Pregnancy in Mind

What is Pregnancy in Mind

Supporting parents’ mental health during pregnancy

Pregnancy in Mind is a preventative mental-health service designed to support parents-to-be who are at risk of, or currently experiencing, mild to moderate anxiety and depression during their pregnancy.

It is an antenatal group intervention delivered by professionals after the first trimester of pregnancy. Parents-to-be are able to attend the programme between 12 and 34 weeks gestation.

How Pregnancy in Mind works

Pregnancy in Mind aims to protect against the impact of parental anxiety and depression during pregnancy. Through building relationships, knowledge and skills, it helps parents to manage any difficulties they are experiencing.

The ultimate objective of this service is to build parents’ capacity to provide sensitive, responsive care to their babies – and help parents keep these new skills up postnatally and as their children develop.

Themes

The programme is underpinned by six core evidence-based themes:

  • mindfulness meditation
  • active relaxation
  • psychoeducation and coping skills
  • social support
  • awareness-raising of foetal development
  • couple and co-parenting relationship (communication and conflict management).
Evidence and evaluation

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.

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.

Make a referral

Who is Pregnancy in Mind for?

Pregnancy in Mind is for new parents between 12 and 34 weeks gestation. Parents can be referred at any point in their early pregnancy, ideally by 26 weeks, but access to the group work will need to be completed by their 34th week of pregnancy.

The programme is for those who are at risk of or already experiencing mild to moderate anxiety and depression. Parents do not have to have a formal diagnosis of anxiety or depression, and this can be based on either parent-report or professional judgement.

As we are keen to provide the service to those that are not yet experiencing symptoms but might be at increased risk, we are also interested in receiving referrals for parents who:

  • have a previous history of anxiety or depression
  • have a family history of mental health problems
  • have a history of childhood adversity and poor parenting themselves
  • are socially isolated or have no social support networks
  • have experienced recent adverse or stressful life events
  • are experiencing poor relationship quality or domestic violence
  • are under 20 years of age
  • are having an unwanted or unplanned pregnancy
  • have drug or alcohol problems (misuse substances).

Making a referral

To see if Pregnancy in Mind is delivered in your area or to make a referral, email help@nspcc.org.uk.

References and resources

References and resources

Hogg, S. (2013) Prevention in mind: all babies count: spotlight on perinatal mental health. London: NSPCC.

Leach, L.S. et al (2016) Prevalence and course of anxiety disorders (and symptom levels) in men across the perinatal period: a systematic review. Journal of Affective Disorders, 190: 675-86.

O’Hara, M.W. and Wisner, K.L. (2014) Perinatal mental illness: Definition, description and aetiology. Best Practice and Research Clinical Obstetrics and Gynaecology, 28(1): 3-12.

Paulson, J.F. and Bazemore, S.D. (2010) Prenatal and postpartum depression in fathers and its association with maternal depression: a meta-analysis. Journal of the American Medical Association, 303(19): 1961-1969.