Perinatal anxiety and potential protective processes are often poorly understood compared to other types of perinatal distress. The present study investigated the relationship between perinatal anxiety and quality of life or life satisfaction in a pregnant sample. Psychological flexibility and self-compassion were examined as moderators of these associations. COVID-19 and other external factors were examined on an exploratory basis. Results indicate significant correlations between perinatal anxiety and satisfaction with life, as well as psychological flexibility and perinatal anxiety; proposed interaction effects were not significant. This study may enhance understanding of these processes and contribute to the growing field of reproductive psychology.
Contemporary prenatal care has made major contributions to maternal and infant health through advances in medical monitoring, risk assessment, and evidence-based intervention. However, within this framework, the fetus is typically positioned as an object of care. This paper proposes Responsive Prenatal Engagement (RPE) as a conceptual framework that reframes the fetus as a relational participant within an emerging parent-child relationship. RPE does not claim evidence of fetal consciousness, intentional communication, or prenatal memory. Rather, it offers a relational perspective for understanding how parents may engage with the unborn child during pregnancy. Drawing on clinical observation, obstetric practice, and scholarship in attachment, prenatal psychology, and early relational development, the framework is organized around three principles: recognition, inclusion, and engagement. These principles describe how parents may acknowledge the fetus as meaningfully present within family life before birth and how such a stance may shape prenatal experience. RPE is presented as a complementary lens to existing models such as prenatal attachment, reflective functioning, and nurturing care, with potential implications for prenatal education, family involvement, and future research.
Prenatal Bonding (BA) is a method of supporting pregnancy that enables a pregnant mother to connect with her unborn child and opens the possibility of mutual communication between the gestational parent and her yet-to-be-born baby. Over time, these communications develop patterns that result in a growing sense of emotional connection, enabling them to experience birth together as a team, something that had never been considered possible by most people, including birth professionals, medical healthcare providers, and psychologists. This retrospective study reviewed the birth outcomes of 295 women who received this method of support during their pregnancies. Results showed that after Prenatal Bonding (BA) facilitation, the need for birth interventions and Cesarean sections are reduced, and breastfeeding rates are increased, while preterm birth, postpartum depression, and infantile colic are exceedingly rare. Because they have already created a connection, the postpartum period becomes a new phase of an existing relationship.
Growing evidence supports the value of compassion-focused therapy (CFT) groups in specialist perinatal mental health community services. However, little is known about their effectiveness in acute inpatient Mother and Baby Units (MBUs), specialist wards for women with severe mental health difficulties and their babies, where stays are short and presentations complex. To our knowledge, this service evaluation is the first to examine a brief, transdiagnostic CFT group for mothers admitted to an MBU. A mixed-methods design assessed a fivesession CFT group (two hours per session, workbook-supported) delivered in an 8-bed MBU. Quantitative data included the Forms of Self-Criticizing/Attacking & Self-Reassuring Scale (FSCRS) and Fears of Compassion Scale (FCS), collected pre- and post-group, alongside sessional ratings of calm and distress and group connection. Qualitative data comprised open-text feedback (n = 56) and semi-structured interviews (n = 6), analyzed using content and reflexive thematic analysis. Large, statistically significant pre-post improvements were observed across FCRS subscales (range: -0.66 to -0.81) and all FCS domains (range: -0.55 to -0.68). Sessional data showed significant changes in calmness and connectedness. On average, mothers attended three of the five sessions. The following qualitative themes were identified: feelings and understandings upon arrival at the MBU, experiencing containment, gaining insight and practical tools, obstacles to engaging with the group, and CFT beyond the MBU. Findings suggest that a brief CFT group is feasible and clinically promising for mothers in an acute MBU, targeting shame reduction, increased safeness, and fears of compassion. Implementation should prioritize facilitator skill, sensory and soothing environments, and inclusive group processes.
This systematic review synthesizes quantitative evidence on factors associated with posttraumatic growth (PTG) in parents following preterm birth. Systematic searches of MEDLINE, Web of Science, PsycINFO, CINAHL, and ProQuest Dissertations & Theses identified peer-reviewed and grey literature published up to August 2025. Studies were included if they involved parents of preterm infants, administered a validated PTG measure at any time after birth, and examined factors related to PTG. Thirteen studies (N = 2,568 parents) met inclusion criteria, with study quality rated as good (n = 2) or fair (n = 11). Across studies, 38 factors were examined. PTG was positively associated with social support, longer neonatal admission, parental well-being, lower gestational age, posttraumatic stress symptoms, resilience, adaptive coping strategies, and deliberate rumination, although some associations were inconsistent or examined in only one study. Overall, findings suggest a complex interplay of demographic, psychological, social, and event-related factors influencing PTG in this population, but methodological heterogeneity limits comparability and the strength of conclusions. Future research should prioritize consistent assessment of key factors and employ longitudinal and intervention designs to inform the development of integrated models of care that address both psychological distress and PTG in parents of preterm infants.
