Dr Nicole Reilly
Faculty of Health and Medicine
Beating the baby blues
Dr Nicole Reilly is investigating how pregnancy and motherhood can impact a woman’s emotional health. Her work has led to nation-wide advancement in the field of perinatal mental health, helping Australian clinicians identify at-risk mothers quickly and provide mental health support when it’s needed most.
Around one in seven women will experience perinatal anxiety or depression—that’s tens of thousands of families affected in Australia alone each year. Esteemed perinatal mental health researcher, Dr Nicole Reilly has dedicated 15 years to the pursuit of answers on behalf of these families and the health professionals who care for them, seeking to boost support for women during an often highly vulnerable time of their lives.
“My research focuses on improving our understanding of how pregnancy and parenthood can affect a woman’s emotional wellbeing, and how we can work together with clinicians and policymakers to achieve the best outcomes for women, children and families.
“A large part of this work involves investigating how we can best prevent and effectively manage depression, anxiety and psychological distress in pregnant women and new mums.”
In partnership with industry service providers, and fellow perinatal mental health research leaders, Nicole is finding ways to encourage women to speak up about their emotional wellbeing and equip clinicians to respond swiftly when needed.
“Personally, I feel very privileged that my research has been able to tell the stories and explore the journeys of women—and of health professionals—whose voices might not otherwise have been heard.”
Early intervention is key
Nicole has been at the forefront of research, policy and practice in perinatal and maternal mental health since 2007, when she worked closely with a national steering committee to co-write the beyondblue National Action Plan for Perinatal Mental Health. The Plan resulted in the $85 million National Perinatal Depression Initiative in 2008, which aimed to improve prevention and early detection of antenatal and postnatal depression and provide women with better support.
In 2018, Nicole became one of just two Australian Rotary Health postdoctoral research fellowship recipients. A significant portion of her research is focused on helping clinicians identify mental illness symptoms and risk factors during the perinatal period, a time when many women are already in regular contact with their midwife, child health nurse, GP or obstetrician. While a woman’s physical health is monitored closely during this time, her emotional health can too frequently be overlooked.
“Identifying symptoms and risk factors as a routine component of antenatal and postnatal care, and helping women access timely, appropriate support, can be so important for the wellbeing of mums, dads and babies for years to come.”
Nicole’s doctoral research, published in 2013, highlighted a lack of mental health screening for pregnant women who were receiving private sector healthcare. Her work informed the Commonwealth Government’s decision to create Medicare-funded depression screening and psychosocial assessments for women, meaning that at-risk women could be more quickly identified during routine checkups and receive timely support.
Based on her doctoral work, Nicole and her team developed innovative new services with industry partners, including ‘mummatters’, a consumer-led web-based tool for perinatal depression screening and psychosocial assessment.
“Mummatters is an Australian-only health tool. Since it was launched in November 2016, it has been downloaded and used by over 3,000 women.”
While Nicole’s work is contributing to significant progress, further research—and additional prevention and care strategies—are urgently needed in Australia.
“Unfortunately, research continues to show that there is still an enormous amount of shame and stigma that can prevent women from seeking help for their emotional health when they most need it. Yet the perinatal period is a time when the vast majority of women are in regular contact with health professionals, and it provides such a unique window to identify concerns and intervene early.”
Strategies for success
To further bolster important screening processes, Nicole is currently involved in validating a revised version of an enormously important screening tool—the Antenatal Risk Questionnaire (ANRQ), developed by UNSW’s Professor Marie-Paule Austin—which put broader psychosocial wellbeing into Australia’s national guidelines in 2017.
Nicole is also assessing a range of screening tools for anxiety, which she reveals can affect up to 15 per cent of women during pregnancy and 10 per cent of women in the year following birth.
“It is now recognised that antenatal and postnatal anxiety is as common as antenatal and postnatal depression. Australian and international clinical practice guidelines advocate for perinatal anxiety screening; however, few studies have examined the test performance of recommended screening measures using gold standard methodology. I’m working to bridge this gap in the evidence base using data from a large cohort of women in Australia.”
Two of Nicole’s current collaborative projects are Australian-first undertakings. The first will evaluate the clinical performance and cost-effectiveness of two models of integrated psychosocial assessment and depression screening in pregnant women. The other will examine healthcare professionals’ adherence to clinical practice guidelines for perinatal mental health and antenatal care.
The eagerly anticipated results are expected to inform strategies to optimise future guideline adherence, which will ultimately result in better-quality care and improved outcomes for women who give birth in Australia.
“This will, for the first time, quantify the degree to which health professionals work to best practice guidance for maternal mental health and will identify underlying factors associated with adherence and non-adherence attitudes and behaviours.”
Nicole is also interested in the intergenerational impact of maternal mental health. Together with colleagues at the Priority Research Centre for Generational Health and Ageing, she is exploring the impact of childhood trauma and adult violence on a woman’s health and parenting practices—and how it also affects their children. Research shows that, separately, a mother’s experience of adult violence and childhood trauma can be detrimental for their children. This research will take these research findings one step further.
“The project will align these fields of research by examining the potential cumulative impact of maternal exposure to adverse childhood experiences and violence across the life course on outcomes for women and their children.”
Nicole is careful to ensure that all her research projects are informed first and foremost by women’s voices, allowing real-world experiences to guide solution-focused interventions.
