Exploring Perinatal Anxiety Detection, and Perinatal Women’s Perceived Social Support From Medical Providers: A Quantitative Study
Abstract
Objective: Anxiety disorders during the perinatal period, or perinatal anxiety (PNA), occur at rates comparable to perinatal depression and often go undetected. Obstetric providers are perfectly positioned to identify PNA; yet, most literature focuses on informal supports as primary protective factors the prevention and detection of PNA. This study aims to contribute to this gap by exploring the relationship between perceived support from medical providers and the detection of PNA.
Materials and methods: The current study asked postpartum women to reflect on their levels of anxiety, perceived social support from obstetric care providers, help seeking behavior, and factors influencing their decision to disclose symptoms of PNA to their obstetric care provider during their perinatal period. Participants were recruited via an electronic flyer posted in social media groups for mothers. They completed an online survey consisting of a demographic questionnaire, Perinatal Anxiety Screening Scale (PASS), Modified Multidimensional Scale of Perceived Social Support (MSPSS), Subscale 1, Subscale 2.
Results: Totally 98 postpartum women participated in this study. A Spearman correlation demonstrated a significant positive relationship between levels of perceived social support from obstetric providers and perinatal women ranking their obstetric provider as a barrier, neutral or motivating factor in help seeking behavior for PNA. A chi-square test of independence indicated a significant relationship between rankings of a provider as a barrier, neutral or motivator in help seeking behavior and the disclosure of PNA directly to obstetric care providers. It was found that levels of perceived social support reported on the Multidimensional Scale of Perceived Social Support (MSPSS) significantly predicted ranking obstetric providers as a barrier, neutral or motivating factor in the decision to disclose symptoms of PNA to their obstetric care provider.
Conclusion: The results of this study indicate a missed opportunity in more effective detection of PNA. Specifically, the role of obstetric providers in detection of PNA and potential to serve as a protective factor or motivator in the disclosure of PNA is mentioned.
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2. Long MM, Cramer RJ, Jenkins J, Bennington L, Paulson JF. A systematic review of interventions for healthcare professionals to improve screening and referral for perinatal mood and anxiety disorders. Arch Womens Ment Health. 2019;22(1):25-36.
3. Maguire PN, Bhullar N, Cosh SM, Wootton BM.
Help-seeking and treatment delivery preferences for women experiencing perinatal anxiety symptoms. Behav Cogn Psychother. 2023;51(4):271-285.
4. World Health Organization. Perinatal mental health [Internet]. Mental Health, Brain Health and Substance Use: World Health Organization; Available from: https://www.who.int/teams/mental-health-and-substance-use/promotion-prevention/maternal-mental-health
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6. Thorsness KR, Watson C, LaRusso EM. Perinatal anxiety: approach to diagnosis and management in the obstetric setting. Am J Obstet Gynecol. 2018;219(4):326-345.
7. Fairbrother N, Janssen P, Antony M, Tucker E, Young A. Perinatal anxiety disorder prevalence and incidence. J Affect Disord. 2016;200:148-155.
8. Lieb K, Reinstein S, Xie X, Bernstein PS, Karkowsky CE. Adding perinatal anxiety screening to depression screening: is it worth it? AJOG MFM. 2020;2(2).
9. Luca DL, Margiotta C, Staatz C, Garlow E, Christensen A, Zivin K. Financial toll of untreated perinatal mood and anxiety disorders among 2017 births in the United States. AM J Public Health. 2020;110(6):888-896.
10. Somerville S, Dedman K, Hagan R, Oxnam E, Wettinger M, Byrne S, et al. The perinatal anxiety screening scale: development and preliminary validation. Arch Womens Ment Health. 2014;17(5):443-454.
11. Staneva A, Bogossian F, Pritchard M, Wittkowski A. The effects of maternal depression, anxiety, and perceived stress during pregnancy on preterm birth: a systematic review. ACM Women and Birth. 2015;28(3):179-193.
