The evidence base
Research has shown that a significant proportion of women experience anxiety or depression in the perinatal period (O’Hara and Wisner, 2014; Hogg, 2013). Partners of pregnant women can also suffer from mental health problems during this period such as depression and anxiety disorders (Paulson and Bazemore, 2010; Leach et al, 2016).
Parental mental illness during pregnancy can have a lasting effect on some children. Stress chemicals produced by women suffering from depression or anxiety can affect their unborn child’s development. Anxiety and depression during pregnancy can also increase the risk of postnatal depression, making it harder for parents to provide warm and responsive care after the baby is born (Hogg, 2013).
It’s important to identify parents who are at risk early, and ensure they get the support they need. Unfortunately, research shows that perinatal anxiety and depression regularly go undetected. When symptoms are identified, parents often struggle to access the treatment they need.
Services often focus solely on the women’s symptoms, without addressing the impact on their developing relationships with their babies. The mental health of fathers or partners can be over looked, despite the important role they play in mothers’ and babies’ lives.
To make sure we were meeting families’ needs, in both the design and development of Pregnancy in Mind we used a co-operative approach involving:
- parents
- practitioners
- service managers
- commissioners and academics.
Evaluating Pregnancy in Mind
We want to learn if Pregnancy in Mind improves:
- levels of depression and anxiety
- quality of relationship between partners
- parents’ relationship with the unborn baby.
We’re evaluating Pregnancy in Mind using both qualitative and quantitative data in several phases. This will allow us to explore the overall experience of the practitioners and families taking part in the service, as well as measure its effect on parental mental health and relationships.
Phase 1: formative evaluation
A formative evaluation of the programme was carried out in 2015/16. It assessed the feasibility of implementing Pregnancy in Mind in its early days and how parents responded. Findings were shared with the programme team and the programme model adapted accordingly.
Phase 2: process and outcomes evaluation
An evaluation carried out in 2018/19 focused on the implementation of the new model, identifying what worked in successful delivery, how parents and referrers viewed the updated model, and whether parents’ outcomes and experiences supported the underlying theory of change.
> Read the process evaluation report
Phase 3: process and outcomes evaluation of the virtual model
A new evaluation was carried out in 2020/21, when Pregnancy in Mind was adapted during the Covid pandemic. This explored the adaptations that practitioners made to deliver the programme using virtual and digital methods, and the outcomes experienced by parents who took part in the programme remotely.
> Read the process evaluation report
We are currently undertaking further research to add to our understanding of the virtual model. This research focuses on parents' views and experiences of virtual participation. It will also include the perspectives of professionals who refer parents to the virtual version of the programme, and of practitioners who assess their suitability to take part remotely.
Phase 4: effectiveness testing
In the future, we hope to do an impact study to help us determine whether Pregnancy in Mind achieves its desired outcomes for parents.