“During my time working in this field, so many women have given up their own time to participate in studies both large and small, and invariably say they are happy to do so if it means that the work will help other women and their families in the future. Their generosity of spirit, even in times of real adversity, are an inspiration.”
Looking to the future
In recent years, Nicole has received due attention for her research expertise, speaking at international and national conferences such as the Marcé Society for Perinatal Mental Health Conference 2019. In the same year, Nicole became one of only 15 people accepted into the inaugural International Marcé Society Mentorship Program.
“I’m honoured to be part of this program, especially as I’ve been paired with Jane Honikman, an inspirational leader and founder of Postpartum Support International, and co-founder of the Postpartum Action Institute.”
Alongside her growing research portfolio, Nicole is also heavily invested in mentoring the next generation, guiding higher degree research students in novel areas such as Indigenous perinatal health support services and the role of preconception health on mental health outcomes during pregnancy and the postpartum.
“The future of perinatal mental health research is exciting! We are starting to see real recognition now of how critical the emotional wellbeing of parents is during pregnancy and early childhood, and a more dedicated focus on the mental health and wellbeing of dads and partners.”
Dr Nicole Reilly is investigating how pregnancy and motherhood can impact a woman’s emotional health. Her work has led to nation-wide advancement in the field of perinatal mental health, helping Australian clinicians identify at-risk mothers quickly and provide mental health support when it’s needed
Dr Nicole Reilly is a Research Fellow at the University of Newcastle’s Priority Research Centre for Generational Health and Ageing (RCGHA). Her research is focused on improving perinatal mental health prevention and early intervention programs across Australia. Over her 15-year career, Dr Reilly has been involved in informing and developing numerous prevention and care guidelines and interventions, many of which are Australia-first projects.
Dr Reilly’s solutions-focused work has led to practical outcomes for women and their families since day one. In 2007, she co-wrote the beyondblue National Action Plan for Perinatal Mental Health, which resulted in the $85 million National Perinatal Depression Initiative. Dr Reilly was also a consultant to beyondblue for the development of Australia’s first clinical practice guidelines for perinatal mental health. In 2013, Dr Reilly co-developed an options paper as part of an NHMRC Partnership Project, which ultimately resulted in three items for antenatal depression screening and psychosocial assessment being included in an agreed set of Australian Institute of Health and Welfare priority data items for improving national perinatal data collection. In the same year, Dr Reilly published her doctoral work. Based on her findings, Dr Reilly instigated the measurement of perinatal mental health screening and service access in the Australian Longitudinal Study for Women’s Health—Australia’s largest longitudinal survey of women. Her ground-breaking results were also included in a report prepared for the Department of Health relating to major mental health findings.
In 2018, Dr Reilly was awarded one of just two highly competitive Australian Rotary Health postdoctoral research fellowships. Her current four-year program of work will be the most comprehensive population-level examination of the impact of preventative programs and service improvements for maternal mental health conducted in Australia to date. It includes an evaluation of the extent to which national prevention and early intervention investments have influenced the mental health outcomes of women who have given birth in Australia over the past 20 years and examines health professional adherence to clinical best practice guidelines for perinatal mental health. In collaboration with RCGHA and UNSW’s Professor Marie-Paule Austin, an internationally recognised expert in the field of perinatal mental health, Dr Reilly will also validate a clinical tool to support the early identification of psychosocial risk during pregnancy.
Dr Reilly is a named investigator on projects totalling over $3 million in competitive research funding and has presented her work at 15 conferences and seminars since 2010. She has authored or co-authored over 30 peer-reviewed publications and is a co-author on two book chapters relating to psychosocial assessment in the perinatal period. She is also a reviewer for more than 10 peer-reviewed journals and is a member of a range of academic societies.
Alongside her role with the University of Newcastle, Dr Reilly holds a Conjoint Senior Lecturer appointment at the School of Psychiatry, University of New South Wales. In 2014, Dr Reilly was awarded the UNSW Faculty of Medicine Dean’s List Award for Outstanding Research.
- Doctor of Philosophy, University of New South Wales
- Bachelor of Psychology (Honours), University of New South Wales
- depression screening
- early intervention
- perinatal mental health
- policy evaluation
- psychosocial assessment
Fields of Research
|111799||Public Health and Health Services not elsewhere classified||20|
|Title||Organisation / Department|
|Research Fellow||University of Newcastle
Faculty of Health and Medicine
|Dates||Title||Organisation / Department|
|1/1/2013 - 16/3/2018||Senior Research Associate||St John of God Burwood Hospital & School of Psychiatry, UNSW
Perinatal & Women’s Mental Health Unit
|1/1/2008 - 31/12/2008||Research Officer||UNSW
Perinatal and Reproductive Epidemiology Research Unit, School of Women's and Children's Health
|1/1/2009 - 31/12/2012||Research Associate||St John of God Burwood Hospital & School of Psychiatry, UNSW
Perinatal & Women’s Mental Health Unit
|1/1/2007 - 31/12/2007||National Project Officer||Beyond Blue Ltd & St John of God Health Care
National Action Plan for Perinatal Mental Health
|1/1/2008 - 31/12/2008||Consultant/National Program Officer||Beyond Blue Ltd
National Perinatal Depression Initiative (NPDI)
|1/5/2003 - 31/12/2008||Research Officer||University of New South Wales
School of Psychiatry
UNSW Faculty of Medicine Dean’s List Award for Outstanding Research
University of New South Wales
UNSW Research Support Scheme Award
University of New South Wales
For publications that are currently unpublished or in-press, details are shown in italics.
