Supporting perinatal anxiety in the digital age; a qualitative exploration of stressors and support strategies

Abstract

Background The period surrounding childbirth is one of profound change, which can often be experienced as stressful and overwhelming. Indeed, around 20% of women may experience significant levels of anxiety in the perinatal period. However, most women experiencing perinatal anxiety (PNA) go unrecognised and untreated. The Internet offers a potentially scalable solution to improve access to support, however a dearth of research in this area means that work is needed to better understand women’s experience of PNA, so that potential targets for intervention can be identified and possible barriers to support overcome. This study aimed to qualitatively explore women’s experience of anxiety triggers and support in the perinatal period; and gain insight into what online support is acceptable for women with PNA. Methods Women who were either pregnant or within one-year postpartum were invited to participate in focus groups across the UK. Focus groups were used to allow a diversity of perspectives to be heard, while simultaneously promoting the identification and prioritisation of important support needs and solutions. Interviews were transcribed and thematically analysed. Results Five key themes emerged in relation to women’s experience with PNA: holding unrealistic expectations of birth and motherhood; stigma; the importance of peer support; uncertainty and poor maternal confidence; and a lack of mental health support and knowledge. Perinatal women felt under-supported and poorly prepared for motherhood. A mismatch between their expectations and the reality of their experience, alongside a pressure to be the ‘perfect mum’ was the primary source of their anxiety. Furthermore, stigma associated with PNA may have exacerbated these issues and led to help-seeking avoidance. Overall, women felt these issues could be addressed via online support, through the delivery of more realistic information, providing psychoeducation about PNA symptoms and management, and the inclusion of authentic peer experiences. Thus, delivering evidence-based information and interventions online may provide a solution that is acceptable to this cohort. Conclusions This work provides unique insight into potential sources of anxiety for women in the perinatal period, while also offering potential internet-based support solutions that are likely to be acceptable and helpful for women with PNA.

Perinatal Anxiety Symptoms: Rates and Risk Factors in Mexican Women

“…Anxiety during the perinatal period (pregnancy and first postpartum year) is a global health issue because of its negative consequences for the mother and her baby [ 1 , 2 , 3 , 4 ]. However, perinatal anxiety symptoms (PAS) are not always diagnosed or treated, increasing the risks for both.…”

Trends of Perinatal Stress, Anxiety, and Depression and Their Prediction on Postpartum Depression

“…We also suggest providing interventions that showed effectiveness in managing perinatal stress, anxiety, and depression to women especially at late pregnancy and postpartum period. This includes mindfulness-based childbirth and parenting programs that has significant effects in reducing perceived stress and depressive symptoms [48], internet-delivered cognitive behavioral therapy and internet-delivered behavioral activation interventions that can significantly improve perinatal depression and anxiety [49], online support, peer experiences sharing, and perinatal anxiety-related psychoeducation, which are recommended by women experiencing perinatal anxiety [50]. Care needs to be provided especially to women who are at high risk of experiencing perinatal mental distress due to certain factors: young, single or not partnered, low literacy, low socioeconomic status, having relationships or social support, experiencing prior miscarriage or perinatal loss, low self-esteem, past depression, lower income level, and higher stress [26,51].…”

Systematic Review on the Efficacy of Interventions for Fear of Childbirth, Anxiety and Fear in Pregnant Women

“…Perinatal Anxiety (PNA) and Perinatal Generalized Anxiety Disorder (GAD). Harrison, Moore and Lazard (2020) characterized the term perinatal anxiety and Misri et al (2015) introduced the term Perinatal Generalized Anxiety Disorder (GAD), which is defined as "excessive, uncontrollable worry that can cause functional impairment".…”