Data of the MAternal Mood Assessment (MAMA) survey for healthcare professionals: A pilot study on midwives in Italy

This article describes the data collected from a survey of 152 midwives in Italy on their knowledge, attitudes, and practices regarding perinatal depression. The survey used the MAternal Mood Assessment (MAMA) questionnaire, a 35-item tool that covers various aspects of perinatal depression, such as definition, prevalence, risk factors, diagnosis, management, and support. The data provides valuable insights into the training needs and experiences of midwives in the area of maternal mental health, which can inform the development of interventions and education programs. The full dataset is available in Mendeley Data repository.


Value of the Data
• Training Needs and Care Quality: The MAMA survey highlights areas where midwives require enhanced training in maternal mental health.This data can refine training approaches and ultimately benefit mothers and infants.• Introduction of the MAMA Survey: We've presented the MAMA survey, a novel instrument to identify and address training gaps in maternal mental health among midwives.• Resource for Research: The data from the MAMA survey is valuable for researchers across maternal mental health, midwifery, and medical education, facilitating new studies, improved training initiatives, and policy recommendations.

Background
Perinatal depression (PND) is a global health concern that affects roughly 12% of women worldwide during pregnancy and the postpartum period [1] .The prevalence varies significantly across countries with different income levels.Recent research indicates that in Italy, about 6.4% of women experience PND during pregnancy, and nearly 20% experience it during the postpartum period [2] .Despite its high occurrence, there is a consensus among healthcare professionals that PND is often not diagnosed [3] .The repercussions of PND are severe, affecting both the mother and the child, from attachment issues to emotional and cognitive development impairments.It's also crucial to note the heightened risk of suicide during the postpartum period due to PND, which is one of the leading causes of maternal mortality in the first year after birth in high-income countries, including Italy [4] .
Midwives have a unique and crucial role in the lives of childbearing women, making them instrumental in identifying mental health issues in this group.However, the lack of a specific tool for PND and the challenge of differentiating depressive symptoms from typical physical and mental characteristics of the pre and post-partum periods must be taken into account.While routine PND screening for all women is recommended in the literature, there is no agreement on the most effective tool.One approach could be to identify risk factors during prenatal checkups, although these factors are not reliable predictors of depressive disorders.Therefore, if midwives suspect PND, they should refer the woman to a mental health professional for a formal evaluation.
Understanding the problem and personal attitudes towards it, which can lead to prejudiced emotional reactions, are two components of stigma [ 5 , 6 ].
Given these factors and the role midwives play in the mental health of childbearing women, we promoted the "MAternal Mood Assessment" (MAMA) study to evaluate their knowledge and perceptions of PND.

Data Description
The MAMA survey provides a rich source of information about the perspectives and experiences of healthcare professionals in dealing with perinatal depression, which can be valuable for informing interventions and training.
Table 1 describes the characteristics of the sample.Participating midwives are fairly evenly distributed across three age groups, ranging from early twenties to late fifties.Their work experience varies from less than a year to over three decades.The majority of participants are located in the North of Italy and work in a hospital setting.The specific workplaces within the healthcare system are diverse, including birthing rooms, obstetrics wards, and private practices, among others.Fig. 1 shows the geographical distribution of the sample.Table 2 describes professional experiences of the sample.A majority of the participants reported that there are no protocols for post-natal depression in their workplaces.Most of them have not attended courses on perinatal mental health.When it comes to assisting patients with post-natal depression, a significant portion of the participants have either never assisted such patients or have assisted fewer than five.A smaller number of participants have assisted between 5 and 10 patients, and only a few have assisted more than 10 patients.