Chapter (2 outputs)
Austin MP, Fisher J, Reilly N, 'Psychosocial Assessment and Integrated Perinatal Care', Identifying Perinatal Depression and Anxiety: Evidence-Based Practice in Screening, Psychosocial Assessment, and Management 121-138 (2014)
© 2015 John Wiley & Sons, Ltd. All rights reserved. It is increasingly recognized that perinatal mental health is multifaceted and should not be limited to screening for a p... [more]
© 2015 John Wiley & Sons, Ltd. All rights reserved. It is increasingly recognized that perinatal mental health is multifaceted and should not be limited to screening for a possible diagnosis of postnatal depression. This chapter discusses the background to, and role of, psychosocial assessment as a component of universal, mainstream antenatal and postnatal care. It highlights the importance of inquiring about broad risk factors including complex psychosocial comorbidities such as interpersonal violence, substance misuse, and history of adverse childhood experiences (e.g., childhood sexual abuse) which are known to impact on maternal mental health, parenting function, and infant outcomes. Concepts central to the implementation of effective integrated perinatal psychosocial assessment and care, and principles for establishing such programs in well-resourced primary care settings, are described. Specific consideration is also given to the challenges and complexities associated with the delivery of integrated perinatal mental health care for women living in resource-constrained settings. Current controversies and future directions are discussed.
|2012||Protopopescu X, Austin M-P, Reilly N, Barnett B, 'Screening and psychosocial assessment for perinatal depression, distress, and dysfunction.', Perinatal Mental Health: A clinical guide, eKindle ed: M&K Publishing, United Kingdom 307-322 (2012)|
Journal article (36 outputs)
Reilly N, Brake E, Kalra H, Austin MP, 'Insights into implementation of routine depression screening and psychosocial assessment in a private hospital setting: A qualitative study', Australian and New Zealand Journal of Obstetrics and Gynaecology, 60 419-424 (2020)
© 2019 The Royal Australian and New Zealand College of Obstetricians and Gynaecologists Background: Studies continue to show that women who give birth in the private maternity sec... [more]
© 2019 The Royal Australian and New Zealand College of Obstetricians and Gynaecologists Background: Studies continue to show that women who give birth in the private maternity sector are less likely to receive depression screening and psychosocial assessment as a routine component of maternity care. However, examples of successfully implemented routine psychosocial assessment programs are beginning to emerge, and there is great value in better understanding the factors that can contribute to the successful delivery of emotional health care in this context. Aim: The aim of this study was to identify factors that facilitated successful implementation of antenatal psychosocial assessment in a private hospital setting. Methods: This study employed a qualitative research design. Semi-structured interviews were used to explore the views and experiences of health professionals involved in implementation of the program at the participating site. Results: Nine health professionals participated in the study (three midwives, three obstetricians, two managers and one mental health worker). Factors that facilitated successful implementation of the program were reflected in five key themes: (i) multidisciplinary support for the program; (ii) training and clinical supervision; (iii) allocation of sufficient resources; (iv) availability of local referral pathways; and (v) normalisation of the process. Conclusion: This study shows that barriers to implementation of perinatal depression screening and psychosocial assessment are surmountable and will provide confidence to other services, that routine ¿mental health assessment¿ as required under updated Medical Benefits Scheme items for obstetric services, can be successfully implemented and sustained in private hospital settings.
Moss KM, Reilly N, Dobson AJ, Loxton D, Tooth L, Mishra GD, 'How rates of perinatal mental health screening in Australia have changed over time and which women are missing out', Australian and New Zealand Journal of Public Health, (2020)
© 2020 The Authors Objectives: To report rates of perinatal mental health screening from 2000 to 2017 and investigate factors associated with not being screened both antenatally a... [more]
© 2020 The Authors Objectives: To report rates of perinatal mental health screening from 2000 to 2017 and investigate factors associated with not being screened both antenatally and postnatally more recently (2013¿2017). Methods: A longitudinal community-based study of self-reported perinatal mental health screening with a national sample of 7,566 mothers from the Australian Longitudinal Study on Women's Health reporting on 9,384 children. The main outcome measure was whether mothers were asked about their emotional wellbeing by a health professional, including completing a questionnaire. Results: From 2000 to 2017, the percentage of women not screened decreased from 40.6% to 1.7%. The percentage of women screened both antenatally and postnatally increased from 21.3% to 79.3%. From 2013 to 2017, women who were older (aOR, 0.77; 95%CI, 0.60¿0.99) and had reported emotional distress (aOR, 0.65; 95%CI, 0.52¿0.81) were less likely to have been screened both antenatally and postnatally. Conclusions: Despite improvements, perinatal mental health screening is not yet universal. One-in-five women are not screened both antenatally and postnatally, including women in high-risk populations such as those who have reported emotional distress. Implications for public health: Women are in regular contact with health professionals in the perinatal period. This opportunity to detect women at risk of perinatal mental health issues is too important to be missed.
