This study was conducted to examine the effect of mothers' perception of birth on separation anxiety, a rarely studied but clinically important topic in perinatal mental health. A descriptive and correlational design was used to identify relationships without intervention. The sample consisted of 305 postpartum women between the seventh day and sixth week, recruited from a private hospital. Data were collected using the Introductory Information Form, the Perception of Birth Scale, and the Adult Separation Anxiety Questionnaire. Statistical analyses included independent t-tests, ANOVA, Pearson correlation, and multiple regression. The mean age of participants was 29.09 ± 6.48 years. Separation anxiety was found to be significantly negatively correlated with the total score of the Perception of Birth Scale (r = -0.43, p ⩽ 0.001). Regression analysis showed that experiences during the pain period (β = -0.32, p < 0.001) and spousal involvement (β = -0.12, p < 0.05) negatively predicted separation anxiety. These two factors explained 21% of the variance. The findings suggest that positive childbirth perceptions, particularly effective pain management and partner support, may reduce maternal separation anxiety. This study contributes an innovative perspective by linking birth perception with separation anxiety, highlighting the need for interventions that promote positive childbirth experiences in order to protect maternal mental health.

Fetal attachment and infant temperament: The mediating role of perinatal mental health.

Putting It Out There: An Overview of Public Reports of Perinatal and Women's Health Indicators in the United States.

Linking maternal childhood maltreatment to infant socioemotional development through perinatal mental health.

Associations between state-level abortion restrictions and postpartum depression symptoms from a United States nationwide cohort.

ABSTRACT This article explores agenda-setting dynamics in the field of perinatal health care in England. Specifically, it analyses the 2024 Birth Trauma Inquiry, which launched after a high-profile campaign spearheaded by then-Member of Parliament Theo Clarke. The article uses the Multiple Streams Framework (Kingdon 2003) to understand how the inquiry led to agenda-setting success, despite numerous previous investigations and media coverage of maternity scandals. It draws on semi-structured interviews with five key actors, as well as extensive secondary and primary data. The article adds to our knowledge of feminist policy studies and agenda-setting on issues that are hidden, taboo, and previously not part of mainstream public discourse. Its key insights concern the importance of a well-connected political figure to push for change; the integral supporting role of advocacy organizations; issue expansion and framing of birth trauma; the use of evidence generated from an open call to the public; and extensive behind-the-scenes political consensus-building and media engagement.

Pregnant women who use specialist perinatal mental health services are more likely to be smokers at the time of birth than those without mental illness. This study explored health professionals' experiences of providing smoking cessation support to pregnant women with complex and severe mental illness. Online video semi-structured interviews were conducted in England October 2023 - October 2024 with 20 National Health Service (NHS) healthcare professionals whose role included discussing smoking cessation with pregnant women with mental illness. Using job descriptions, participants were categorised 'signposters' (n= 11) or 'stop smoking practitioners (SSP)' (n=9). Interview topic guides and data analysis were guided by the Theoretical Domains Framework. Reported barriers to effective provision of smoking cessation support included prioritising mental health over smoking cessation and being cautious about communicating harms of smoking in case it caused women's mental health to deteriorate. Health professionals also lacked confidence that pregnant women with mental illness could quit. Lacking knowledge about the relationship between mental health and smoking was a barrier specifically for many 'signposters'. Facilitators included having capacity for health professionals to be responsive to women's needs, offering flexibility and effective integration of smoking cessation services within maternity and mental health care settings. Barriers to effective smoking cessation support included prioritising mental illness over smoking cessation advice and a pessimistic view that pregnant women with mental illness would struggle to quit smoking. Facilitators included full integration of services and adapting to women's needs by offering flexible timing and delivery of smoking cessation support.ImplicationsThis study shows multiple areas which may be impacting on the effectiveness of smoking cessation support available to pregnant women with mental illness. Future research could address some of the barriers identified in the study including prioritising mental health over smoking cessation, addressing health professionals' beliefs that pregnant women with mental illness are unlikely to quit smoking, training on communicating harms of smoking and improving knowledge on effect of smoking on mental health. Future research could also focus on sharing good practice including appointment flexibility and full integration of smoking cessation services within maternity and perinatal mental health services.

