Unveiling Maternal Mental Health: Exploring the Perceptions and Practices of Mental Health Care for Pregnant and Postnatal Women in Kingdom of Saudi Arabia: A Mixed Methods Study

Abstract

Background: Mental health during pregnancy and the postpartum period is critical yet often overlooked. In Saudi Arabia, cultural and societal norms significantly influence perceptions and practices related to mental health and these are compounded in the context of maternal mental health. Objective: This thesis aimed to explore the knowledge, perceptions, and challenges faced by women and healthcare providers (HCPs) regarding mental health during pregnancy and postpartum in Hail, Saudi Arabia. Methods: An embedded mixed-method design was used. Semi-structured interviews with ten pregnant and postpartum women and ten HCPs. An online cross-sectional survey was conducted with 349 HCPs to evaluate their knowledge of depression symptoms, risk factors, and treatment options. Results: Qualitative interviews revealed four major themes: Awareness and Education on Maternal Mental Health, Stigma and Shame, Barriers to Accessibility, and Enhancing Maternal Mental Health Care. Women's misconceptions and fears of stigma led to reluctance to seek help. HCPs highlighted gaps in training and guidelines, with barriers including limited time and inadequate mental health education. Quantitative results showed insufficient knowledge among HCPs, with an average score of 8.62 out of 20 (44.86% correct). Knowledge was higher in treatment (53%) compared to assessment (45.88%) and education (35.71%) domains. Discussion: The integrated findings reveal gaps in knowledge and perceptions of maternal mental health among both women and HCP. This study offers novel insights by combining perspectives from both groups, uncovering underexplored cultural barriers and care gaps. It highlights how cultural stigma, HCP training, and systemic issues impact Saudi women’s perinatal and postnatal experiences. Conclusion: This thesis provides new insights into maternal mental health issues in Saudi Arabia, highlighting the need for targeted education, reduce stigma, and improved support systems. Future research should explore socio-cultural interventions to address these gaps and enhance care delivery