Reilly N, Kingston D, Loxton D, Talcevska K, Austin MP, 'A narrative review of studies addressing the clinical effectiveness of perinatal depression screening programs', Women and Birth, 33 51-59 (2020) [C1]
© 2019 Australian College of Midwives Background: Clinical practice guidelines recommend that women be screened for depression as a routine component of maternity care however the... [more]
© 2019 Australian College of Midwives Background: Clinical practice guidelines recommend that women be screened for depression as a routine component of maternity care however there is ongoing debate about the benefits of depression screening programs in this context. Aim: This narrative review identifies and describes the clinical effectiveness of perinatal depression screening programs in relation to one or more of the following interrelated domains: referral for additional mental health support or treatment; engagement with mental health support or treatment options; and, maternal mental health or parenting outcomes. Methods: English-language studies, published up to July 2017, were identified and their methodological quality was assessed. RCTs and non-RCTs were included. Results: Overall, the majority of the fourteen studies identified showed that participation in a perinatal depression screening program increases referral rates and service use, and is associated with more optimal emotional health outcomes. One of four available studies demonstrated an improvement in parenting outcomes as a result of participation in an integrated postnatal depression screening program. Conclusion: This small but important body of work is integral to the continuing debate over the merits of screening for depression in the perinatal period. Current evidence favours the overall benefits of perinatal depression screening programs across the three focus areas of this review. Future research should consider a woman's broader psychosocial context and should address the economic as well as clinical outcomes of these programs. Rigorous evaluation of emerging digital approaches to perinatal depression screening is also required.
Brake E, Berle D, Reilly NM, Austin MP, 'The relationship between emotion dysregulation and postnatal attachment in women admitted to a mother baby unit', Australian Journal of Psychology, (2020)
© 2020 The Australian Psychological Society Objective: Mothers with insecure attachment styles may have increased difficulty establishing secure attachment with their infant and m... [more]
© 2020 The Australian Psychological Society Objective: Mothers with insecure attachment styles may have increased difficulty establishing secure attachment with their infant and may experience emotion regulation difficulties in the postpartum period. This study aimed to examine the mediating effect of emotion dysregulation (ED) on the relationship between maternal insecure attachment style and self-reported attachment to infant in women admitted to a mother-baby unit. Methods: At admission, women completed self-report questionnaires measuring attachment style, ED, postnatal attachment and postnatal depression (PND) symptoms. Descriptive statistics, correlations, and mediation analyses (PROCESS macro) were conducted. Results: Insecure maternal attachment style was found to predict postnatal attachment through ED. When PND symptoms were accounted for, this model was no longer significant, and instead a serial mediation found that ED predicted PND, which was in turn associated with reduced postnatal attachment quality. Conclusions: This study provides preliminary support for continued research into maternal ED as a predictor of adverse maternal and infant outcomes postnatally. Individuals with attachment insecurity experiencing emotion regulation difficulties may be at an increased risk of developing PND and in turn experiencing adverse mother-infant attachment outcomes. This has clinical implications for the screening, assessment and treatment of women experiencing mental health or attachment related concerns postnatally.
Forder PM, Rich J, Harris S, Chojenta C, Reilly N, Austin MP, Loxton D, 'Honesty and comfort levels in mothers when screened for perinatal depression and anxiety', Women and Birth, 33 e142-e150 (2020)
© 2019 Australian College of Midwives Purpose: To evaluate the degree of honesty and level of comfort reported by women when questioned about their emotional wellbeing during the ... [more]
© 2019 Australian College of Midwives Purpose: To evaluate the degree of honesty and level of comfort reported by women when questioned about their emotional wellbeing during the perinatal period; to investigate if honesty and comfort are associated with perinatal depression or perinatal anxiety; and to examine the reasons why women may not always respond honestly. Methods: Qualitative and quantitative data from 1597 women from the cross-sectional perinatal mental health substudy (part of the Australian Longitudinal Study on Women's Health) were analysed using a mixed methods approach. Results: When questioned by their health practitioner about their emotional wellbeing in the perinatal period, 20.7% of women indicated they had not always responded honestly. Reasons for not being honest reflected four main themes: normalizing of symptoms/coping; negative perceptions (self-and others); fear of adverse repercussions; and fear of involvement of health services (trust and confidentiality). The 38.9% of women who did not feel comfortable when questioned by their health practitioner about their emotional wellbeing were four times more likely to report perinatal depression (odds ratio = 4.09; 95% confidence interval = 2.55, 6.57) and nearly twice as likely to report perinatal anxiety (odds ratio = 1.90; 95% confidence interval = 1.24, 2.94) than other women. Conclusions: Women who are most likely to need mental health care during the perinatal period are also those least likely to be honest about their mental health. A non-judgemental, open and reassuring approach by clinicians may help to reduce the stigma and fears contributing to lack of honest responses, and improve early diagnosis and treatment of mental health problems.
Reilly N, Brake E, Briggs N, Austin M-P, 'Trajectories of clinical and parenting outcomes following admission to an inpatient mother-baby unit.', BMC Psychiatry, 19 336 (2019) [C1]
Farrell JM, Nee AF, Francis K, Reilly N, 'Measuring the impact of pastoral services on patients in a private psychiatric hospital', Health and Social Care Chaplaincy, 6 95-113 (2018) [C1]
© Equinox Publishing Ltd 2018. This study explores the impact of pastoral care interventions on the mental and emotional health of inpatients at a private psychiatric hospital in ... [more]
© Equinox Publishing Ltd 2018. This study explores the impact of pastoral care interventions on the mental and emotional health of inpatients at a private psychiatric hospital in Sydney. A total of 99 patients completed study questionnaires over a three month period. Feedback for the service was overwhelmingly positive, with the vast majority of patients reporting benefits during and after their meetings, regardless of their religious beliefs. Almost 88% of patients reported a lessening of anxiety after their meetings with pastoral care practitioners, with 85% suggesting that their interactions with the pastoral team had a significant and positive impact on their mental health. These findings were contextualized further with free text responses from respondents. The study results clearly demonstrate the importance of pastoral services interventions in mental health settings.
