Research Summaries

This systematic review synthesises research to identify chronic and modifiable risk factors for postpartum anxiety (PPA). Findings show that historic and concurrent anxiety or depression symptoms and low social support are the most frequently evidenced risk factors for PPA.

The research recommends that clinicians screen for chronic vulnerabilities, such as demographic factors (e.g., income, age, immigration status, and employment), and psychiatric history to identify individuals who may benefit from additional monitoring and support. Peer support, particularly emotional and informational, should be made available to people with heightened vulnerability to PPA to buffer cumulative risk. Developing support strategies that enhance parenting confidence and address cognitive vulnerabilities, such as dysfunctional beliefs about motherhood, is also highly recommended.

This research investigates “sharenting,” revealing that mothers primarily use photo sharing as an authentic display of pride, linked to the societal expectation of “good parenting”. It encourages clinicians to recognise that mothers operate under significant pressure from the “intensive mothering” ideology, which demands perfection and intense emotional and financial labour. This pressure makes posting a high-stakes activity, leading to public criticism (digital narcissism).

Healthcare professionals should validate the difficulty mothers face in seeking support, as asking for sympathy is often viewed as attention-seeking. Instead, mothers often seek to facilitate empathy and shared experiences among peers.

This study evaluated the effectiveness of internet-based Cognitive Behaviour Therapy (iCBT) for managing anxiety and depression symptoms in pregnant and postnatal Australian women in routine community care settings. Both the pregnancy and postnatal programs demonstrated medium effect size reductions in generalised anxiety, depression, and psychological distress symptoms.

This supports the use of iCBT as a scalable treatment option for women across the full spectrum of symptom severity, including those with sub-threshold symptoms. Adherence rates were approximately 35–42%, with lower baseline depression severity being associated with a greater likelihood of program completion.

This qualitative study explored the feelings, symptoms, and sources of perinatal distress experienced by women during the first UK COVID-19 pandemic lockdown in 2020. Distress symptoms were often more indicative of anxiety and generalised distress than traditional depression symptoms, despite high rates of probable depression in the sample. Key stressors included unrealistic expectations of motherhood, lack of support, and fears for family wellbeing.

The research recommended greater provision for support that normalises experiences, challenges unrealistic ideals (the “perfect mum” myth), and addresses anxiety related to perceived obstetric trauma.

This scoping review examined the relationship between repetitive negative thinking (RNT), including worry and rumination, and perinatal depression and anxiety. Cross-sectional data consistently showed an association between RNT and both depression and anxiety in pregnant and postnatal cohorts. Longitudinally, antenatal worry consistently predicted subsequent depression and anxiety. This establishes RNT as a potentially modifiable transdiagnostic target for intervention in the perinatal period.

Psychological treatments, including Cognitive Behavioural Therapy (CBT) and mindfulness, demonstrated potential utility in reducing RNT/worry and the role of social support in mitigating the effects of RNT was also highlighted.

This study investigated whether perceived social support mitigates the link between repetitive negative thinking (RNT) and postnatal anxiety and depression during the COVID-19 pandemic. Results indicated that high levels of perceived social support specifically from friends (not family or a significant other) buffered the negative effects of RNT on both depression and anxiety symptoms.

It is recommended that strategies focused on increasing peer social support should be included in interventions to prevent and treat postnatal depression and anxiety. Encouraging digital communication methods, such as video calls and texting were also considered helpful during periods of social isolation.

This research investigated the relationship between perceived social support and symptoms of anxiety and depression in pregnant women during the COVID-19 pandemic, focusing on loneliness and repetitive negative thinking (RNT) as potential mediators. The findings confirm that low perceived social support is associated with increased anxiety and depression, and importantly, loneliness and RNT fully mediated this relationship.

This suggests that RNT and loneliness are psychological processes that should be targeted in interventions aimed at preventing mood disorders in pregnant women. Encouraging pregnant women to actively maintain social contact through digital communication, such as voice or video calls, may help reduce feelings of isolation and RNT.

