Women' and midwives' experiences of perinatal mental health care: A qualitative study.

Background: Perinatal mental health problems affect one in five women during pregnancy and the first postpartum year, negatively impacting maternal and infant health. Despite its importance, healthcare remains focused on physical aspects, whereas mental health is neglected, highlighting the need for comprehensive and effective approaches. Aim: To explore the current status of perinatal mental healthcare from the perspective of women and midwives, and to identify needs, challenges, and potential solutions to improve comprehensive care during pregnancy and the postpartum period. Methods: An exploratory qualitative study in which 20 midwives from different care settings and 30 women at different stages of pregnancy and postpartum participated in individual semi-structured interviews. Reflexive thematic analysis assisted by Nvivo12 was used for data analysis. Results: Four main themes emerged from the data analysis: (I) Challenges in Emotional Care: Cultural stigma identified as a significant barrier. Culturally sensitive care and strong therapeutic relationships highlighted as essential for emotional support. Need for dedicated time and safe spaces to facilitate emotional openness. (II) Significance of Perinatal Mental Health: Importance widely recognized but rarely addressed effectively. Mental health closely linked to emotional well-being, yet often neglected in daily practice. (III) Training-related challenges: Midwives report feeling unprepared. Need for ongoing, specific mental health training and standardized assessment tools. (IV) Challenges in Clinical Practice: Absence of clear protocols. High workloads hinder emotional care. Inconsistent approaches contribute to fragmented care. Conclusions: This study highlights key priorities to improve perinatal mental healthcare: including culturally sensitive training, validated and standardised assessment tools, clear clinical protocols, and sufficient time for emotional support. Strengthening therapeutic relationships between midwives and pregnant and postpartum women emerged as essential for effective care. Findings support implementing structured support groups, multidisciplinary collaboration, and a more responsive, holistic care model.