Intervention Lessens Likelihood of Developing Postpartum Anxiety, Depression

Results from a large clinical trial funded by NIH show that an intervention for anxiety provided to pregnant women living in Pakistan significantly reduced the likelihood of the women developing moderate-to-severe anxiety, depression or both six weeks after birth. 

The unique intervention was administered by non-specialized providers who had the equivalent of a bachelor’s degree in psychology—but no clinical experience. Results suggest this intervention could be an effective way to prevent the development of postpartum mental health challenges in women living in low-resource settings.

“In low-resource settings, it can be challenging for women to access mental health care due to a global shortage of trained mental health specialists,” said NIMH Director Dr. Joshua A. Gordon. “This study shows that non-specialists could help to fill this gap, providing care to more women during this critical period.”

Led by Dr. Pamela Surkan of Johns Hopkins Bloomberg School of Public Health, the study was conducted in the Punjab Province of Pakistan between April 2019 and January 2022. 

Pregnant women with symptoms of at least mild anxiety were randomly assigned to receive either routine pregnancy care or a cognitive behavioral therapy (CBT)-based intervention called Happy Mother-Healthy Baby. Researchers assessed participants (380 women in the CBT group and 375 women in the routine care group) for anxiety and depression six weeks after the birth of their child.

Investigators found that 9% of women in the intervention group developed moderate-to-severe anxiety compared with 27% of women in the routine care group. Additionally, 12% percent of women in the intervention group developed depression compared with 41% of women in the routine care group.

The Happy Mother-Healthy Baby intervention was created using input from pregnant women in a hospital in Rawalpindi, Pakistan. Pregnant women took part in six intervention sessions where they learned to identify anxious thoughts and behaviors, such as thoughts about possible miscarriage, and to practice replacing them with helpful thoughts and behaviors. The first five sessions were conducted in early to mid-pregnancy and the sixth session occurred in the third trimester.