12. Fairbrother N, Young A, Zhang A, Janssen P, Antony MM. The prevalence and incidence of perinatal anxiety disorders among women experiencing a medically complicated pregnancy. Arch Womens Ment Health. 2017;20(2):311-319.
13. Furtado M, Van Lieshout RJ, Van Ameringen M, Green SM, Frey BN. Biological and psychosocial predictors of anxiety worsening in the postpartum period: a longitudinal study. J Affect Disord. 2019;250:218-225.
14. Sinesi A, Maxwell M, O’Carrol R, Cheyne H. Anxiety scales used in pregnancy: systematic review. BJPsych Open. 2019;5(1):e5.
15. Berger A, Schenk K, Ging A, Walther S, Cignacco E. Perinatal mental health care from the user and provider perspective: protocol for qualitative study in Switzerland. Reprod Health. 2020;17(1):26.
16. Grigoriadis S, Graves L, Peer M, Mamisashvili L, Tomlinson G, Vigod SN, et al. Maternal anxiety during pregnancy and the association with adverse perinatal outcomes: systematic review and meta-analysis. J Clin Psychiatry. 2018;79(5):17r12011.
17. Marchesi C, Ossola P, Amerio A, Daniel BD, Tonna M, De Panfilis C. Clinical management of perinatal anxiety disorders: a systematic review. J Affect Disord. 2016;190:543-550.
18. McKee K, Admon LK, Winkelman TNA, Muzik M, Hall S, Dalton VK, et al. Perinatal mood and anxiety disorders, serious mental illness, and delivery-related health outcomes, United States, 2006-2015. BMC Women’s Health. 2020;20(1):150.
19. Nillni YI, Mehralizade A, Mayer L, Milanovic S. Treatment of depression, anxiety, and trauma-related disorders during the perinatal period: a systematic review. 2018;66:136-148.
20. Posmontier B, Geller PA, Horowitz JA, Elgohail M, Chiarello L. Intensive perinatal mental health programs in the United States: a call to action. Psychiatr Serv. 2022;73(8):930-932.
21. Chin K, Wendt A, Bennett IM, Bhat A. Suicide and maternal mortality. Curr Psychiatric Rep. 2022;24(4):239-275.
22. Palladino CL, Singh V, Campbell J, Flynn H, Gold KJ. Homicide and suicide during the perinatal period: findings from the National Violent Death Reporting System. Obstet Gynecol. 2011;118(5):1056-1063.
23. Trost SL, Beauregard JL, Smoots AN, Ko JY, Haight SC, Moore Simas TA, et al. Preventing pregnancy-related mental health deaths: insights from 14 US maternal mortality review committees, 2008-17. Health Aff. 2021;40(10):1551-1559.
24. Gimble LA, Weingarten SJ, Smid MC, Hoffman MC. Maternal mental health as a major contributor to maternal morality. Semin Perinatol. 2024;48(6).
25. CDC. Severe maternal morbidity [Internet]. Maternal Infant Health: CDC; 2024 [2023]. Available from: https://www.cdc.gov/reproductivehealth/maternalinfanthealth/severematernalmorbidity.html
26. Diaz-Tello F. Invisible wounds:obstetric violence in
the United States. Reprod Health Matters 2016;24(47):56-64.
27. Declercq E, Zephyrin LC. Severe maternal morbidity in the United States: a primer [Internet]. The Common Wealth Fund; 2021 [2023]. Available from: https://www.commonwealthfund.org/publications/issue-briefs/2021/oct/severe-maternal-morbidity-united-states-primer
28. Accortt EE, Wong MS. It is time for routine screening for perinatal mood and anxiety disorders in obstetrics and gynecology settings. OGS. 2017;72(9):553-568.
29. Toscano M, Royzer R, Castillo D, Li D, Poleschuck E. Prevalence of depression or anxiety during antepartum hospitalizations for obstetric complications: a systematic review and meta-analysis. Obstet Gynecol. 2021;137(5):881-891.
30. Glazer KB, Howell EA. A way forward in the maternal mortality crisis: addressing maternal health disparities and mental health. Arch Womens Ment Health. 2021;24:823-830.