Chambers GM, Randall S, Hoang VP, Sullivan EA, Highet N, Croft M, et al., 'The National Perinatal Depression Initiative: An evaluation of access to general practitioners, psychologists and psychiatrists through the Medicare Benefits Schedule', Australian and New Zealand Journal of Psychiatry, 50 264-274 (2016)
© 2015 The Royal Australian and New Zealand College of Psychiatrists. Objective: To evaluate the impact of the National Perinatal Depression Initiative on access to Medicare servi... [more]
© 2015 The Royal Australian and New Zealand College of Psychiatrists. Objective: To evaluate the impact of the National Perinatal Depression Initiative on access to Medicare services for women at risk of perinatal mental illness. Method: Retrospective cohort study using difference-in-difference analytical methods to quantify the impact of the National Perinatal Depression Initiative policies on Medicare Benefits Schedule mental health usage by Australian women giving birth between 2006 and 2010. A random sample of women of reproductive age enrolled in Medicare who had not given birth where used as controls. The main outcome measures were the proportions of women giving birth each month who accessed a Medicare Benefits Schedule mental health items during the perinatal period (pregnancy through to the end of the first postnatal year) before and after the introduction of the National Perinatal Depression Initiative. Results: The proportion of women giving birth who accessed at least one mental health item during the perinatal period increased from 88 to 141 per 1000 between 2007 and 2010. The difference-in-difference analysis showed that while there was an overall increase in Medicare Benefits Schedule mental health item access as a result of the National Perinatal Depression Initiative, this did not reach statistical significance. However, the National Perinatal Depression Initiative was found to significantly increase access in subpopulations of women, particularly those aged under 25 and over 34 years living in major cities. Conclusion: In the 2 years following its introduction, the National Perinatal Depression Initiative was found to have increased access to Medicare funded mental health services in particular groups of women. However, an overall increase across all groups did not reach statistical significance. Further studies are needed to assess the impact of the National Perinatal Depression Initiative on women during childbearing years, including access to tertiary care, the cost-effectiveness of the initiative, and mental health outcomes. It is recommended that new mental health policy initiatives incorporate a planned strategic approach to evaluation, which includes sufficient follow-up to assess the impact of public health strategies.
Christl B, Reilly N, Yin C, Austin M-P, 'Clinical profile and outcomes of women admitted to a psychiatric mother-baby unit.', Arch Womens Ment Health, 18 805-816 (2015)
Reilly N, Yin C, Monterosso L, Bradshaw S, Neale K, Harrison B, Austin MP, 'Identifying psychosocial risk among mothers in an Australian private maternity setting: A pilot study', Australian and New Zealand Journal of Obstetrics and Gynaecology, 55 453-458 (2015)
© 2015 The Royal Australian and New Zealand College of Obstetricians and Gynaecologists. Background Psychosocial assessment and depression screening are recommended for all pregna... [more]
© 2015 The Royal Australian and New Zealand College of Obstetricians and Gynaecologists. Background Psychosocial assessment and depression screening are recommended for all pregnant and postnatal women in Australia. However, women who give birth in private maternity settings remain less likely to participate in psychosocial assessment programs, making it difficult to comment on the potential resource implications. Aims To describe the psychosocial profile of a sample of women who had recently given birth in a private hospital and to examine the acceptability and feasibility of introducing psychosocial assessment as a routine component of maternity care. Materials and Methods Two hundred and twenty participants were recruited in a four-month period from a private tertiary hospital located in Murdoch, Western Australia. All participants completed the Edinburgh Depression Scale (EDS) and a Antenatal Risk Questionnaire (ANRQ) prior to discharge via an iPad. Results The mean total score for the EDS was 4.77 (SD = 3.93), with 5% of women scoring above the recommended cut-off of 13 or more. The mean total score for the ANRQ was 17.73 (SD = 10.72). 45.0% of all women endorsed no significant risk factors. The proportion of women scoring above the recommended ANRQ cut-off of 23 or more was 32.3%. Approximately 11% of women were referred for additional support or treatment. Acceptability of the ANRQ was high at 97.3%. Conclusions This study describes the psychosocial profile of a sample of women who recently gave birth in an Australian private maternity hospital and demonstrates that with additional resources, the implementation of psychosocial assessment as a routine component of maternity care was feasible and highly acceptable in this setting.
