Results from a substantial clinical trial supported by the National Institutes of Health reveal that an anxiety intervention offered to pregnant women in Pakistan significantly diminished the likelihood of these women developing moderate-to-severe anxiety, depression, or a combination of both six weeks after giving birth. The distinctive intervention was administered by non-specialized providers with a bachelor’s degree in psychology but lacking clinical experience. The outcomes suggest that this intervention could prove effective in preventing postpartum mental health challenges among women in low-resource settings.

“In regions with limited resources, women may face difficulties in accessing mental health care due to a global shortage of trained specialists,” stated Joshua A. Gordon, M.D., Ph.D., Director of the National Institute of Mental Health, part of NIH. “This study indicates that non-specialists could help bridge this gap, offering care to more women during this crucial period.”

Conducted in the Punjab Province of Pakistan between April 2019 and January 2022, the study, led by Pamela J. Surkan, Ph.D., Sc.D., of Johns Hopkins Bloomberg School of Public Health, Baltimore, randomly assigned pregnant women with at least mild anxiety symptoms to receive routine pregnancy care or a cognitive behavioral therapy (CBT)-based intervention called Happy Mother-Healthy Baby. The assessment, carried out six weeks postpartum, involved 380 women in the CBT group and 375 women in the routine care group.

The findings revealed that 9% of women in the intervention group developed moderate-to-severe anxiety, compared to 27% in the routine care group. Furthermore, 12% of women in the intervention group developed depression, in contrast to 41% in the routine care group.

“Postpartum depression not only affects mothers; it is also linked to poorer physical growth and delayed cognitive development in their children,” emphasized Dr. Surkan. “The connection between maternal and child health underscores the critical importance of developing effective strategies to address postpartum anxiety and depression.”

The Happy Mother-Healthy Baby intervention, developed with input from pregnant women in Rawalpindi, Pakistan, involved six sessions where participants learned to identify anxious thoughts and behaviors, addressing issues like thoughts about potential miscarriage. The sessions occurred in early to mid-pregnancy, with the final one taking place in the third trimester.

Given that up to 30% of women in the Global South report experiencing anxiety during pregnancy, the prenatal period becomes a crucial target for intervention, considering its predictive role in postpartum anxiety and depression. In low-resource settings, accessing clinical care can be challenging, making interventions like Happy Mother-Healthy Baby valuable in preventing postpartum mental health issues.

“In the future, we can expand on these findings through implementation research. Having identified an effective intervention, the next step is to determine the optimal ways to deliver treatment to those in need, bridging the gap between scientific knowledge and practical application,” concluded Dr. Surkan.


Remember, if you need further guidance or support, don’t hesitate to reach out to your mental health professional or contact us for assistance.