31. Fawcett EJ, Fairbrother N, Cox ML, White IR, Fawcett JM. The prevalence of anxiety disorders during pregnancy and the postpartum period: a multivariate bayesian meta-analysis. J Clin Psychiatry. 2019;80(4):18r12527.
32. Goodman JH, Chenausky KL, Freeman MP. Anxiety disorders during pregnancy: a systematic review. J Clin Psychiatry. 2014;75(10):e1153-e1184.
33. Leach LS, Poyser C, Fairweather SK. Maternal perinatal anxiety: a review of prevalence and correlates. Clin Psychol. 2017;21(1):4-19.
34. Misri S, Abizadeh J, Sanders S, Swift E. Perinatal generalized anxiety disorder: assessment and treatment. J Women’s Health. 2015;24(9):762-770.
35. Small R, Taft AJ, Brown SJ. The power of social connection and support in improving health: lessons from social support interventions with childbearing women. BMC Public Health. 2011;11(Suppl 5):S4.
36. Kendig S, Keats JP, Hoffman MC, Kay LB, Miller ES, Moore Simas TA, et al. Consensus bundle on maternal mental health: perinatal depression and anxiety. Obstet Gynecol. 2017;129(3):422-430.
37. Kingston D, Austin MP, Heaman M, McDonald S,
Lasiuk G, Sword W, et al. Barriers and facilitators of mental health screening in pregnancy. J Affect Disord. 2015;186:350-357.
38. Goodman JH, Tyer-Viola L. Detection, treatment, and referral of perinatal depression and anxiety by obstetrical providers. J Womens Health. 2010;19(3):477-490.
39. Fairbrother N, Corbyn B, Thordarson DS, Ma A, Surm D. Screening for perinatal anxiety disorders: room to grow. J Affect Disord. 2019;250:363-370.
40. Biaggi A, Conroy S, Pawlby S, Pariante CM. Identifying the women at risk of antenatal anxiety and depression: a systematic review. J Affect Disord. 2016;191:62-77.
41. Gennaro S, O’Connor C, McKay EA, Gibeau A, Aviles M, Hoying J, et al. Perinatal anxiety and depression in minority women. MCN AM J Matern Child Nurs. 2020;45(3):138-144.
42. Kiraly C, Boyle-Duke B, Shklarski L. The role of maternal and child healthcare providers in identifying and supporting perinatal mental health disorders. PLOS One. 2024;19(7):e0306265.
43. Koukopoulos A, Mazza C, De Chiara L, Sani G, Simonetti A, Kotzalidis GD, et al. Psychometric properties of the perinatal anxiety screening scale administered to Italian women in the perinatal period. Front Psychiatry. 2021;12.
44. Zimet G, Powell SS, Farley GK, Werkman S, Berkoff KA. Psychometric characteristics of the multidimensional scale of perceived social support.
J Pers Assess. 1990;55(3-4):610-617.
45. Zimet G, Dahlem N, Farley G. The multidimensional scale of perceived social support. J Pers Assess. 1988;52(1):30-41.
46. Dambi JM, Corten L, Chiwaridzo M, Jack H, Mlambo
T, Jelsma J. A systematic review of the psychometric properties of the cross-cultural translations and adaptations of the Multidimensional Perceived Social Support Scale (MSPSS). Health Qual Life Outcomes. 2018;16(80).
47. Harden-Khalil K, Mayo AM. Psychometric properties of the Multidimensional Scale of Perceived Social Support. Clin Nurse Spec. 2015;29(5):258-261.
48. Harrison V, Moore D, Lazard L. Supporting perinatal anxiety in the digital age; a qualitative exploration of stressors and support strategies. BMC Pregnancy Childbirth. 2020;20(1):363.
49. Forder PM, Rich J, Harris S, Chojenta C, Reilly N, Austin MP, et al. Honesty and comfort levels in mothers when screened for perinatal depression and anxiety. ACM. 2020;33(2):e142-e150.
