Women's Experiences of Care and Support Following Postpartum Psychosis: A Meta-Ethnography

Abstract

Background
Postpartum psychosis is a psychiatric emergency that occurs following childbirth. Women are often cared for in general psychiatric units or in psychiatric Mother and Baby units. Postpartum psychosis is associated with a significant risk of relapse. There is a need to explore how women perceive care to understand what works well or needs further improvement.

Aims
This review aimed to explore women's experiences of care and support for postpartum psychosis.

Design
A systematic review using meta-ethnographic methods was conducted.

Data Sources
Comprehensive searches were conducted between 4 March 2024 and 4 March 2025 on five databases (CINAHL, EMBASE, MEDLINE, PsycINFO and Web of Science). Backward and forward chain searching was also undertaken.

Review Methods
Critical appraisal was conducted following screening. Reciprocal and refutational translation were used to form the synthesis, and a line of argument was developed. The eMERGe reporting guidelines were used.

Results
Fifteen studies were included within this synthesis. All the studies were conducted in high income countries and included 235 women. Three main themes were developed. ‘Navigating the unknown’ explored women's perceptions of postpartum psychosis as a less well-known condition, and their informational needs. ‘The double-edged sword of care’ found that there were helpful elements of formal mental health care, but that accessing care was sometimes traumatic, stigmatising and conflicting to women's identities. ‘Seeking consolation and recovery’ explored women's need for psychological support and experiences of peer support.

Conclusion
The findings of this review highlighted women's needs in respect to informational support, medication support, psychological support and in-patient care settings. Mother and baby units were strongly preferred by women.

Impact
The findings highlighted a need for specialised care for postpartum psychosis.

Patient or Public Contribution
There were no patient or public contributions.

Trial Registration
Prospero (CRD42024515712)