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

By Virginia Harrison, Donna Moore & Lisa Lazard, BMC Pregnancy and Childbirth, vol 20, no 363, 17 June 2020 on 22 March 2021


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.


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.


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.


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. For more information click here.

Further reference 

The effectiveness of online psychotherapy interventions for the treatment of perinatal mental health disorders: a systematic review, Rachel Black, Marlene Sinclair, Paul Miller et al, MIDIRS Midwifery Digest, March 2021, volume 31, number 1. Subscribe to MIDIRS to get more articles like this here.

Literature search pack 

P198 - Perinatal mental health | (481 abstracts)

This search pack encompasses the treatment and experiences of women and partners experiencing mental health problems during the perinatal period. Includes service provision and interventions, rates of mental illness and levels of provision, and the impact on the infant. The pack does not include postnatal depression (see search packs PN16, PN115, PN116), antenatal depression (see search pack P132) or women with specific diagnosed mental disorders (see search pack MS54).

Get this literature search pack or find out more here.