Postpartum nutrition is often discussed as if the primary challenge were food quality. Common recommendations include prioritizing whole foods, focusing on nutrient density, avoiding ultra-processed ingredients, increasing protein intake, balancing blood sugar, and supporting hormones. These recommendations are familiar, widely accepted, and on their own, insufficient. An often-overlooked question is not what postpartum women should eat, but whether their bodies can digest and absorb what they are eating in the first place. This distinction matters more than most clinical conversations allow. Nourishment is not defined by the nutrient content of food alone, but by what the body can break down, transport, and utilize. Food that cannot be digested does not nourish—regardless of how nutrient-dense it appears on paper.
The current study examined whether behavioral activation strategies, characterized by engaging in activities that promote well-being, such as exercise and mindfulness practices, during the COVID-19 pandemic, were associated with postpartum depressive and anxiety symptoms, and whether mental health diagnoses during pregnancy moderated these associations. Participants were 351 mothers of infants aged 8-10 months, drawn from the Perinatal Experience and COVID-19 Effects (PEACE) Study. Participants completed baseline and follow-up surveys via REDCap, assessing demographics, maternal mental health history, depressive and anxiety symptoms, and behavioral activation. Among participants, 29.7% reported clinically relevant depressive symptoms and 19.5% reported generalized anxiety symptoms; 12.8% reported a depression diagnosis and 19.4% reported a generalized anxiety diagnosis. Behavioral activation was associated with fewer postpartum maternal mental health symptoms. Mental health diagnoses during pregnancy were positively associated with postpartum mental health symptoms within this pandemic cohort. Importantly, depression diagnosis during pregnancy moderated the association between behavioral activation and postpartum mental health symptoms, with more behavioral activation linked to lower symptomatology, particularly for mothers with a depression diagnosis. Behavioral activation through work during the pandemic was associated with fewer postpartum mental health symptoms, especially for mothers with a depression or anxiety diagnosis. Engaging in behavioral activation may mitigate postpartum mental health symptoms among mothers with mental health diagnoses during pregnancy. Interventions that promote behavioral activation may enhance maternal resilience during crises.
One of the biggest unknowns in epigenetic research is how to target specific genes to restore their inhibited expression. In this paper, we give a solution to this problem by describing how to target and repair an epigenetically inhibited gene using simple psychological trauma-healing techniques (e.g., Eye Movement Desensitization and Reprocessing (EMDR)). Importantly, we also show how to find the causes of psychological disorders, other diseases of unknown etiology, and the relevant inhibited genes of these disorders and diseases. Together, this means that a psychotherapist, using simple trauma-healing techniques, can target and quickly eliminate a specific psychological disorder in their clients. Most importantly, we can now treat disorders that were not treatable before. In this paper, part two of a three-part series, we derive the subcellular psychobiology theory by examining the biology of the primary cell (Lykkegaard et al., 2024). Using prenatal regression to observe the cell interior, we find that traumatic memories are accessed in ribosomes inside the primary cell. In turn, we show how epigenetically damaged gene coatings are the source of the traumatic feelings found in these memories. Effective trauma-healing techniques take advantage of this intracellular biology. We also discuss some safety issues with research using psychobiology techniques that interact with or change the primary cell’s intracellular biology. Part three of this paper, published in JOPPPAH Summer 2025, provides three examples of practical applications of the subcellular psychobiology theory: dizziness, hearing voices, and Asperger’s syndrome. Keywords: developmental psychobiology, psychoimmunology, primary cell model, epigenetic inheritance, RNA, trauma, trauma epigenetics, trauma psychobiology, trauma biology, WHH, EMDR
The lack of effective treatments for chronic disease and mental disorders is a tragic and growing healthcare crisis. Despite tremendous efforts by generations of researchers and substantial investments, little progress has been made. For example, in the area of psychiatric disorders, this situation has deteriorated to the point where drug companies have essentially abandoned efforts to find pharmacological solutions due to so many years of costly failures. In our view, the lack of progress in these areas is primarily caused by two key problems: an inability to identify the underlying causes of diseases of unknown etiology, and the spiraling costs and difficulties associated with developing effective pharmaceuticals. In this paper, the last in a three-part series, we present a practical solution to these intractable problems. Based on subcellular psychobiology theory, we start with a step-by-step approach for finding the underlying intracellular causes of diseases of unknown etiology, utilizing kinesthetic markers and regression to key developmental traumas. With this, we then show how to design effective treatments using trauma therapy techniques. Keywords: subcellular psychobiology, psycho-immunology, subcellular marker, primary cell, trauma, dizziness, vertigo, vestibular vertigo, benign paroxysmal positional vertigo, mitochondrial disease, Asperger’s syndrome, mind chatter, hearing voices, ribosomal voices, postpartum intrusive thoughts, intrusive thoughts
This article explores the dynamics between experiential play therapy (EPT) and the need to align therapeutic goals with parental expectations. Using two case studies of children 3.5 years old presenting with behavioral issues taken from a larger study, the article examines how play behaviors can be linked to early imprints, especially neonatal trauma, and caregivers’ working models of relationships, highlighting the importance of understanding these connections to break the cycle of intergenerational transmission and foster healthier family dynamics. The cases illustrate how therapists can maintain the core principles of play therapy while addressing concrete parental goals, leading to sustainable improvements in the children’s emotional and relational health. Keywords: Experiential Play Therapy (EPT), neonatal trauma, therapeutic goals, parental expectations, intergenerational transmission
