Perceived quality of perinatal mental health care in Italy: a cross-sectional study (IMAgiNE)
M Verdecchia, I Mariani, M Camanni, LG Cora, M LazzeriniAbstract
Background
Perinatal mental health (PMH) conditions are common and have important implications for maternal and child health; nevertheless, access to PMH screening practices and support in care is limited. This study aimed to assess, among women giving birth in Italy, PMH screening practices, symptoms, and access to support, as well as childbirth-related emotional difficulties and to identify associated factors.
Methods
As part of the IMAgiNE Research Network, women aged ≥18 years and who gave birth in Italian hospitals between 2022 and 2024, completed an anonymous online questionnaire. Outcomes were PMH screening, self-reported PMH symptoms, adequate support among symptomatic women, and childbirth-related emotional difficulties. Multivariable logistic regression identified associated factors.
Results
Among 15,869 women, 17.4% were not screened at recommended visits, 45.6% reported PMH symptoms, and among those with symptoms, 32.4% perceived not having received adequate support. Childbirth-related emotional difficulties affecting mental health were reported by 12.9% of the sample, of whom 63.6% reported severe difficulties. Women from the South had overall poorer outcomes (p ≤ 0.001). Women giving birth in 2024 had lower odds of not being screened (aOR 0.49) and of reporting symptoms (aOR 0.78) compared with those in 2022. Caesarean birth was associated with higher odds of not being screened, reporting PMH symptoms, and not receiving adequate support (aOR 1.37, 1.17, and 1.15, respectively). Not receiving screening was strongly associated with reporting PMH symptoms (aOR 2.08) and inadequate support (aOR 11.53).
Conclusions
Substantial gaps remain in PMH screening, support, and childbirth-related experiences in Italy, with marked regional inequalities. Strengthening PMH care requires expanding screening coverage and ensuring effective referral pathways and access to care.