50. Oh S, Chew-Graham CA, Silverwood V, Shaheen SA, Walsh-House J, Sumathipala A, et al. Exploring women’s experiences of identifying, negotiating and managing perinatal anxiety: a qualitative study. BMJ Open. 2020;10(12):e040731.
51. Avalos LA, Raine-Bennett T, Chen H, Adams AS, Flanagan T. Improved perinatal depression screening, treatment, and outcomes with a universal obstetric program. Obstet Gynecol. 2016;127(5):917-925.
2. Long MM, Cramer RJ, Jenkins J, Bennington L, Paulson JF. A systematic review of interventions for healthcare professionals to improve screening and referral for perinatal mood and anxiety disorders. Arch Womens Ment Health. 2019;22(1):25-36.
3. Maguire PN, Bhullar N, Cosh SM, Wootton BM.
Help-seeking and treatment delivery preferences for women experiencing perinatal anxiety symptoms. Behav Cogn Psychother. 2023;51(4):271-285.
4. World Health Organization. Perinatal mental health [Internet]. Mental Health, Brain Health and Substance Use: World Health Organization; Available from: https://www.who.int/teams/mental-health-and-substance-use/promotion-prevention/maternal-mental-health
5. Ayers S, Horsch A, Garthus-Niegel S, Nieuwenhuijze M, Bogaerts A, Hartmann K, et al. Traumatic birth and childbirth-related post-traumatic stress disorder: international expert consensus recommendations for practice, policy, and research. ACM Women and Birth. 2024;37(2):362-367.
6. Thorsness KR, Watson C, LaRusso EM. Perinatal anxiety: approach to diagnosis and management in the obstetric setting. Am J Obstet Gynecol. 2018;219(4):326-345.
7. Fairbrother N, Janssen P, Antony M, Tucker E, Young A. Perinatal anxiety disorder prevalence and incidence. J Affect Disord. 2016;200:148-155.
8. Lieb K, Reinstein S, Xie X, Bernstein PS, Karkowsky CE. Adding perinatal anxiety screening to depression screening: is it worth it? AJOG MFM. 2020;2(2).
9. Luca DL, Margiotta C, Staatz C, Garlow E, Christensen A, Zivin K. Financial toll of untreated perinatal mood and anxiety disorders among 2017 births in the United States. AM J Public Health. 2020;110(6):888-896.
10. Somerville S, Dedman K, Hagan R, Oxnam E, Wettinger M, Byrne S, et al. The perinatal anxiety screening scale: development and preliminary validation. Arch Womens Ment Health. 2014;17(5):443-454.
11. Staneva A, Bogossian F, Pritchard M, Wittkowski A. The effects of maternal depression, anxiety, and perceived stress during pregnancy on preterm birth: a systematic review. ACM Women and Birth. 2015;28(3):179-193.
12. Fairbrother N, Young A, Zhang A, Janssen P, Antony MM. The prevalence and incidence of perinatal anxiety disorders among women experiencing a medically complicated pregnancy. Arch Womens Ment Health. 2017;20(2):311-319.
13. Furtado M, Van Lieshout RJ, Van Ameringen M, Green SM, Frey BN. Biological and psychosocial predictors of anxiety worsening in the postpartum period: a longitudinal study. J Affect Disord. 2019;250:218-225.
14. Sinesi A, Maxwell M, O’Carrol R, Cheyne H. Anxiety scales used in pregnancy: systematic review. BJPsych Open. 2019;5(1):e5.
15. Berger A, Schenk K, Ging A, Walther S, Cignacco E. Perinatal mental health care from the user and provider perspective: protocol for qualitative study in Switzerland. Reprod Health. 2020;17(1):26.
16. Grigoriadis S, Graves L, Peer M, Mamisashvili L, Tomlinson G, Vigod SN, et al. Maternal anxiety during pregnancy and the association with adverse perinatal outcomes: systematic review and meta-analysis. J Clin Psychiatry. 2018;79(5):17r12011.