Maternal HIV infection is associated with increased risks of pregnancy complications and adverse perinatal outcomes, particularly in high-prevalence settings like South Africa. The COVID-19 pandemic disrupted healthcare access, potentially exacerbating challenges in antenatal care and HIV management. To our knowledge, limited South African data exist regarding the impact of maternal HIV on birth complications and perinatal birth outcomes especially during the COVID-19 pandemic. This study thus evaluates the impact of maternal HIV on pregnancy and perinatal outcomes before and during the COVID-19 pandemic using archived chart records from a tertiary hospital in KwaZulu-Natal, South Africa. A retrospective analysis of 8456 birth records from March 2019 to December 2020 was conducted, categorized into pre-pandemic and pandemic periods. Data were stratified by maternal HIV status and analyzed for demographics, antenatal care attendance, ART regimens, labor characteristics, and birth outcomes. Statistical tests, including Chi-square and logistic regression, were used to assess associations between HIV status and outcomes. Hospital attendance declined during the COVID-19 period, especially among women living with HIV, whose age ranged between 19 and 35years, and were multigravida, and multiparous. Antenatal care attendance was suboptimal and worsened during the COVID-19 period. ART coverage remained high with maintained viral suppression. Women living with HIV had shorter "active labor" and higher elective cesarean rates during the COVID-19 period. Preterm birth risk was also higher pre-pandemic among women living with HIV but not significantly different during COVID-19 period. Birth weights were lower in HIV-exposed infants pre-pandemic with a non-significant shift during COVID-19 period. Sepsis incidence increased among women living with HIV during COVID-19 period. No maternal deaths were reported. A decline in hospital attendance was noted during the COVID-19 period among women living with HIV, with antenatal care attendance being suboptimal and exacerbated. Maternal HIV remains a critical factor influencing birth outcomes, necessitating sustained focus on tailored care during crises to protect vulnerable populations.

Literacy is a social determinant of health that can affect perinatal help seeking and maternal and neonatal outcomes. This study aimed to evaluate the readability of online information concerning perinatal mental health and psychotropic medication safety. Online materials were identified through Google searches that mirrored a typical patient's experience; readability was assessed via the Flesch-Kincaid Grade Level. On average, general and perinatal mental health information was written at or above a 12th-grade level, higher than the national recommended reading level. Information regarding medication safety during pregnancy required even higher levels of literacy. Patients may benefit from having perinatal mental health education materials tailored to their literacy level.

This study investigated perinatal depressive symptoms among pregnant and postpartum Filipino women. Cross-sectional survey. The Philippines. Participants were recruited online and face-to-face from maternal care facilities. Perinatal depressive symptoms were assessed using the Edinburgh Postnatal Depression Scale (EPDS) score, with prevalence calculated based on ≥13 cut-off, indicating clinically significant symptoms of depression. Patterns of depressive symptoms were examined by demographics, perinatal time period and other obstetric information using adjusted regression coefficients (ab) and risk ratios (aRR). A total of 856 women participated in the study, comprising 356 pregnant and 500 postpartum women. EPDS scores were, on average, similar between pregnant (14.4) and postpartum women (14.1). Using the locally validated cut-off of ≥13 revealed that 69.1% of pregnant and 62.0% of postpartum women reported clinically significant depressive symptoms. Consistent EPDS scores and prevalence were observed across pregnancy trimesters and within 12 months postpartum and beyond. Women who received adequate prenatal care were less likely to experience antenatal (ab=-1.59, 95% CI -3.13 to -0.05) and postpartum (ab=-1.30, 95% CI -2.48 to -0.12) depressive symptoms. Postpartum EPDS scores and depressive symptom prevalence (EPDS score ≥13) were higher among 18-24-year olds (ab=1.96, 95% CI 0.30 to 3.61; aRR=1.23, 95% CI 1.03 to 1.47) and single mothers (ab=3.46, 95% CI 0.22 to 6.71; aRR=1.42, 95% CI 1.07 to 1.90), compared with older and married mothers, respectively. At least 60% Filipino mothers experienced clinically significant perinatal depressive symptoms, which exceeds the established global average of 25%. Younger and single postpartum women were at greater risk, while pregnant and postpartum women who attended adequate prenatal visits were less likely to report depressive symptoms. Our study underscores the need for further research to uncover the true burden of poor perinatal mental health and calls for targeted early interventions and integrative public health strategies to support at-risk mothers, particularly those from socially disadvantaged backgrounds.

