Conceptualising women's perinatal well-being: A systematic review of theoretical discussions

Wadephul, Franziska; Glover, Lesley; Jomeen, Julie

doi:10.1016/j.midw.2019.102598

Cited by 25 publications

(18 citation statements)

References 54 publications

(121 reference statements)

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“…Although anxiety and stress are also highly associated, they are distinct constructs with potentially differential mechanisms of effect on maternal and child outcomes (Glover, 2011). As perinatal distress is a complex and multifaceted construct (Wadephul et al, 2020), future trials of interventions should incorporate a broad range of outcomes, including stress and anxiety (Alderdice et al, 2013).…”

Section: Discussionmentioning

confidence: 99%

Effects of maternal stress and/or anxiety interventions in the first 1000 days:Systematic review of reviews

Matvienko‐Sikar

Redsell

Flannery

2021

Journal of Reproductive and Infant Psychology

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Objective: Effective interventions are needed to mitigate effects of stress and anxiety from conception and up to two years postpartum (the first 1000 days), but it is unclear what works, for what populations and at what time points. This review aimed to synthesise evidence from existing reviews of the effects of stress and anxiety interventions. Methods: A systematic review of systematic reviews was conducted. PsycINFO, CINAHL, MEDLINE and the Cochrane databases were searched (inception to January 2020). Reviews were eligible if they examined effects of interventions during the first 1000 days on women's stress and/or anxiety. Extracted data were narratively synthesised. Review quality was assessed using existing recommendations including the AMSTAR tool . Results: Thirty-four reviews were eligible for inclusion; 21 demonstrated high methodological quality. Cognitive behavioural therapy demonstrates some beneficial effects for anxiety across the first 1000 days for general and at-risk populations. Support-based interventions demonstrate effects for stress and anxiety for at-risk mothers in the postpartum. Music, yoga and relaxation demonstrate some effects for stress and anxiety, but studies are limited by high risk of bias. Conclusion: Existing evidence is inconsistent. Cognitive behavioural therapy and support-based interventions demonstrate some benefits. Further methodologically and conceptually robust research is needed.

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Section: Discussionmentioning

confidence: 99%

Effects of maternal stress and/or anxiety interventions in the first 1000 days:Systematic review of reviews

Matvienko‐Sikar

Redsell

Flannery

2021

Journal of Reproductive and Infant Psychology

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“…None of the included studies were solely targeted at improving symptoms of anxiety, which may reflect a greater focus on broader concepts of psychological well-being and respond to the reported comorbidity and associations between common mental health and psychosocial and physical health concerns in the perinatal period [76][77][78]. Although a multidimensional approach has been reported as an important factor in promoting psychological well-being in pregnancy [79], interventions targeting 1 condition may not be effective for the other comorbid conditions [80]; the underpinning theory of change needs to be defined for each condition before further testing the mechanisms of change.…”

Section: Principal Findingsmentioning

confidence: 99%

Remotely Delivered Interventions to Support Women With Symptoms of Anxiety in Pregnancy: Mixed Methods Systematic Review and Meta-analysis

