Reviewer's report 
 Becoming the best mom that I can: Womens experiences of managing depression during pregnancy - Title: 
a qualitative study 
 2  29 January 2007 Version: Date: 
 Anne Buist Reviewer: 
Reviewer's report: 
General 
This article takes a qualatative approach to women's experince of depression. Whilst there are a number of 
articles taking this approach postnatally, as the authors note, this has not been done antenatally. Whilst this 
is an approach that not all are familiar or comfortable with, there is clear merit in perinatal depression in 
guiding quantatative research and clinical practice through an understanding of women's experiences. 
The approach is well defined and clearly reported and is of appropriate standards. In the abstract I think more stress/explanation is needed to accurately portry the content; emphasis of it being diagnosed depression (see minor revisions) and one line explaining why effective care in pregnancy 
might jeopardise the fetus. 
In the background the authors note that the experince of depression in pregnancy is likely to be substanially 
diffeent to postpartum - I think they mean the TREATMENT experience is likely to be different and this 
should be reworded. They don't discuss here and possibly could, that the experience of depression when 
the baby is more fantasy than reality is also likely to be significant - something that is also likely to have 
different impact on the relationship with the partner which they touch on later but also could be expanded 
upon (postnatally women are often preoccupied with the infant and its physical demands to the exclusion of 
the partner - this is much less the case antenatally). 
One weakness of the study that is mentioned is that these women are higher socioeconomic status but as 
there is a significant number who suffer depression in this group and therefore these findings are still highly 
relevant. The other weakness however is that these are women with DIAGNOSED depression; a vast 
majority of women who are depressed in pregnancy are not recognised. Their process of working through 
their situation to ask for help may however help guide antenatal services in how best to approach these 
women in an acceptable manner. 
Major Compulsory Revisions (that the author must respond to before a decision on publication can be 
reached) 
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Minor Essential Revisions (such as missing labels on figures, or the wrong use of a term, which the author 
can be trusted to correct) 
Not sure what the (p.495) refers to on page 5 line 5 of second paragraph and doesn't seem to be necessary 
I think the word "diagnosed" should be added in the background session of abstract between managing and 
depression. 
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Discretionary Revisions (which the author can choose to ignore) 
 Accept after discretionary revisions What next?: 
 An article of importance in its field Level of interest: 
 Acceptable Quality of written English: 
 No, the manuscript does not need to be seen by a statistician. Statistical review: 
Declaration of competing interests: 
I declare that I have no competeing interests