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Literature review
Expanding midwifery’s role to improve perinatal mental healthcare access
  1. Cindy-Lee Dennis1,2,
  2. Simone Vigod3
  1. 1 Faculty of Nursing, University of Toronto, Toronto, Ontario, Canada
  2. 2 Li Ka Shing Knowledge Institute, St. Michael’s Hospital, Toronto, Ontario, Canada
  3. 3 Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada
  1. Correspondence to Professor Cindy-Lee Dennis, Faculty of Nursing, University of Toronto Toronto Ontario Canada ; cindylee.dennis{at}

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Commentary on: Viveiros CJ, Darling EK. Perceptions of barriers to accessing perinatal mental healthcare in midwifery: a scoping review. Midwifery 2019;70:106–118.

Implications for practice and research

  • Midwives increasingly provide important perinatal care but their role in the identification and management of mental illness, one of the most common complications of pregnancy, remains unclear.

  • Access to mental healthcare in midwifery is hampered by supply-side barriers and there are also barriers due to the clients’ inability to interact with midwives to optimise access to care

  • Research in innovative strategies to train midwives to provide psychosocial and psychological interventions to women with mild-to-moderate symptom severity is needed to ensure timely access to evidence-based treatment and appropriate follow-up.


Despite increased awareness of perinatal mental health issues, management remain suboptimal. Barriers are diverse and areas to target for greatest impact …

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  • Competing interests SV receives royalties from UpToDate Inc for authorship of materials related to depression and pregnancy.

  • Provenance and peer review Commissioned; internally peer reviewed.