Evans¹,

Rennick-Egglestone²,

Cox³

et al. 2022

J Med Internet Res

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Background Symptoms of anxiety are common in pregnancy, with severe symptoms associated with negative outcomes for women and babies. Low-level psychological therapy is recommended for women with mild to moderate anxiety, with the aim of preventing an escalation of symptoms and providing coping strategies. Remotely delivered interventions have been suggested to improve access to treatment and support and provide a cost-effective, flexible, and timely solution. Objective This study identifies and evaluates remotely delivered, digital, or web-based interventions to support women with symptoms of anxiety during pregnancy. Methods This mixed methods systematic review followed a convergent segregated approach to synthesize qualitative and quantitative data. The ACM Digital Library, Allied and Complementary Medicine Database, Applied Social Sciences Index and Abstracts, Centre for Reviews and Dissemination database, the Cochrane Central Register of Controlled Trials, the Cochrane Library, CINAHL, Embase, Health Technology Assessment Library, IEEE Xplore, Joanna Briggs Institute, Maternity and Infant Care, MEDLINE, PsycINFO, and the Social Science Citation Index were searched in October 2020. Quantitative or qualitative primary research that included pregnant women and evaluated remotely delivered interventions reporting measures of anxiety, fear, stress, distress, women’s views, and opinions were included. Results Overall, 3 qualitative studies and 14 quantitative studies were included. Populations included a general antenatal population and pregnant women having anxiety and depression, fear of childbirth, insomnia, and preterm labor. Interventions included cognitive behavioral therapy, problem solving, mindfulness, and educational designs. Most interventions were delivered via web-based platforms, and 62% (8/13) included direct contact from trained therapists or coaches. A meta-analysis of the quantitative data found internet-based cognitive behavioral therapy and facilitated interventions showed a beneficial effect in relation to the reduction of anxiety scores (standardized mean difference −0.49, 95% CI −0.75 to −0.22; standardized mean difference −0.48, 95% CI −0.75 to −0.22). Due to limitations in the amount of available data and study quality, the findings should be interpreted with caution. Synthesized findings found some evidence to suggest that interventions are more effective when women maintain regular participation which may be enhanced by providing regular contact with therapists or peer support, appropriate targeting of interventions involving components of relaxation and cognitive-based skills, and providing sufficient sessions to develop new skills without being too time consuming. Conclusions There is limited evidence to suggest that women who are pregnant may benefit from remotely delivered interventions. Components of interventions that may improve the effectiveness and acceptability of remotely delivered interventions included providing web-based contact with a therapist, health care professional, or peer community. Women may be more motivated to complete interventions that are perceived as relevant or tailored to their needs. Remote interventions may also provide women with greater anonymity to help them feel more confident in disclosing their symptoms.

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“…The perinatal period involves not only physiological changes but also psychological/emotional rapid and profound changes in a woman's sense of identity and purpose. 1 Furthermore, although change occurs during the whole perinatal period, it is most marked at the time of birth. The birth is often considered as summative from a clinical perspective; that is, product/baby/outcomeoriented.…”

Section: Introductionmentioning

confidence: 99%

“…The perinatal period (a period that spans pregnancy to one year postnatal) is a very important and unique experience for the mother and the infant that can be affected by various environmental and social factors. The perinatal period involves not only physiological changes but also psychological/emotional rapid and profound changes in a woman's sense of identity and purpose 1 . Furthermore, although change occurs during the whole perinatal period, it is most marked at the time of birth.…”

Section: Introductionmentioning

confidence: 99%

Using an emotion‐focused approach in preventing psychological birth trauma

İşbir

Yılmaz

Thomson

2021

Perspect Psychiatric Care

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Purpose: This discussion article considers how an emotion-focused approach can be adopted to prevent psychological birth trauma and to optimize perinatal wellbeing for women and their families. Conclusion:Emotion-focused approaches have a different perspective when compared to other classic psychotherapy methods. This approach may help women to resolve the negative impacts of psychological birth trauma; to prevent posttraumatic stress disorder onset; to lead to better results for mother and baby wellbeing; and may be cost effective.Practice Implications: Mental health nurses/midwives should receive education about emotion-focused approaches in addition to gaining competence in basic counseling skills so that they can utilize these approaches with women.

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Conceptualising women's perinatal well-being: A systematic review of theoretical discussions

Cited by 25 publications

References 54 publications

Effects of maternal stress and/or anxiety interventions in the first 1000 days:Systematic review of reviews

Effects of maternal stress and/or anxiety interventions in the first 1000 days:Systematic review of reviews

Remotely Delivered Interventions to Support Women With Symptoms of Anxiety in Pregnancy: Mixed Methods Systematic Review and Meta-analysis

Using an emotion‐focused approach in preventing psychological birth trauma

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