Climate change-induced international migration has the potential to negatively impact the health and well-being of displaced populations. Pregnancy often serves as a point of entry into the health care system for migrant women; however, these women often face reduced access to maternal health care services compared to nonmigrants. In the context of climate-related international migration, these disparities may be further exacerbated, increasing the risk of maternal morbidity and adverse perinatal outcomes. While the intersections between climate change, migration, and health are increasingly acknowledged, literature specifically focused on international climate-related migrant women-particularly during the perinatal period-remains limited and dispersed. Thus, there is a growing need for research and synthesized data on climate change, population movements, and the perinatal health care needs of childbearing women. The aim of this study is to examine and describe the scope and nature of available evidence on maternal health and care for international climate-related migrant women, from pregnancy through the postpartum period. We will conduct a scoping review following the Joanna Briggs Institute methodology. A tailored search strategy using key terms related to climate change, migration, women, and perinatal health care will be applied to four databases-Embase, CINAHL, PsycINFO, and Ovid MEDLINE-without restriction on publication date. Relevant gray literature sources will also be searched and considered for inclusion. Only literature published in English, French, Portuguese, or Spanish will be included. Two reviewers will independently screen full-text records based on predefined inclusion criteria and extract the relevant data. A total of 741 studies were screened from 1113 records. Results summarizing perinatal health outcomes and needs, care experiences, barriers faced by international climate-related migrant women, and recommendations will be reported using the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) 2020 flow diagram. We anticipate finalizing the manuscript for this work in 2026. Considering vulnerability factors related to migration status is essential to improving access to integrated perinatal health care and reducing health inequities among immigrant women. This review will provide valuable insights to tailor interventions to the social and cultural needs of climate-affected migrant women during the perinatal period.

Gendered racism (unique discrimination targeting intersecting racial/ethnic and gender identities) is associated with pregnancy-specific stress among Black and Latina American Women. Gendered racism's associations with perinatal mental health are not understood, despite perinatal mental health's impact on maternal and infant outcomes. Social support boosts mental health and may buffer against discrimination, yet gendered racism may diminish support. We examined gendered racism's associations with perinatal anxiety and depressive symptoms, and whether social support moderates and/or mediates these associations. The analytic sample included 130 pregnant U.S. adult women drawn from an online survey (Mage=26.42; 8% Black, 9% Latina, 13% Multiracial including Black and/or Latina, 61% white, 9% other). Bivariate analyses explored racial/ethnic group differences. Regression, moderation, and mediation analyses tested associations among gendered racism, overall and sub-types of social support (appraisal, belonging, tangible), and depressive and anxiety symptoms. Black, Latina, and Multiracial (including Black and/or Latina) Women experienced greater gendered racism and lower social support than other Women. In adjusted models, gendered racism was not directly associated with anxiety or depressive symptoms nor did social support moderate their relationships. However, there were positive indirect associations of gendered racism with anxiety and depressive symptoms through social support. Appraisal support mediated the relationship between gendered racism and anxiety symptoms, while belonging support mediated the relationship between gendered racism and depressive symptoms. Gendered racism poses mental health risks for pregnant Women of Color through reduced social support. Interventions need to address gendered racism and social support to promote pregnant Women of Color's well-being.

