Bakhuis CF, Suelmann BB, van Dooijeweert C, Moelans CB, van der Wall E, van Diest PJ Breast cancer during pregnancy and the postpartum period: challenging diagnosis of an aggressive disease. Ned Tijdschr Geneeskd. 2023; 167:D7631-D7631

Bhutta ZA, Bhavnani S, Betancourt TS, Tomlinson M, Patel V Adverse childhood experiences and lifelong health. Nat Med. 2023; 29:(7)1639-1648

Bryson H, Perlen S, Price A, Mensah F, Gold L, Dakin P, Goldfeld S Patterns of maternal depression, anxiety, and stress symptoms from pregnancy to 5 years postpartum in an Australian cohort experiencing adversity. Arch Womens Mental Health. 2021; 24:(6)987-997

Cameron EE, Sedov ID, Tomfohr-Madsen LM Prevalence of paternal depression in pregnancy and the postpartum: an updated meta-analysis. J Affect Disord. 2016; 206:189-203

Carlbring P, Andersson G, Cuijpers P, Riper H, Hedman-Lagerlöf E Internet-based vs. face-to-face cognitive behavior therapy for psychiatric and somatic disorders: an updated systematic review and meta-analysis. Cognitive Behav Ther. 2018; 47:(1)1-18

CBTALKS. EP14 managing mental health during pregnancy. 2022a. https// (accessed 28 February 2024)

CBTALKS. EP11 the role of mental health in perinatal care. 2022b. https// (accessed 28 February 2022)

Chhabra J, McDermott B, Li W Risk factors for paternal perinatal depression and anxiety: a systematic review and meta-analysis. Psychol Men Masculin. 2020; 21:(4)

Clinkscales N, Golds L, Berlouis K, MacBeth A The effectiveness of psychological interventions for anxiety in the perinatal period: a systematic review and meta-analysis. Psychol Psychother. 2023; 96:(2)296-327

Cuijpers P, Karyotaki E The effects of psychological treatment of perinatal depression: an overview. Arch Womens Ment Health. 2021; 24:801-806

Cuijpers P, Franco P, Ciharova M Psychological treatment of perinatal depression: a meta-analysis. Psychol Med. 2023; 53:(6)2596-2608

Darwin Z, Domoney J, Iles J, Bristow F, Siew J, Sethna V Assessing the mental health of fathers, other co-parents, and partners in the perinatal period: mixed methods evidence synthesis. Front Psychiatry. 2021; 11

Delap N Trauma-informed care of perinatal women. In: Abbott L (ed). Switzerland: Springer Cham; 2021

De Natale A, Hall S, McFadyen A, Minnis H, Blane DN ‘Breaking the cycle’: a qualitative study exploring general practitioners' views of infant mental health. BJGP Open. 2023; 7:(4)

Dennis C L, Falah-Hassani K, Shiri R Prevalence of antenatal and postnatal anxiety: systematic review and meta-analysis. Br J Psychiatry. 2017; 210:(5)315-323

Falah-Hassani K, Shiri R, Dennis CL The prevalence of antenatal and postnatal co-morbid anxiety and depression: a meta-analysis. Psychological Medicine. 2017; 47:(12)2041-2053

Ford E, Roomi H, Hugh H, van Marwijk H Understanding barriers to women seeking and receiving help for perinatal mental health problems in UK general practice: development of a questionnaire. Prim Health Care Res Dev. 2019; 20

Giallo R, D'Esposito F, Christensen D Father mental health during the early parenting period: results of an Australian population based longitudinal study. Soc Psychiatry Psychiatr Epidemiol. 2012; 47:(12)1907-1916

Gournay K, Haddad M, Clough I Digital mental health platforms. Br J Midwifery. 2023; 31:(4)232-235

Heys S, Downe S, Thomson G ‘I know my place’; a meta-ethnographic synthesis of disadvantaged and vulnerable women's negative experiences of maternity care in high-income countries. Midwifery. 2021; 103

Hoffman C, Dunn DM, Njoroge WF Impact of postpartum mental illness upon infant development. Curr Psychiatry Rep. 2017; 19:1-6

Hunter LJ, Da Motta G, McCourt C Better together: a qualitative exploration of women's perceptions and experiences of group antenatal care. Women Birth. 2019; 32:(4)336-345

Huschke S, Murphy-Tighe S, Barry M Perinatal mental health in Ireland: a scoping review. Midwifery. 2020; 89

Iturralde E, Hsiao CA, Nkemere L Engagement in perinatal depression treatment: a qualitative study of barriers across and within racial/ethnic groups. BMC Pregnancy Childbirth. 2021; 21:(1)1-11

Izett E, Rooney R, Prescott SL, De Palma M, McDevitt M Prevention of mental health difficulties for children aged 0–3 years: a review. Front Psychol. 2021; 11

