Towards parenthood: an antenatal intervention to reduce depression, anxiety and parenting difficulties.

Background: There have been few antenatal interventions aimed at preparing women for the transition to parenthood and previous attempts to intervene antenatally to prevent postnatal depression and anxiety have had limited impact.

Methods: We evaluated the effectiveness of an antenatal intervention which targeted risk factors for poor postnatal adjustment, with the dual aim of reducing both postnatal symptoms of depression/anxiety and parenting difficulties (a nine-unit self-guided workbook with weekly telephone support). Based on an initial feasibility study (n=200) which confirmed a low level of help-seeking among distressed women during pregnancy, an additional community networking component was developed aimed at increasing social support and access to health professionals to facilitate treatment of current antenatal depression/anxiety, if present. In the evaluation of a second version of the intervention, pregnant women (n=143) were randomly allocated to receive either the intervention or routine care.

Results: Following the antenatal intervention there were significantly fewer cases scoring above threshold for mild-to-severe depression/anxiety symptoms postnatally compared to routine care, along with a trend towards reduced parenting stress. The community networking component appeared helpful and women with higher baseline depression scores showed higher levels of help-seeking in both intervention and routine care groups.

Limitations: It was not possible to evaluate the efficacy of individual program components separately.

Conclusions: The findings provide support for the effectiveness of the Towards Parenthood intervention both as a preparation for parenthood program and in reducing symptoms of postnatal depression/anxiety.