King S, Kildea S, Austin MP, Brunet A, Cobham VE, Dawson PA, et al., 'QF2011: A protocol to study the effects of the Queensland flood on pregnant women, their pregnancies, and their children's early development', BMC Pregnancy and Childbirth, 15 (2015)
© 2015 King et al. Background: Retrospective studies suggest that maternal exposure to a severe stressor during pregnancy increases the fetus' risk for a variety of disorders... [more]
© 2015 King et al. Background: Retrospective studies suggest that maternal exposure to a severe stressor during pregnancy increases the fetus' risk for a variety of disorders in adulthood. Animal studies testing the fetal programming hypothesis find that maternal glucocorticoids pass through the placenta and alter fetal brain development, particularly the hypothalamic-pituitary-adrenal axis. However, there are no prospective studies of pregnant women exposed to a sudden-onset independent stressor that elucidate the biopsychosocial mechanisms responsible for the wide variety of consequences of prenatal stress seen in human offspring. The aim of the QF2011 Queensland Flood Study is to fill this gap, and to test the buffering effects of Midwifery Group Practice, a form of continuity of maternity care. Methods/design: In January 2011 Queensland, Australia had its worst flooding in 30 years. Simultaneously, researchers in Brisbane were collecting psychosocial data on pregnant women for a randomized control trial (the M@NGO Trial) comparing Midwifery Group Practice to standard care. We invited these and other pregnant women to participate in a prospective, longitudinal study of the effects of prenatal maternal stress from the floods on maternal, perinatal and early childhood outcomes. Data collection included assessment of objective hardship and subjective distress from the floods at recruitment and again 12 months post-flood. Biological samples included maternal bloods at 36 weeks pregnancy, umbilical cord, cord blood, and placental tissues at birth. Questionnaires assessing maternal and child outcomes were sent to women at 6 weeks and 6 months postpartum. The protocol includes assessments at 16 months, 2 1/2 and 4 years. Outcomes include maternal psychopathology, and the child's cognitive, behavioral, motor and physical development. Additional biological samples include maternal and child DNA, as well as child testosterone, diurnal and reactive cortisol. Discussion: This prenatal stress study is the first of its kind, and will fill important gaps in the literature. Analyses will determine the extent to which flood exposure influences the maternal biological stress response which may then affect the maternal-placental-fetal axis at the biological, biochemical, and molecular levels, altering fetal development and influencing outcomes in the offspring. The role of Midwifery Group Practice in moderating effects of maternal stress will be tested.
Chojenta C, Harris S, Reilly N, Forder P, Austin MP, Loxton D, 'History of pregnancy loss increases the risk of mental health problems in subsequent pregnancies but not in the postpartum', PLoS ONE, 9 (2014) [C1]
While grief, emotional distress and other mental health conditions have been associated with pregnancy loss, less is known about the mental health impact of these events during su... [more]
While grief, emotional distress and other mental health conditions have been associated with pregnancy loss, less is known about the mental health impact of these events during subsequent pregnancies and births. This paper examined the impact of any type of pregnancy loss on mental health in a subsequent pregnancy and postpartum. Data were obtained from a sub-sample (N = 584) of the 1973-78 cohort of the Australian Longitudinal Study on Women's Health, a prospective cohort study that has been collecting data since 1996. Pregnancy loss was defined as miscarriage, termination due to medical reasons, ectopic pregnancy and stillbirth. Mental health outcomes included depression, anxiety, stress or distress, sadness or low mood, excessive worry, lack of enjoyment, and feelings of guilt. Demographic factors and mental health history were controlled for in the analysis. Women with a previous pregnancy loss were more likely to experience sadness or low mood (AOR = 1.75, 95% CI: 1.11 to 2.76, p = 0.0162), and excessive worry (AOR = 2.01, 95% CI: 1.24 to 3.24, p = 0.0043) during a subsequent pregnancy, but not during the postpartum phase following a subsequent birth. These results indicate that while women who have experienced a pregnancy loss are a more vulnerable population during a subsequent pregnancy, these deficits are not evident in the postpartum. © 2014 Chojenta et al.
Xu F, Austin MP, Reilly N, Hilder L, Sullivan EA, 'Length of stay for mental and behavioural disorders postpartum in primiparous mothers: A cohort study', International Journal of Environmental Research and Public Health, 11 3540-3552 (2014)
Background: Previous research showed that there was a significant increase in psychiatric hospital admission of postpartum mothers. The aim of the current study is to describe the... [more]
Background: Previous research showed that there was a significant increase in psychiatric hospital admission of postpartum mothers. The aim of the current study is to describe the length of hospital stays and patient days for mental and behavioural disorders (MBD) of new mothers in the first year after birth. Method: This was a cohort study based on linked population data between the New South Wales (NSW) Midwives Data Collection (MDC) and the NSW Admitted Patients Data Collection (APDC). The study population included primiparous mothers aged from 18 to 44 who gave birth between 1 July 2000 and 31 December 2005. The Kaplan-Meier method was used to describe the length of hospital stay for MBD. Results: For principal diagnoses of MBD, the entire length of hospital stay in the first year postpartum was 11.38 days (95% CI: 10.70-12.06) for mean and 6 days (95% CI: 5.87-6.13) for median. The length of hospital stay per admission was 8.47 days (95% CI: 8.03-8.90) for mean and 5 days (95% CI: 4.90-5.10) for median. There were 5,129 patient days of hospital stay per year for principal diagnoses of postpartum MBD in new mothers between 1 July 2000 and 31 December 2005 in NSW, Australia. Conclusions: MBD, especially unipolar depressions, adjustment disorders, acute psychotic episodes, and schizophrenia, or schizophrenia-like disorders during the first year after birth, placed a significant burden on hospital services due to long hospital stays and large number of admissions. © 2014 by the authors; licensee MDPI, Basel, Switzerland.
