Psychological distress is common during pregnancy. The objective of this thesis was to evaluate the
effectiveness of antenatal cognitive behavioural based treatments in reducing psychological distress in
pregnant women.
A systematic review was undertaken of randomised controlled studies utilizing antenatal cognitive
behavioural based treatment in reducing anxiety and stress compared to treatment as usual. Eleven
papers were identified through a systematic search of databases using predefined criteria comparing
intervention groups to treatment as usual in pregnant women with anxiety or stress. The systematic
review revealed preliminary evidence for the effectiveness of cognitive behavioural based treatment
with several studies noting changes over time in anxiety and stress; however, only a few studies reported
intervention effects when compared to control. While the systematic review results suggest that a small
number of cognitive behavioural based interventions may be effective in reducing anxiety and stress
during pregnancy compared to treatment as usual, confidence in these findings is limited due to
methodological limitations such as lack of follow-up, high attrition rates and difficulties with
generalisability. The evidence base is currently insufficient and further research which utilises a robust
methodology is needed before any reliable conclusions can be drawn.
An empirical study was conducted to examine the effectiveness of a brief, single-session stress
reduction programme introducing cognitive behavioural techniques aimed at reducing general anxiety,
other pregnancy related distress and improving general well-being and pregnancy outcomes. Twenty-nine
participants with clinically significant levels of anxiety were recruited to the empirical study from
the local maternity hospital. Participants completed measures of general anxiety, pregnancy related
anxiety, general well-being and childbirth experience. The control was derived from a historical dataset
where 37 participants were matched for baseline anxiety levels. The empirical study demonstrated
significant reductions in general anxiety; however, similar findings were also observed in the control
group. Significant reductions were observed with pregnancy related anxiety and women also reported
their childbirth experience similarly regardless of delivery type. Although our findings were not
significant when compared to control, our recruitment design resulted in good return rates following
birth. Further studies using sophisticated study design with use of robust control group are required