Pregnancy in Mind

Last updated: 25 Apr 2019
Introduction

Supporting parents’ mental health during pregnancy

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.

It is an antenatal group intervention delivered by professionals during the middle trimester of pregnancy. Parents-to-be are able to attend the programme between 12 and 28 weeks gestation.

How it works

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 base

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 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.
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 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 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
  • quality of relationship between partners
  • parents’ relationship with the unborn baby.

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 engagement, attrition (whether people continue taking part in the programme or drop out), demographics and the needs of parents joining the programme
  • recording what’s delivered in sessions and what resources are used
  • looking at changes in parents’ levels of anxiety and depression, relationship quality, and parent-foetal relationship
  • interviewing parents to understand their experiences of the programme and explore the range of outcomes they are reporting
  • interviewing staff to explore experiences of delivering the programme
  • interviewing referrers to understand how Pregnancy in Mind meets the needs of local families.

The evaluation marks the second of three phases of testing that Pregnancy in Mind will go through.

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 evaluation

The current evaluation focuses on the implementation of the new model, identifying what works in successful delivery, how parents and referrers view the updated model, and whether parents’ outcomes and experiences support the underlying theory of change.

Phase 3: effectiveness testing

In 2020, we hope that an impact or outcomes study will help us determine the effectiveness of Pregnancy in Mind in achieving its desired outcomes for parents. During this phase, validated and reliable questionnaires will be given to parents when they start and finish the programme. Statistical analyses of scores will then explore whether there are changes and what might affect these.

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.