Reilly N, Harris S, Loxton D, Chojenta C, Forder P, Austin MP, 'The impact of routine assessment of past or current mental health on help-seeking in the perinatal period', Women and Birth, (2014) [C1]
Background: Clinical practice guidelines now recommend that women be asked about their past or current mental health as a routine component of maternity care. However, the value o... [more]
Background: Clinical practice guidelines now recommend that women be asked about their past or current mental health as a routine component of maternity care. However, the value of this line of enquiry in increasing engagement with support services, as required, remains controversial. Aim: The current study aimed to examine whether assessment of past or current mental health, received with or without referral for additional support, is associated with help-seeking during pregnancy and the postpartum. Methods: A subsample of women drawn from the Australian Longitudinal Study on Women's Health (young cohort) who reported experiencing significant emotional distress during pregnancy (N = 398) or in the 12 months following birth (N = 380) participated in the study. Results: Multivariate analysis showed that women who were not asked about their emotional health were less likely to seek any formal help during both pregnancy (adjOR = 0.09, 95%CI: 0.04-0.24) and the postpartum (adjOR = 0.07, 95%CI: 0.02-0.13), as were women who were asked about these issues but who were not referred for additional support (antenatal: adjOR = 0.26, 95%CI: 0.15-0.45; postnatal: adjOR = 0.14, 95%CI: 0.07-0.27). However, considerable levels of consultation with general practitioners, midwives and child health nurses, even in the absence of referral, were evident. Conclusion: This study demonstrates that enquiry by a health professional about women's past or current mental health is associated with help-seeking throughout the perinatal period. The clinical and resource implications of these findings for the primary health care sector should be considered prior to the implementation of future routine perinatal depression screening or psychosocial assessment programmes. © 2014 Australian College of Midwives.
Austin M-PV, Middleton P, Reilly NM, Highet NJ, 'Detection and management of mood disorders in the maternity setting: the Australian Clinical Practice Guidelines.', Women Birth, 26 2-9 (2013)
Christl B, Reilly N, Smith M, Sims D, Chavasse F, Austin MP, 'The mental health of mothers of unsettled infants: Is there value in routine psychosocial assessment in this context?', Archives of Women's Mental Health, 16 391-399 (2013)
This study aims to investigate the (1) pattern of psychosocial risk factors among mothers of unsettled infants, (2) the relationship between these risk factors and current mental ... [more]
This study aims to investigate the (1) pattern of psychosocial risk factors among mothers of unsettled infants, (2) the relationship between these risk factors and current mental health status and (3) acceptability of psychosocial risk assessment in the parentcraft setting. Women with unsettled infants aged up to 12 months were assessed using the Edinburgh Postnatal Depression Scale, a diagnostic interview (Mini-International Neuropsychiatric Interview (MINI)) and a psychosocial assessment tool, the Postnatal Risk Questionnaire (PNRQ). Of the women, 27.5 % met the MINI diagnostic criteria for a current (predominantly) anxiety disorder, and 43.1 %, for a past psychiatric diagnosis. On the Edinburgh Postnatal Depression Scale, 29.9 % of women scored above 12 (mean 9.8; SD 5.1). The most common psychosocial risk factors were high trait anxiety (40.9 %), past mental health problems (40.7 %), perfectionistic traits (38.1 %) and 'abuse trauma' of any kind (31.6 %). The likelihood of meeting diagnostic criteria for a current mental illness was significantly increased for women who experienced emotional abuse during childhood (adj. odds ratio (OR) 3.386; p = 0.006), had high trait anxiety (adj. OR = 2.63, p = 0.003) or had a negative birth experience (adj. OR 2.78; p = 0.015). The majority of women (78 %) felt moderately to very comfortable completing the PNRQ. The results showed high rates of current anxiety disorders (almost twice that of the general postnatal population) and multiple significant psychosocial risk factors among mothers with unsettled infants. Identification of specific psychosocial risk factors in mothers of unsettled infants can help to address issues beyond infant settling difficulties such as mother-infant interaction, especially for mothers with unresolved issues around their own parenting or trauma history. © 2013 Springer-Verlag Wien.
