Women's mental health nursing: depression, anxiety and stress during pregnancy


D. A. Parcells
9951 Lago Dr
Boynton Beach
FL 33437
E-mail: dax.parcells@alum.emory.edu


Accessible summary

  • • Despite recognition of the diagnostic implications of postpartum depression, prenatal depression remains an often-overlooked condition. Nonetheless, researchers recognize considerable negative effects of maternal psychosocial distress on newborns and infants.
  • • The current study assessed maternal depression, anxiety and stress of 59 pregnant women (average age = 22 years) at 26–28 and 32–34 weeks of pregnancy. Measures included clinical interviews, maternal self-report and an estimate of the stress hormone cortisol from maternal saliva samples.
  • • The results indicated high incidences of prenatal depression, anxiety and stress across the third trimester. Therefore, the diagnosis of psychosocial conditions in women of childbearing age requires continued application of a caring nursing framework and open communication between patients, families and caregivers. Self-report measures may suffice in reaching a probable diagnosis, yet additional information may be extracted using a structured clinical interview for formal diagnosis.
  • • Moreover, women of childbearing age need to appreciate the potential negative impact of maternal psychosocial distress on their lives and on foetal and infant development. Hopefully, continued dialogue will eliminate any associated stigma with mental health diagnosis and treatment, especially before, during and after pregnancy.
  • • Finally, women and families need to understand a variety of treatment options, including social support, counselling and possibly medication, exist for these conditions. Nonetheless, treatment decisions require weighing the pros and cons with the help of a physician or nurse.


Depression affects more women than men, with a preponderance of cases occurring during prime childbearing years (15–44 years of age). Research shows newborns and infants exposed to maternal antepartum depression, anxiety and stress exhibit pronounced neurobiobehavioral dysregularities. The present study investigated the relationship between maternal psychosocial and biochemical profiles during the antepartum period. Participants were recruited from prenatal registration at a large metropolitan hospital in the southeastern USA – the sample consisted of 59 pregnant women (mean age = 22 years). Structured clinical interviews and maternal self-report were utilized to assess maternal psychosocial distress at mid- (26–28 weeks) and late- (32–34 weeks) gestation. Salivary cortisol levels served as an objective stress measure. The resultant high incidences of maternal depression, anxiety and stress provide evidence of the need for nurses to closely monitor psychosocial and biochemical profiles of all women to thwart the negative effects on the developing human foetus. Clinical nursing implications of the requisite consideration of antepartum maternal psychosocial conditions are discussed.