Experimental Design, Materials and Methods
The study was designed as a cross-sectional survey, with the primary aim of assessing the perceptions and experiences of healthcare professionals regarding maternal mood disorders during the perinatal period.
MAMA is a comprehensive survey tool designed for healthcare professionals to assess their knowledge, attitudes, and experiences regarding perinatal depression.The questionnaire, made up of 37 questions that are either multiple-choice or open-ended, was crafted by blending symptoms from the DSM-5 and crucial risk factors found in medical studies.Extra questions were added by the authors to better gauge the midwives' understanding of perinatal depression.
The MAMA questionnaire uses a variety of response formats, including multiple-choice questions, Likert scale ratings, and open-ended questions.The Likert scale ratings range from 0 (not at all) to 4 (very much).No composite score was calculated and no item was reversed.Some open-ended questions allow respondents to provide more detailed and nuanced responses.
The survey is divided into several sections, each focusing on a different aspect of perinatal depression.
The first section (A) collects socio-demographic information about the healthcare professionals, including their age, gender, professional qualification, year of graduation, years of service, and the location and context of their current work.
The second section (B) focuses on the healthcare professionals' training and experience in dealing with perinatal depression.This includes questions about whether there is a specific pathway for perinatal depression in their facility, whether they have participated in specific training on perinatal depression, and how often they have encountered mothers with a diagnosis of perinatal depression.
The third section (C) of the survey aims to assess the healthcare professionals' understanding and perception of perinatal depression.This includes questions about the definition of perinatal depression, the perceived prevalence, risk factors, and the most appropriate reactions to maintain a good relationship with a mother showing symptoms of perinatal depression.
The fourth section (D) focuses on the healthcare professionals' experiences and feelings when dealing with cases of perinatal depression.This includes questions about their reactions upon learning that a patient is suffering from perinatal depression, their interactions with the family, and their opinions on the most effective approaches to support women with symptoms of perinatal depression.
The fifth section (E) of the survey asks about the healthcare professionals' opinions on various aspects of managing perinatal depression, such as breastfeeding, the role of the father, the involvement of different professional figures, and the usefulness of having guidelines on the management of perinatal depression.
A final section (F) is comprised of three open-end questions, asking free-text responders' opinions on the most important and the most difficult aspects in the management of perinatal depressive disorders, and a textbox for any free comment.
The structure of the survey is reported in Table 3 The survey was administered to a sample of 152 midwives across Italy.The participants were selected using a convenience sampling method, with the questionnaire being distributed via email and social media platforms.
The data collected from the MAMA questionnaire was then analyzed using descriptive statistics to provide an overview of the healthcare professionals' perceptions and experiences of perinatal depression.This included calculating frequencies and percentages for the multiple-choice and Likert scale questions, and conducting a thematic analysis of the open-ended responses.

Ethics Statement
The survey was voluntary and anonymous, no personal data were recorded, in no way it was possible to identify the single respondents.Informed consent was obtained from all participants.Data were acquired in compliance with GDPR regulation (General Data Protection Regulation, European Union 2016/679).When applicable, the research proposal was approved by participating hospital authorities.

( 5 - 4 (
10%), Not very frequently (10-20%), Quite frequently ( > 20%) Prolonged asthenia -Sadness without cause -Episodes of repeated crying -Continual irritability -Difficulty falling asleep -Loss of appetite/anorexia -Constant weight loss / constant weight gain -Generalized anxiety -Depressed mood -Loss of interest in daily activities -Sense of danger/alert for the child -Disinterest in the child -Aggressiveness towards the child -Insomnia -Hypersomnia -Motor slowing down -Fear of not being fit to be a mother -Belief of being an incapable mother -Feeling guilty -Fear of not interpreting the newborn's cry correctly -Difficulty in tolerating the crying of the newborn -Repeated difficulty falling asleep -Repeated difficulty falling back asleep after waking up -Difficulty in taking care of the child -Difficulty in taking care of one's own home environment -Difficulty taking care of oneself -Difficulty asking for help -Overcommitment -Loss of interest in the newborn -Auditory hallucinations -Presence of delusions -Lack of insight -Belief of being in danger due to the presence of the child -Belief of being in danger due to operators or family members -Indifference to the needs of the newborn -Physical agitation -Indecision and worry -Suicidal ideation -Fear of going down the stairs with the baby -Fear of leaning out the window with the baby in your arms -Fear of handling knives in the same room as the child -Having attempted suicide -Feeling like a failure -Negative thoughts about the future -Recurring thoughts of death -Difficulty leaving the house with the child -Difficulty concentrating 0continued on next page )

Table 1
General characteristics of the sample.

Table 2
Professional experiences of the sample.

Table 3
Structure of MAMA survey.

Table 3 (
continued ) It is contraindicated because the mother is stressed, It is possible if the mother wishes, It is always desirable, It is possible but only if mixed, It is useful because it keeps the mother busy, It is possible if the mother does not take drugs