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  4. Perinatal Mental Health in Croatia: Research and Practices




Perinatal Mental Health in Croatia: Research and Practices



Public, Staff, Students, Alumni

Speaker: Sandra Nakić Radoš


Perinatal health care in Croatia on a high-quality level. Primary health care is free for all taxpayers, and perinatal women are offered at least nine prenatal check-ups and three ultrasounds during pregnancy with prenatal screening. Every year about 40,000 women give birth in Croatia. All deliveries are attended by a skilled health professional (WHO, 2013). Home birth or an elective caesarean section is not offered to women on demand. However, an increase in the caesarean section rate has been observed over the last two decades (Rodin, 2010, 2017) and the current rate is 23% (Rodin, 2017). The maternal mortality rate of 8 per 100 000 is somewhat lower than the average rate of 12 for countries in developed regions (WHO, 2015).

Although perinatal health care is quite favourable, mental health care specific for perinatal period lags behind. Research on perinatal mental health in Croatia is still quite scarce. Studies have mainly focused on anxiety during pregnancy, such as anxiety due to prenatal diagnostic procedures (Brajenović-Milić, Martinac Dorčić, Kuljanić, & Petrović, 2010), fear of childbirth (Jokić Begić, Žigić, & Nakić Radoš, 2013), postnatal depression (PND) (Čuržik & Jokić-Begić, 2012; Reić Ercegovac & Penezić, 2011), and posttraumatic stress disorder (PTSD) following childbirth (Srkalović Imširagić, Begić, Šimičević, & Bajić, 2016).

The studies have mainly focused on the prevalence and risk factors of these adversities during the perinatal period. Anxiety during pregnancy is a present phenomenon, and about 15% of nulliparous women experience fear of childbirth (Jokić-Begić et al., 2013). The longitudinal studies showed that the levels of both depression and anxiety decrease from the pregnancy to 6-8 weeks postnatally (Nakić, 2011; Nakić Radoš, Tadinac, & Herman, 2018). However, 8.1% experience postnatal depression when examined by interview and even higher figure of 22.4% reported depressive symptoms above the cut-off score (Nakić Radoš, Tadinac, & Herman, 2013). Moreover, 35% and 20% of women report high anxiety during pregnancy and postpartum, respectively, with comorbidity with depressive symptoms of 75% (Nakić Radoš et al., 2018). One in four women experiences traumatic childbirth with 2% of women reporting severe PTSD symptoms (Nakić Radoš, Sawyer, Ayers, & Burn, 2014, in press). Furthermore, one in three women reports at least moderate post-traumatic growth after childbirth women (Sawyer, Nakić Radoš, Ayers, & Burn, 2015). Different risk and protective factors for FOC, PND, and PTSD have been examined and will be discussed. In respect to measurement scale, several instruments for prenatal anxiety have been developed (Košec, Nakić Radoš, & Gall, 2014; Nakić Radoš, Tadinac, & Herman, 2015) and the Edinburgh Postnatal Depression Scale, a scale for depression screening the most used worldwide, has been validated in Croatian women, as well (Nakić Radoš, Tadinac, & Herman, 2013).

While in other European countries and worldwide many different interventions for perinatal mental health have already been extensively implemented, and its efficiency and effectiveness have been examined, in Croatia, such programs are rarely available in the first place. The only programme that is available on a regular basis is prenatal classes, although they are focused more on the medical aspect of the childbirth. Opportunities for mental health care during pregnancy and postnatal period for women in Croatia will be presented, and research findings will be discussed in the context of state of the art.

About the speaker

Sandra Nakić Radoš is a researcher in perinatal mental health. She is a specialist in clinical psychology, educated in cognitive-behavioural therapy. Her doctoral thesis focused on postnatal depression, but her research extends to perinatal anxiety, sexuality during pregnancy, and other topics related to reproductive health psychology. She is a co-author of 20 scientific papers and 40 conference abstracts.

She worked for seven years at the Ob/Gyn department at the University Hospital Centre “Sisters of Mercy” (Zagreb, Croatia) as a research assistant and since 2015 she has been an assistant professor at the Department of Psychology, the Catholic University of Croatia where she teaches clinical psychology and research methods. She spent three months on a research scholarship at the University of Sussex (2011) where she worked on birth trauma. For this work, she was awarded the Voya Kondić by the British Scholarship Trust. She is also a co-founder and the lead of the NGO Centre for Reproductive Mental Health (Zagreb, Croatia).

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When & where

12.30pm - 2.30pmTuesday 27th November 2018

AG11 College Building City, University of London St John Street London EC1V 4PB United Kingdom