Pregnancy in Mind

Last updated: 16 Jan 2019
Introduction

Supporting parents’ mental health during pregnancy and the first year

Pregnancy in Mind is a preventative mental-health service designed to support parents who are at risk of or experiencing mild to moderate anxiety and depression during pregnancy and the first year after birth.

Parents-to-be are able to attend the programme between 12 and 28 weeks gestation (the middle trimester of pregnancy).

Pregnancy in Mind has two core elements:

  • an antenatal group intervention delivered by professionals during the middle trimester of pregnancy
  • a peer-support programme delivered by a team of volunteers and a volunteer manager that takes place both during pregnancy and across the first year after birth.
How it works

How Pregnancy in Mind works

Pregnancy in Mind aims to protect against the impact of parental anxiety and depression during the perinatal period. 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 as their children develop.

This contributes to the NSPCC’s overall goal of ensuring that babies are safe, nurtured and able to thrive.

Themes

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

  • mindfulness meditation
  • active relaxation
  • psychoeducation and coping skills
  • social support
  • tuning-in to the baby (also called mind-mindedness).
Evidence base

The evidence base

Research has shown that a significant proportion of women experience anxiety or depression in the perinatal period (Hogg, 2013).

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.
Who it is for

Who is Pregnancy in Mind for?

Pregnancy in Mind is for new parents between 12 and 28 weeks gestation (the middle trimester of pregnancy). Parents can be referred at any point in their early pregnancy, but access to the group work will need to be in the middle trimester period.

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 referral 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 make a referral to Pregnancy in Mind, get in touch with one of the service centres offering this service, as listed under the Locations tab.

Evaluation

Evaluation of Pregnancy in Mind

We want to learn if Pregnancy in Mind improves:

  • levels of depression and anxiety
  • level of social support
  • quality of relationship with partner
  • attachment to the unborn baby
  • use of mindfulness techniques
  • use of active relaxation techniques.

How we’re evaluating this service

We’re evaluating Pregnancy in Mind using both qualitative and quantitative data. 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.

We are currently in the process of:

  • collecting data on recruitment, engagement, attrition (whether people continue taking part in the programme or drop out), demographics and ongoing referral pathways
  • interviewing staff to explore experiences of delivering the programme
  • looking at changes in parents’ levels of anxiety and depression
  • interviewing parents to understand their experiences of the programme and explore the range of outcomes they are reporting
  • interviewing parents who have a home visit but don’t attend any sessions to assess their reasons for deciding not to continue with the programme.

The evaluation is planned to take place across four phases:

Phase 1: feasibility testing

The initial phase of evaluation will include:

  • collecting data on recruitment, retention, parents’ and practitioners’ levels of satisfaction, and parents’ experiences of any behaviour changes
  • collecting parent recruitment, retention and socio-demographic data
  • collecting ‘group session rating scales’ and parent satisfaction questionnaires
  • conducting focus groups with practitioners and interviews with parents and volunteers.

Phase 2: data analysis and programme refinement

Phase 3: effectiveness testing

During this phase, validated and reliable questionnaires will be given to parents when they start and finish the programme and at various points in between.

These questionnaires will be scored and statistical analyses will explore whether there are changes in:

  • depression and anxiety symptoms
  • level of social support
  • quality of relationship with partner
  • mind-mindedness capacity
  • mindfulness skills.

Phase 4: cost effective analysis