Johansson M, Benderix Y, Svensson I Mothers' and fathers' lived experiences of postpartum depression and parental stress after childbirth: a qualitative study. Int J Qual Stud Health Well-being. 2020; 15:(1)

Kranenburg L, Lambregtse-van den Berg M, Stramrood C Traumatic childbirth experience and childbirth-related post-traumatic stress disorder (PTSD): a contemporary overview. Int J Environ Res Public Health. 2023; 20:(4)

Saving lives, improving mothers' care core report - lessons learned to inform maternity care from the UK and Ireland confidential enquiries into maternal deaths and morbidity 2019-21. In: Knight M, Bunch K, Felker A (eds). Oxford: National Perinatal Epidemiology Unit, University of Oxford; 2023

Lattie EG, Stiles-Shields C, Graham AK An overview of and recommendations for more accessible digital mental health services. Nat Rev Psychol. 2022; 1:87-100

Leach LS, Poyser C, Fairweather-Schmidt K Maternal perinatal anxiety: a review of prevalence and correlates. Clin Psychol. 2017; 21:(1)4-19

Leiferman JA, Farewell CV, Jewell J Anxiety among fathers during the prenatal and postpartum period: a meta-analysis. J Psychosom Obstet Gynecol. 2021; 42:(2)152-161

Loughnan SA, Joubert AE, Grierson A Internet-delivered psychological interventions for clinical anxiety and depression in perinatal women: a systematic review and meta-analysis. Arch Womens Ment Health. 2019; 22:737-750

Mental Health Foundation. Mental Health Foundation strategy 2020-2025 making prevention happen. 2020. https// (accessed 5 March 2024)

Mohr DC, Ho J, Duffecy J Effect of telephone-administered vs face-to-face cognitive behavioral therapy on adherence to therapy and depression outcomes among primary care patients: a randomized trial. JAMA. 2012; 307:(21)2278-2285

National Institute for Health and Care Excellence. Eight digitally enabled therapies to treat depression and anxiety in adults conditionally recommended by NICE. 2023. https// (accessed 5 March 2024)

Olthuis JV, Watt MC, Bailey K, Hayden JA, Stewart SH Therapist-supported internet cognitive behavioural therapy for anxiety disorders in adults. Cochrane Database Syst Rev. 2016; (3)

Philpott LF, Savage E, FitzGerald S, Leahy-Warren P Anxiety in fathers in the perinatal period: a systematic review. Midwifery. 2019; 76:54-101

Sambrook Smith M, Lawrence V, Sadler E Barriers to accessing mental health services for women with perinatal mental illness: systematic review and meta-synthesis of qualitative studies in the UK. BMJ Open. 2019; 9

SilverCloud. Eva's case study. 2024. https// (accessed 28 February 2024)

Watson K, White C, Hall H, Hewitt A Women's experiences of birth trauma: a scoping review. Women Birth. 2021; 34:(5)417-424

Webb R, Uddin N, Constantinou G Meta-review of the barriers and facilitators to women accessing perinatal mental healthcare. BMJ Open. 2023; 13:(7)

Woolhouse H, Brown S, Krastev A, Perlen S, Gunn J Seeking help for anxiety and depression after childbirth: results of the Maternal Health Study. Arch Womens Mental Health. 2009; 12:75-83

Zhou X, Snoswell CL, Harding LE The role of telehealth in reducing the mental health burden from COVID-19. Telemed J E Health. 2020; 26:(4)377-379

Digitally enabled perinatal mental health programmes' role in contemporary maternity care

02 April 2024
Volume 32 · Issue 4


This article explores the use of digitally enabled programmes to support perinatal mental healthcare in the NHS. Focusing on the Perinatal Wellbeing Programme from SilverCloud® by Amwell®, participant experiences drawn from published case studies are considered. With mental health conditions recognised as a continued and significant cause of maternal death in the UK, the need for innovative, flexible and effective interventions and support has never been more important. Exploring the place of digitally enabled programmes in contemporary midwifery practice, and the need for further evidence of their efficacy, this article continues the discourse of a previously published article on digital mental health platforms.

Mental health conditions continue to account for a significant portion of maternal deaths in the UK; in the most recent MBRRACE-UK report, mental health conditions accounted for 10% of maternal deaths (Knight et al, 2023). This report emphasised that pregnant, recently pregnant and breastfeeding women must be treated in the same way as a non-pregnant person, unless there is a very clear reason not to. This reduces the risk of missed diagnosis or treatment where symptoms may be attributed to a benign perinatal cause. This situation was highlighted recently in relation to breast cancer occurring during pregnancy (Bakhuis et al, 2023), and is further emphasised by the National Institute for Health and Care Excellence (2023) conditionally recommending eight digitally enabled therapies to treat depression and anxiety in adults. However, this does not make specific mention of their use in the perinatal period. This article continues the discourse of a previously published article (Gournay et al, 2023), which explored digital mental health platforms.

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