The Perinatal Anxiety Screening Scale (PASS)

1. Worry about the baby/pregnancy

Not at all Sometimes Often Almost always

2. Fear that harm will come to the baby

Not at all Sometimes Often Almost always

3. A sense of dread that something bad is going to happen

Not at all Sometimes Often Almost always

4. Worry about many things

Not at all Sometimes Often Almost always

5. Worry about the future

Not at all Sometimes Often Almost always

6. Feeling overwhelmed

Not at all Sometimes Often Almost always

7. Really strong fears about things, e.g., needles, blood, birth, pain, etc

Not at all Sometimes Often Almost always

8. Sudden rushes of extreme fear or discomfort

Not at all Sometimes Often Almost always

9. Repetitive thoughts that are difficult to stop or control

Not at all Sometimes Often Almost always

10. Difficulty sleeping even when I have the chance to sleep

Not at all Sometimes Often Almost always

11. Having to do things in a certain way or order

Not at all Sometimes Often Almost always

12. Wanting things to be perfect

Not at all Sometimes Often Almost always

13. Needing to be in control of things

Not at all Sometimes Often Almost always

14. Difficulty stopping checking or doing things over and over

Not at all Sometimes Often Almost always

15. Feeling jumpy or easily startled

Not at all Sometimes Often Almost always

16. Concerns about repeated thoughts

Not at all Sometimes Often Almost always

17. Being 'on guard' or needing to watch out for things

Not at all Sometimes Often Almost always

18. Upset about repeated memories, dreams, or nightmares

Not at all Sometimes Often Almost always

19. Worry that I will embarrass myself in front of others

Not at all Sometimes Often Almost always

20. Fear that others will judge me negatively

Not at all Sometimes Often Almost always

21. Feeling really uneasy in crowds

Not at all Sometimes Often Almost always

22. Avoiding social activities because I might be nervous

Not at all Sometimes Often Almost always

23. Avoiding things which concern me

Not at all Sometimes Often Almost always

24. Feeling detached like you're watching yourself in a movie

Not at all Sometimes Often Almost always

25. Losing track of time and can't remember what happened

Not at all Sometimes Often Almost always

26. Difficulty adjusting to recent changes

Not at all Sometimes Often Almost always

27. Anxiety getting in the way of being able to do things

Not at all Sometimes Often Almost always

28. Racing thoughts making it hard to concentrate

Not at all Sometimes Often Almost always

29. Fear of losing control

Not at all Sometimes Often Almost always

30. Feeling panicky

Not at all Sometimes Often Almost always

31. Feeling agitated

Not at all Sometimes Often Almost always

The PASS