfer their knowledge if it is complex?

A single-case study methodology informs the theory-building in this paper. The paper examined a case of collaboration between the natural childbirthing social movement and state maternity hospitals in Russia and Ukraine. The case was constructed from interviews, primary sources and secondary sources.

Social movement and KM theories were used in a case analysis to formulate theoretical propositions about the complexity of social movement knowledge, why and how movements transfer their knowledge through collaborations with the state, and how administrators assess movement knowledge and its transfer. The case suggests that administrators’ lack of capacity to recognize and deal with complex knowledge results in the underutilization of social groups’ knowledge. In particular, administrators treat complex knowledge as simple, and they misunderstand and underestimate its effects on collaboration.

To the best of this author’s knowledge, this paper is the first attempt in public administration to engage in theory-building from social movement and KM theories.

The mortality rate due to intrapartum asphyxia is generally considered a good guide to the quality of perinatal care. Using a routine system of surveillance, we identified a six‐fold difference in mortality rate due to intrapartum asphyxia depending on the hospital of birth, with the lowest rate (95 per cent confidence intervals) of 0.25 (0.10, 0.64)/1,000 births and the highest rate of 1.59 (0.77, 3.27)/1,000 births. A framework of internal and external reviews of the clinical services was developed, that is able to tackle such clinical governance issues in a robust but sensitive manner. The outcome included specific improvements in service provision. The model is generally applicable and is thus suitable for use wherever such clinical governance issues are identified.

Perinatal mental health (PMH) is acknowledged as a significant public health issue associated with significant personal, family, social and economic burden. Research demonstrates that healthcare practitioners lack knowledge and confidence in this area but there is likely to be a complexity of factors that may influence practitioner behaviours, including negative attitudes towards people with mental health and inaccurate illness perceptions. The purpose of this paper is to evaluate the psychometric properties of the Perinatal Illness Perceptions Scale (PIPS), a conceptual derivation of the Illness Perception Questionnaire – Revised.

A cross-sectional and exploratory instrument development design, using exploratory factor analysis, was employed.

The scale demonstrated good psychometric properties revealing three sub-scales: causes, consequences (mother); consequences (baby).

The findings implicate the PIPS as the first robust psychometric measure, which can be used to in the assessment of practitioner knowledge of the causes and consequences of PMH. The PIPS could offer the opportunity to assess these domains within both educational and training context and identify practitioner attitudes which may affect clinical decision making and referral decisions.

This chapter at hand applies and extends Friedland and Alford's model of institutional logics to the case of birth practises focusing on a number of interrelated topics, namely, identity, trust, and ideology. It draws on Giddens's theory of modernity to “bring society back in,” as Friedland and Alford have formulated one major point of critique against existing institutional approaches. In its theoretical discussion, the chapter will focus on two issues: first, the treatment of conflict as a motor of institutional dynamics, and second, the relation between institutions and agency. The empirical data is based on participant observation, qualitative interviews with midwives and obstetricians, and a review of magazines and television material concerning birth and parenting.

The purpose of this paper is to examine knowledge and attitudes about preconception health care among Chinese immigrants in Canada.

A cross-sectional internet-based survey, informed by the principles of the health belief model, was administered to a convenience sample in Ottawa, Canada. In total, 76 respondents from the Chinese community participated in the online survey.

Overall, participants demonstrated: low to moderate awareness of preconception related risk factors and preconception health; neutral to slightly positive attitudes toward carrying out preconception care; considerable confusion over the differences among preconception care, premarital health care (Mainland China), and prenatal health care; great sensitivity to subjective norms related to spouses, parents, and friends; and a strong desire for receiving information and communication from health care professionals.

An emphasis on reducing misperceptions and offering information about the preconception period and potential severe pregnancy-related risks may contribute to a better knowledge and intended behavior toward preconception care among Chinese immigrants, and ultimately optimize both their reproductive health and their future children’s health.

The cultural norms and population policies in the sending country may frame immigrants’ knowledge and attitudes related to preconception health care. This study fills the gap in the literature regarding Chinese immigrants’ knowledge levels and attitudes toward preconception care in Canada and thus offers insights into how to deliver culturally competent care and design effective communication strategies to reach out to ethnocultural communities.

It is well understood that women’s work situations are critical to their well-being during pregnancy and in terms of potential risks to the fetus. It has also long been known that undocumented women workers face particularly difficult work conditions and being undocumented precludes access to key social benefits (i.e. public health insurance, paid maternity leave, child benefits and subsidized daycare) that support pregnant women and new mothers. Yet, this paper aims to write about the intersection of undocumented women’s pregnancy with work experiences.

Drawing on the results of a broader qualitative study that was focussed on access to healthcare for undocumented (and therefore, uninsured) women who were pregnant and gave birth in Montreal, Canada, the authors begin this paper with a review of the relevant literature for this topic related to the work conditions of undocumented women, how work exacerbates barriers to accessing healthcare and the resulting health outcomes, particularly in relation to pregnancy. The authors highlight the social determinants of health human rights framework (Solar and Irwin, 2010), before presenting methodology. In conclusion, the authors discuss how an understanding of undocumented women’s work situations sheds light on their pregnancy experiences.

The authors then present participants’ work conditions before becoming pregnant, working conditions while pregnant and employment options and pressures after giving birth.

The authors emphasize that attention to undocumented pregnant women’s work situations might help health and social service practitioners to better serve their needs at this critical point in a woman’s life and at the beginning of the life of their children, born as full citizens.

Integrating preventive oral care into prenatal care is suggested as a strategy for reducing the burden of oral diseases among pregnant women and their offspring. This scoping review sought to synthesize available information and identify knowledge gaps on integrating oral health into prenatal care.

The scoping review was conducted based on the Joanna Briggs Institute scoping review framework using the following databases: CINAHL, Cochrane Database of Systematic Reviews, Medline, ProQuest Dissertation and theses Global, Psychinfo and Web of Science®. No search limits were used. Content analysis of the included articles was performed to identify conceptual frameworks, types of integration used, study designs, study objectives and outcomes.

Overall, 2,861 references were obtained from the databases search; and based on the inclusion and exclusion criteria 35 references were included in the final analysis. Of these 35 references, one document presented a conceptual model, six documents reviewed guidelines for integrating oral health in prenatal care, two were policy documents aimed at interprofessional collaboration for oral health during pregnancy, eight documents described programs focused on providing oral care during pregnancy, five of the references were literature reviews and the remaining 13 evaluated the impact of integration. Linkages between healthcare professionals were the most common type of integration used.

Despite advances in understanding integrated care concepts for healthcare delivery, there is little evidence available on the impact of the various types of, and strategies for, integrating oral health into prenatal care. Future research to bridge the identified gaps is recommended.

The originality of this study is to provide evidence on integrated oral healthcare during pregnancy.