17. Marchesi C, Ossola P, Amerio A, Daniel BD, Tonna M, De Panfilis C. Clinical management of perinatal anxiety disorders: a systematic review. J Affect Disord. 2016;190:543-550.
18. McKee K, Admon LK, Winkelman TNA, Muzik M, Hall S, Dalton VK, et al. Perinatal mood and anxiety disorders, serious mental illness, and delivery-related health outcomes, United States, 2006-2015. BMC Women’s Health. 2020;20(1):150.
19. Nillni YI, Mehralizade A, Mayer L, Milanovic S. Treatment of depression, anxiety, and trauma-related disorders during the perinatal period: a systematic review. 2018;66:136-148.
20. Posmontier B, Geller PA, Horowitz JA, Elgohail M, Chiarello L. Intensive perinatal mental health programs in the United States: a call to action. Psychiatr Serv. 2022;73(8):930-932.
21. Chin K, Wendt A, Bennett IM, Bhat A. Suicide and maternal mortality. Curr Psychiatric Rep. 2022;24(4):239-275.
22. Palladino CL, Singh V, Campbell J, Flynn H, Gold KJ. Homicide and suicide during the perinatal period: findings from the National Violent Death Reporting System. Obstet Gynecol. 2011;118(5):1056-1063.
23. Trost SL, Beauregard JL, Smoots AN, Ko JY, Haight SC, Moore Simas TA, et al. Preventing pregnancy-related mental health deaths: insights from 14 US maternal mortality review committees, 2008-17. Health Aff. 2021;40(10):1551-1559.
24. Gimble LA, Weingarten SJ, Smid MC, Hoffman MC. Maternal mental health as a major contributor to maternal morality. Semin Perinatol. 2024;48(6).
25. CDC. Severe maternal morbidity [Internet]. Maternal Infant Health: CDC; 2024 [2023]. Available from: https://www.cdc.gov/reproductivehealth/maternalinfanthealth/severematernalmorbidity.html
26. Diaz-Tello F. Invisible wounds:obstetric violence in
the United States. Reprod Health Matters 2016;24(47):56-64.
27. Declercq E, Zephyrin LC. Severe maternal morbidity in the United States: a primer [Internet]. The Common Wealth Fund; 2021 [2023]. Available from: https://www.commonwealthfund.org/publications/issue-briefs/2021/oct/severe-maternal-morbidity-united-states-primer
28. Accortt EE, Wong MS. It is time for routine screening for perinatal mood and anxiety disorders in obstetrics and gynecology settings. OGS. 2017;72(9):553-568.
29. Toscano M, Royzer R, Castillo D, Li D, Poleschuck E. Prevalence of depression or anxiety during antepartum hospitalizations for obstetric complications: a systematic review and meta-analysis. Obstet Gynecol. 2021;137(5):881-891.
30. Glazer KB, Howell EA. A way forward in the maternal mortality crisis: addressing maternal health disparities and mental health. Arch Womens Ment Health. 2021;24:823-830.
31. Fawcett EJ, Fairbrother N, Cox ML, White IR, Fawcett JM. The prevalence of anxiety disorders during pregnancy and the postpartum period: a multivariate bayesian meta-analysis. J Clin Psychiatry. 2019;80(4):18r12527.
32. Goodman JH, Chenausky KL, Freeman MP. Anxiety disorders during pregnancy: a systematic review. J Clin Psychiatry. 2014;75(10):e1153-e1184.
33. Leach LS, Poyser C, Fairweather SK. Maternal perinatal anxiety: a review of prevalence and correlates. Clin Psychol. 2017;21(1):4-19.
34. Misri S, Abizadeh J, Sanders S, Swift E. Perinatal generalized anxiety disorder: assessment and treatment. J Women’s Health. 2015;24(9):762-770.
35. Small R, Taft AJ, Brown SJ. The power of social connection and support in improving health: lessons from social support interventions with childbearing women. BMC Public Health. 2011;11(Suppl 5):S4.