Reilly N, Harris S, Loxton D, Chojenta C, Forder P, Milgrom J, Austin M, 'Disparities in reported psychosocial assessment across public and private maternity settings: a national survey of women in Australia', BMC Public Health, 13 632 (2013) [C1]
Reilly N, Harris S, Loxton D, Chojenta C, Forder P, Milgrom J, Austin M, 'Referral for Management of Emotional Health Issues During the Perinatal Period: Does Mental Health Assessment Make a Difference?', Birth, 40 297-306 (2013) [C1]
Austin MP, Colton J, Priest S, Reilly N, Hadzi-Pavlovic D, 'The antenatal risk questionnaire (ANRQ): Acceptability and use for psychosocial risk assessment in the maternity setting', Women and Birth, 26 17-25 (2013)
Objectives: To assess the value of the Antenatal Risk Questionnaire (ANRQ) as a predictor of postnatal depression, to evaluate its acceptability to pregnant women and midwives, an... [more]
Objectives: To assess the value of the Antenatal Risk Questionnaire (ANRQ) as a predictor of postnatal depression, to evaluate its acceptability to pregnant women and midwives, and to consider its use as part of a model for integrated psychosocial risk assessment in the antenatal setting. Method: This paper further analysed published data from the Pregnancy Risk Questionnaire in a sample of 1196 women. We extracted 12 items from the original 23 item Pregnancy Risk Questionnaire to assess how the shorter ANRQ would perform, and undertook the analysis in the subset who were administered the Composite International Diagnostic Interview (CIDI) at 2 or 4 months postpartum to assess for major depression (N=276). We also sampled a subset of pregnant participants (N=378) and midwives (N=44) to assess the tool's acceptability to these groups respectively. Findings: ROC curve analysis for the ANRQ yielded an acceptable area under the curve of 0.69. The most 'clinically' useful cut off on the ANRQ was a score of 23 or more, yielding a sensitivity of 0.62 and specificity of 0.64 with positive predictive value of 0.3. The odds that a woman scoring 23 or more on the ANRQ is also a case was 6.3 times greater than for a woman scoring less than 23. Acceptability of the ANRQ was high among both women and midwives. Conclusion: The ANRQ is a highly acceptable self-report psychosocial assessment tool which aids in the prediction of women who go on to develop postnatal depression. In combination with a symptom based screening measure (e.g., the Edinburgh Postnatal Depression Scale) and routine questions relating to drug and alcohol use and domestic violence, the ANRQ becomes most useful as a key element of a "screening intervention" aimed at the early identification of mental health risk and morbidity across the perinatal period. Evaluation of this model in terms of clinical outcomes remains to be undertaken. © 2011 Australian College of Midwives.
Austin M-PV, Hadzi-Pavlovic D, Priest SR, Reilly N, Wilhelm K, Saint K, Parker G, 'Depressive and anxiety disorders in the postpartum period: How prevalent are they and can we improve their detection?', Archives of Women's Mental Health, 13 395-401 (2010) [C1]
|Show 33 more journal articles|
Grants and Funding
|Number of grants||5|
Click on a grant title below to expand the full details for that specific grant.
20181 grants / $300,000
Prevention and early intervention for maternal mental illness: a research program that will inform policy and clinical practice$300,000
Funding body: Australian Rotary Health
|Funding body||Australian Rotary Health|
|Project Team||Doctor Nicole Reilly|
|Scheme||Geoffrey Betts Postdoctoral Fellowship|
|Type Of Funding||C3112 - Aust Not for profit|
20151 grants / $1,060,000
Critical illness in children: Can we afford to neglect the psychosocial risks? The impact, acceptability, and cost-effectiveness of routine psychosocial assessment and stepped care for families of infants with heart disease$1,060,000
Funding body: Australian National Health and Medical Research Council
|Funding body||Australian National Health and Medical Research Council|
A/Prof N Kasparian, Prof D Schofield, Prof M-P Austin, A/Prof D Winlaw, Prof A Girgis, A/Prof G Sholler, Dr N Reilly, D Rose, J Blake, J Descallar, K Leclair, K Walker, Dr R Bryant
|Type Of Funding||Aust Competitive - Commonwealth|
20121 grants / $1,100,000
The Australian perinatal mental health reforms: using population data to evaluate their impact on service utilisation and related costeffectiveness$1,100,000
Funding body: Australian National Health and Medical Research Council
|Funding body||Australian National Health and Medical Research Council|
Professor Marie-Paule Austin, Dr Nicole Highet, Professor Vera Morgan, A/Prof Cathrine Mihalopoulos, A/Prof Georgina Chambers, A/Prof MAxine Croft, Dr Nicole Reilly, Dr Fenglian Xu, Ms Catherine Knox
|Type Of Funding||Aust Competitive - Commonwealth|
20111 grants / $870,000
QF2011: The effects of the Queensland Flood on pregnant women, their pregnancies, and their children's early development$870,000
Funding body: Canadian Institutes of Health Research (CIHR)
|Funding body||Canadian Institutes of Health Research (CIHR)|
Prof S King, Prof S Kildea, Prof M-P Austin, Dr A Brunet, Dr E Hurrion, Dr D Laplante, Dr B McDermott, Dr N Reilly, Dr D McIntyre, Dr N Schmitz, Dr H Stapleton, Dr C Vaillancourt et al
|Type Of Funding||International - Competitive|
20101 grants / $248,000
Funding body: Bupa Foundation
|Funding body||Bupa Foundation|
Professor Marie-Paule Austin, Dr Nicole Reilly, Professor Deborah Loxton, Dr Catherine Chojenta, Ms Peta Forder, Professor Jeannette Milgrom
|Scheme||Bupa Foundation Resarch Grant|
|Type Of Funding||Aust Competitive - Non Commonwealth|
Number of supervisions
|Commenced||Level of Study||Research Title||Program||Supervisor Type|
|2019||PhD||Assessing the Effectiveness of Using an ArtsHealth Intervention to Improve the Social and Emotional Welling of Mothers and Carers of Indigenous Children from Birth to School Age||PhD (Public Health & BehavSci), Faculty of Health and Medicine, The University of Newcastle||Co-Supervisor|
|2017||PhD||Improving Health Outcomes through Challenging Conversations with Aboriginal Women during the Perinatal and Early Childhood Periods.||PhD (Gender & Health), Faculty of Health and Medicine, The University of Newcastle||Co-Supervisor|
|2017||PhD||Healthy Mother, Sustainable Nation: A Study into the Factors Averting Poor Perinatal Mental Health||PhD (Gender & Health), Faculty of Health and Medicine, The University of Newcastle||Co-Supervisor|