This qualitative study explored anxiety triggers and support preferences among women experiencing perinatal anxiety (PNA). Major stressors included the overwhelming pressure to be the ‘perfect mum’, holding unrealistic expectations of motherhood, stigma, and poor mental health literacy. Online support was found to be acceptable to this cohort and should provide unbiased, evidence-based, and realistic information on key areas like childbirth, breastfeeding, and PNA symptoms.

Interventions delivered online should also include psychoeducation and peer narratives that normalise experiences and directly challenge internal and external stigma, which act as barriers to help-seeking.

This meta-synthesis investigated how online forums influence stigma and identity among women experiencing maternal mental illness. Forums offer a safe, non-judgmental environment for anonymous disclosure of stigmatised symptoms. The forum discourse acts to repair the maternal identity by separating the illness from the mother’s sense of self, challenging the notion of being a “bad mother”. This virtual support and normalisation of experience encourage some women to disclose their symptoms to healthcare providers and pursue professional treatment.

The use of moderated forums is recommended for perinatal families to help explore internal stigma.

This review evaluated 50 websites for information related to perinatal anxiety (PNA) to assess their quality and accuracy of this information for use by healthcare professionals (HCPs) and the general public. Findings indicated that information was often incomplete and frequently conflated PNA with postnatal depression (PND). Screening information was scarce and often inaccurately recommended tools like the Edinburgh Postnatal Depression Scale.

Websites require further development to be easily readable and navigable, and must provide accurate, evidence-based content that explicitly distinguishes PNA from PND, details symptoms, risk factors, and impact.

Harrison, V., Moore, D. and Lazard, L., 2020. Supporting perinatal anxiety in the digital age; a qualitative exploration of stressors and support strategies. BMC Pregnancy and Childbirth, 20(1), p.363.

Harrison, V., Moulds, M.L. and Jones, K., 2022. Perceived social support and prenatal wellbeing; The mediating effects of loneliness and repetitive negative thinking on anxiety and depression during the COVID-19 pandemic. Women and Birth, 35(3), pp.232-241.

Harrison, V., Moulds, M.L. and Jones, K., 2022. Support from friends moderates the relationship between repetitive negative thinking and postnatal wellbeing during COVID-19. Journal of Reproductive and Infant Psychology, 40(5), pp.516-531.

Jones, K., Folliard, K., Di Malta, G., Oates, J., Gilbert, L. and Harrison, V., 2025. Risk factors associated with postpartum anxiety in Australia, Europe, and North America: A systematic review and narrative synthesis. Journal of affective disorders.

Jones, K., Harrison, V., Moulds, M.L. and Lazard, L., 2022. A qualitative analysis of feelings and experiences associated with perinatal distress during the COVID-19 pandemic. BMC Pregnancy and Childbirth, 22(1), p.572.

Mahoney, A., Shiner, C.T., Grierson, A.B., Sharrock, M.J., Loughnan, S.A., Harrison, V. and Millard, M., 2023. Online cognitive behaviour therapy for maternal antenatal and postnatal anxiety and depression in routine care. Journal of affective disorders, 338, pp.121-128.

Moore, D. and Harrison, V., 2018. Advice for health care professionals and users: An evaluation of websites for perinatal anxiety. JMIR Mental Health, 5(4), p.e11464.

Moore, D., Drey, N. and Ayers, S., 2020. A meta-synthesis of women’s experiences of online forums for maternal mental illness and stigma. Archives of Women’s Mental Health, 23(4), pp.507-515.

Moulds, M.L., Bisby, M.A., Black, M.J., Jones, K., Harrison, V., Hirsch, C.R. and Newby, J.M., 2022. Repetitive negative thinking in the perinatal period and its relationship with anxiety and depression. Journal of affective disorders, 311, pp.446-462.