36. Kendig S, Keats JP, Hoffman MC, Kay LB, Miller ES, Moore Simas TA, et al. Consensus bundle on maternal mental health: perinatal depression and anxiety. Obstet Gynecol. 2017;129(3):422-430.
37. Kingston D, Austin MP, Heaman M, McDonald S,
Lasiuk G, Sword W, et al. Barriers and facilitators of mental health screening in pregnancy. J Affect Disord. 2015;186:350-357.
38. Goodman JH, Tyer-Viola L. Detection, treatment, and referral of perinatal depression and anxiety by obstetrical providers. J Womens Health. 2010;19(3):477-490.
39. Fairbrother N, Corbyn B, Thordarson DS, Ma A, Surm D. Screening for perinatal anxiety disorders: room to grow. J Affect Disord. 2019;250:363-370.
40. Biaggi A, Conroy S, Pawlby S, Pariante CM. Identifying the women at risk of antenatal anxiety and depression: a systematic review. J Affect Disord. 2016;191:62-77.
41. Gennaro S, O’Connor C, McKay EA, Gibeau A, Aviles M, Hoying J, et al. Perinatal anxiety and depression in minority women. MCN AM J Matern Child Nurs. 2020;45(3):138-144.
42. Kiraly C, Boyle-Duke B, Shklarski L. The role of maternal and child healthcare providers in identifying and supporting perinatal mental health disorders. PLOS One. 2024;19(7):e0306265.
43. Koukopoulos A, Mazza C, De Chiara L, Sani G, Simonetti A, Kotzalidis GD, et al. Psychometric properties of the perinatal anxiety screening scale administered to Italian women in the perinatal period. Front Psychiatry. 2021;12.
44. Zimet G, Powell SS, Farley GK, Werkman S, Berkoff KA. Psychometric characteristics of the multidimensional scale of perceived social support.
J Pers Assess. 1990;55(3-4):610-617.
45. Zimet G, Dahlem N, Farley G. The multidimensional scale of perceived social support. J Pers Assess. 1988;52(1):30-41.
46. Dambi JM, Corten L, Chiwaridzo M, Jack H, Mlambo
T, Jelsma J. A systematic review of the psychometric properties of the cross-cultural translations and adaptations of the Multidimensional Perceived Social Support Scale (MSPSS). Health Qual Life Outcomes. 2018;16(80).
47. Harden-Khalil K, Mayo AM. Psychometric properties of the Multidimensional Scale of Perceived Social Support. Clin Nurse Spec. 2015;29(5):258-261.
48. Harrison V, Moore D, Lazard L. Supporting perinatal anxiety in the digital age; a qualitative exploration of stressors and support strategies. BMC Pregnancy Childbirth. 2020;20(1):363.
49. Forder PM, Rich J, Harris S, Chojenta C, Reilly N, Austin MP, et al. Honesty and comfort levels in mothers when screened for perinatal depression and anxiety. ACM. 2020;33(2):e142-e150.
50. Oh S, Chew-Graham CA, Silverwood V, Shaheen SA, Walsh-House J, Sumathipala A, et al. Exploring women’s experiences of identifying, negotiating and managing perinatal anxiety: a qualitative study. BMJ Open. 2020;10(12):e040731.
51. Avalos LA, Raine-Bennett T, Chen H, Adams AS, Flanagan T. Improved perinatal depression screening, treatment, and outcomes with a universal obstetric program. Obstet Gynecol. 2016;127(5):917-925.
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| Issue | Vol 20, No 2 (June 2026) | |
| Section | Original Articles | |
| Keywords | ||
| Perinatal Anxiety Perinatal Mood Disorder Perinatal Anxiety Detection Perinatal Anxiety Disclosure Social Support Help Seeking Behavior Quantitative Study | ||
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How to Cite
1.
Patterson R, Smith K. Exploring Perinatal Anxiety Detection, and Perinatal Women’s Perceived Social Support From Medical Providers: A Quantitative Study. J Family Reprod Health. 2026;20(2):108-119.