Maternal postpartum depression (PPD) is a significant mental health issue that affects over 15% of mothers, with adverse effects on their children. Ethnic disparities in PPD represent a pressing public health concern, and minority mothers are found to have a higher likelihood of being affected by PPD. Identifying specific risk factors for these mothers is crucial for developing targeted preventive strategies that can help mitigate the disparities in PPD. This study used CDC data (N = 39,637) from the Pregnancy Risk Assessment Monitoring System to examine how risk factors for PPD vary among mothers from different ethnic groups. We applied Random Forest machine learning (ML) algorithms, and the final model achieved a mean ROC AUC of 0.65 and PR AUC of 0.66 during cross-validation on balanced samples, though performance declined on the held-out test set (PR AUC = 0.28; two times higher than the baseline of 0.11). The top predictors include prepregnancy and prenatal depression, family income, prior PPD-related visits, WIC participation, employment-based insurance, breastfeeding, pregnancy intention, and parental education. Subgroup analyses revealed both shared and unique predictors across racial and ethnic groups. While the results for White mothers closely aligned with overall trends, smoking and pregnancy termination ranked high among Black mothers. For Hispanic/Latina mothers, unintended pregnancy and smoking were more prominent, whereas, for Asian mothers, infant sleep arrangements, prepregnancy health behaviors, and infant sex emerged as key predictors. This study demonstrates the value of using ML to identify data-driven, population-specific predictors of PPD and highlights the need for culturally sensitive, early preventative approaches in perinatal mental health care.

Childhood cancer survivors (CCS) are at increased risk of treatment-related infertility and may require assisted reproductive technologies (ART) to achieve parenthood. This scoping review aimed to synthesise the existing scientific evidence on the use of ART among CCS, focusing on fertility outcomes and associated maternal, perinatal, and child health indicators. Adapted from Joanna Briggs Institute (JBI) and PRISMA-ScR guidelines, MEDLINE (OVID), CINAHL, and Embase were searched (conducted from the inception of each database up to February 2025) for studies of CCS diagnosed before age 18, surviving ≥ 5years, and reporting ART-related fertility, obstetric, or perinatal outcomes. Screening and extraction were conducted independently via Covidence. From 4,785 records, 10 studies met theinclusion criteria. Five studies reported higher infertility rates among female CCS (4.5-34%) compared with non-cancer controls. ART success rates were generally comparable to siblings, though pelvic or cranial radiotherapy reduced live birth rates by 17-32%. Three studies demonstrated the feasibility of ovarian tissue cryopreservation (OTC), particularly for prepubertal girls. Male CCS were more likely to require intracytoplasmic sperm injection (ICSI) and had lower ART success than non-cancer siblings. Neonatal studies found increased multiple gestations, preterm births, and low birth weight among ART-conceived offspring, but no rise in congenital anomalies or childhood cancer. ART enables parenthood for childhood cancer survivors, though prior gonadotoxic therapies can impair success and increase perinatal risks, highlighting the need for long-term survivorship research. ART provides viable fertility options, but early counseling and integrated reproductive care are essential to optimise outcomes and ensure equitable access for all cancer survivors.

Outpatient management of women with preterm prelabour rupture of the membranes: A retrospective multicentre cohort study.

Perinatal mental health (PMH) conditions are the most common complications of pregnancy and the first postpartum year. Adverse childhood experiences (ACEs) are increasingly recognized as important contributors to PMH, particularly postpartum depression and anxiety (PPD/A). This study examines a broad range of ACEs—including parental mental illness and substance use, incarceration, death, divorce, discrimination, economic hardship, and forced migration—to assess their influence on PPD/A. Using a modified explanatory sequential mixed-methods design, phase I included an online survey of racially, ethnically, and socioeconomically diverse U.S. women (n = 306) who delivered a live infant in the past year. Hierarchical regression showed that while ACEs initially predicted PPD/A, this association was no longer significant when social support, material hardship, and discrimination were added to the model. These current life circumstances emerged as stronger direct predictors of PPD/A than ACEs. In phase II, purposive and stratified sampling identified participants with ACE scores ≥ 4 for interviews (n = 22). Qualitative findings identified social support, financial security, work flexibility and choice, and time for self-care as central protective factors in adjustment to motherhood when these resources aligned with mothers’ individual needs and values. Results can inform clinical counseling, ACEs screening, and policies to strengthen PMH support.

