Barriers to Preventing Perinatal and Postnatal Depression

Barriers to Preventing Perinatal and Postnatal Depression
PICOT Question: Among expectant mothers (Population), how effective are non-pharmacological interventions (Intervention) compared to pharmacological interventions (Comparison) in managing depression (Outcome) during the perinatal period (Time)?
Qualitative Studies
Background of Study
Preventing and managing perinatal depression will improve health outcomes in pregnant mothers and infants social-emotional. Researchers have identified different interventions, including a cognitive-behavioral intervention for managing perinatal depression. Low-income women are disproportionately affected by postpartum depression, and interventions for addressing maternal depression are either individualized or group-based based on what is feasible. Both non-pharmacological and pharmacological interventions prevent, treat and manage depression. Still, the lack of integrated interventions to manage maternal depression affects the ability to enhance long-term outcomes (Baggett et al., 2021).
Identifying barriers to preventing perinatal and postnatal depression and implementing the most effective preventive interventions help promote maternal health (Diebold et al., 2020). The research by Diebold et al. (2020) considers the mothers-babies programs in group intervention to manage perinatal depression and professionals actively involved in implementing the intervention. The research question is the appropriateness of the mothers-babies (MB) programs in managing perinatal depression showed it was a viable option that is also potentially acceptable by professionals.
Relationship with PICOT Question
 The research by Baggett et al. (2021) highlighted interventions in social-emotional-communication development reduce the risk of postpartum depression-related outcomes. The researchers opposed a non-pharmacological approach that mothers can use. Similarly, the article by Diebold et al. (2020) is related to the PICOT question and focuses on mothers-babies programs, a non-pharmacological intervention effective in perinatal depression. Both articles focus on prenatal depression and address the efficacy of a non-pharmacological intervention in maternal depression. 
 The articles address the PICOT question's main focus with non-pharmacological interventions studied to determine their effectiveness in prenatal and perinatal depression, which is the same as that of the PICOT question. Still, the comparison is pharmacological interventions, and there is more research on the effectiveness of different medications in maternal depression. The articles did not compare the main non-pharmacological intervention with non-pharmacological or pharmacological interventions. 
Method of Study
Baggett et al. (2021) used a two-arm randomized controlled intent-to-explore trial method with a randomized assignment. Such randomized controlled trial (RCT) studies the effect compared to control treatment, and participants were analyzed based on a specific category, irrespective of the treatment they received. The approach is an unbiased method to evaluate the intervention's effectiveness, making the method reliable and generalizable results. Still, the method is expensive and requires more time than most other research. 
Diebold et al. (2020) relied on semi-structured interviews attempted with a randomly- chosen subset of the full sample, with each sample having an equal chance of being selected. Data was later obtained from particular subsets, and the semi-structured interview method allows asking open-ended questions and discussions with interviewees. Thus, the main advantage is flexibility in obtaining more information, while randomization minimizes biasness. Still, the semi-structured and randomization methods are time-consuming and expensive.
Results of Study
 In the research by Baggett et al. (2021), the Mom and Baby Net (MBN) was associated with significant reductions in depression. The researchers also found out that there was an improvement in sensitive and responsive parent practices and improved social-communication and social-emotional in infants. Consequently, there was an improvement in the mothers' and infants' emotional wellbeing. Women may experience psychological issues, but there are racial/ethnic disparities in diagnosis and access to appropriate mental health care access and testament (Iturralde et al., 2021).
Diebold and others (2020) reported that the Mothers and Babies Program (MB) perinatal depression intervention was acceptable whether or not mental health professionals were involved in implementing the intervention. Furthermore, paraprofessionals were able to use the preventive intervention effectively, and there was support for the MB intervention. MB is an acceptable and appropriate depression intervention and is more effective when there are facilitators and an understanding of the contextual factors influencing the risk of depression.
Both studies highlighted non-pharmacological preventing and treating perinatal depression, and there was a significant reduction in depression among expectant mothers. There is a need for healthcare practitioners to be more informed and knowledgeable in incorporating non-pharmacological methods to reduce depressive symptoms and improve mental health outcomes.  
Outcomes Comparison
The PICOT question compares non-pharmacological to pharmacological interventions in managing prenatal depression, and non-pharmacological methods were expected to be effective. Both studies supported the benefits of non-pharmacological interventions in addressing prenatal depression, which is consistent with the PICOT question. Mothers and Babies Program (MB) and Mom and Baby Net are evidence-based interventions that are developmentally appropriate for pregnant mothers and help manage and prevent prenatal depression.
Ethical Considerations 
 In the study by Baggett et al. (2021), the investigators were trained on consent protocol, and the researchers obtained informed consent from the participants. There was voluntary participation, and they were informed about the aim of the research. Some mothers chose the oral administration of the questions, and researchers allowed this to collect data and information from responses. 
The Northwestern University's Institutional Review Board (IRB) provided ethical approval to Diebold et al. (2020) research. There was a waiver of written documentation since there was no significant risk to participants, but the participants provided consent voluntarily, while the research part...