In South Africa, perinatal depression, stress or anxiety affect an estimated 16% to 50% of women posing serious concerns for both mothers and infants. The vast majority of women receive no perinatal mental healthcare through the public health system, partly due to high levels of stigma and a lack of culturally sensitive mental health care. South African musical traditions such as group singing are culturally significant for supporting social connection and coping with challenges experienced in everyday life. However, there is little research on how group music making could be used to support perinatal mental health in South Africa. This study aimed to explore the potential for developing a culturally embedded, music-based intervention to support women in the perinatal period. Using Community-Based Participatory Research, we held five focus group discussions with: 1) community health workers, 2) music experts, 3) traditional healers, 4) professional healthcare workers, and 5) the management team of a rural health NGO. Through thematic analysis, four themes were identified. Theme 1 encompasses the various challenges that contribute to perinatal mental distress, including social determinants of mental health, unhelpful coping strategies, stigma, and isolation. Theme 2 reflects existing community music practices: the way music is embedded in culture, processes of cultural change, and musical practices associated with perinatal health. Theme 3 encompasses the perceived benefits of music making in supporting social connections and effecting transformation in relation to individual mood and spiritual experiences. Theme 4 includes consideration of factors that are important for the development of a music-making intervention to support perinatal mental health. The findings suggest strong potential for implementing music-based mental health interventions in South Africa, adaptable to various facilitators and community contexts.

Federal Policy Changes Endanger Medicaid's Critical Role in Perinatal Care and Health Equity.

This study explored young Australian mothers’ (aged 16–24) perinatal mental health and wellbeing using Participatory Action Research. Co-design workshops with 80 young mothers revealed three themes: (1) The Emotional Tides of Young Motherhood , capturing dialectical experiences of joy alongside anxiety, judgement, and isolation; (2) Rising Strong , highlighting resilience in navigating stigma and hardships while pursuing growth; and (3) The Strength in Support , emphasising the critical role of non-judgemental networks, accessible resources, and self-care. Findings underscore heightened mental health risks exacerbated by societal stigma yet also showcase their resilience when empowered by community and supportive interventions. The study concludes that addressing systemic biases, fostering trauma-informed care, and co-designing resources are essential. It advocates for policies that validate experiences, reduce stigma, and strengthen protective factors for maternal and child wellbeing.

In low- and middle-income countries (LMICs), mental health systems face persistent challenges in access, coverage, and quality, especially for vulnerable groups such as perinatal women. This case study from Pakistan describes an innovative, system-level model for scaling up a psychosocial intervention for perinatal depression - the World Health Organization Thinking Healthy Programme (THP). Originally designed for delivery by Community Health Workers, THP was adapted for delivery by trained lived-experience peers using a social franchise model led by a local non-governmental organization (NGO). The model integrated several innovations: public–private partnerships that leveraged the comparative strengths of government institutions, tertiary mental health services, and community organizations; a stepped-care service delivery framework embedded in primary health care; and digital platforms for intervention-delivery, training, supervision, and quality assurance. Community-based identification through informants and structured screening using PHQ-9 facilitated early detection. Health information generated by the NGO-led franchise was aligned with primary care data standards and partially integrated into the District Health Information System, enhancing accountability and visibility. This case-study illustrates how strategic innovation across multiple health system building blocks can enable the delivery of scalable, community-anchored mental health care in LMICs, offering a replicable model aligned with global goals for Universal Health Coverage and mental health equity.