Despite improvements in obstetric care, stillbirth rates in the United States remain disproportionately high among Black birthing individuals, who experience losses at more than twice the rate of non-Hispanic White and Hispanic counterparts. This qualitative study explores the postpartum experiences of Black birthing people following stillbirth, with a focus on social support, emotional responses, and healthcare quality. Thematic analysis of focus group discussions revealed five central themes: the multifaceted nature of social support, complex emotional reactions, interactions with healthcare professionals, the impact of racial concordance in care, and challenges with postpartum follow-up. Participants described inconsistent or absent support, feelings of isolation, and interactions with providers that often lacked empathy and cultural understanding. When racial concordance was present, it enhanced communication and trust but was rarely available. These findings highlight significant gaps in grief-informed and identity-affirming care, as well as the broader systemic inequities that shape care experiences. By centering the voices of Black birthing individuals, this study provides critical insights into the unique challenges faced after stillbirth. It underscores the need for targeted interventions and policy reforms to improve care quality and outcomes. Addressing these gaps is essential to promoting equity and healing for this underserved population. Keywords: Black birthing people, stillbirth, postpartum care, social support, grief, racial disparities, racial concordance, healthcare experiences
In the fifteen years since Every Mother Counts (EMC) was founded, Christy Turlington Burns has become one of the most visible and influential advocates for maternal health, globally and in the United States. What began as a deeply personal experience has grown into an international movement with a mission to make the maternal health journey before, during, and after childbirth safe for everyone, everywhere. “I became a maternal health advocate the day I became a mother,” Turlington Burns recalls. “That was the day I also became a statistic.” After experiencing a postpartum hemorrhage following the birth of her first child, she discovered that hundreds of thousands of women around the world die each year from similar, preventable complications. Intergenerational awareness also fuels her advocacy, knowing firsthand how the death of a mother reverberates over time in families. She recounts, “My mother’s paternal grandmother died in childbirth. Her husband and children never recovered from that loss.” Keywords: Christy Turlington Burns, Every Mother Counts, maternal health advocacy, global maternal mortality, maternal health equity
This study explored the experiences of Brazilian pregnant women who underwent mindfulness and self-compassion training during pregnancy. Using a qualitative approach and interpretative phenomenological analysis (IPA), the subjective experiences of participants in a 9-week Mindful Self-Compassion (MSC) program were examined. Analysis of the transcripts revealed four main themes: perceived benefits of MSC during pregnancy, challenges faced during the program, evaluations of the online format, and anticipated future use of learned skills. Participants identified challenges such as fatigue and physical limitations but found MSC training to be a valuable tool for self-care, well-being, and mental health during gestation. The findings underscore the role of MSC in enhancing emotional resilience and coping strategies during pregnancy, with participants expecting to apply these skills postpartum. The study advocates for the integration of MSC training into prenatal care to support maternal mental health and improve outcomes for mothers and children.
Birth trauma and pregnancy-related distress are common issues for women and birthing people. The North Cumbria Maternal Mental Health Service (MMHS) was established in March 2022 in direct response to the NHS (NHS, 2019a), which called for the implementation of regional maternal mental health services and support networks. This paper evaluates the performance and effectiveness of the North Cumbria MMHS during the 2023–2024 financial year, taking into account local and national challenges and their clinical implications. Patient outcome data, collected using the Clinical Outcomes in Routine Evaluation 10 and the Warwick–Edinburgh Mental Well-being Scale, were analyzed to assess service effectiveness across 2023–2024. A thematic analysis was conducted of all qualitative patient feedback. A Wilcoxon signed–rank test showed a significant reduction in psychological distress and a significant increase in mental well-being post-intervention (p = .005). Most participant feedback was positive, and thematic analysis yielded five key themes: the importance of the therapeutic relationship, gratitude, the return to self, tools for moving forward, and areas for improvement. In conclusion, notable improvements in post-treatment outcomes were observed, and patient feedback was overwhelmingly positive. The data indicate that, despite significant challenges, the North Cumbria MMHS provides a vital and effective service to women and birthing people, offering unique insight into regional MMHS operations.
This article, "From Eugenics to Evidence: A Historical Perspective on Prenatal Physical Activity Guidelines and Their Present Impact on Maternal Health," traces the evolution of prenatal physical activity guidelines from their origins in eugenics to contemporary evidence-based practices. The review highlights how long-standing medical caution and cultural norms have shaped perceptions of pregnancy and exercise, often leading to low participation rates and inconsistent provider guidance. By examining historical influences and current maternal health outcomes, the author recommends better alignment between evidence-based recommendations and clinical practice to improve health outcomes for mothers and their babies. The article highlights the importance of incorporating historical context into modern healthcare practices to improve maternal health and well-being.
One of the biggest unknowns in epigenetic research is how to target specific genes to restore their inhibited expression. In this paper, we give a solution to this problem by describing how to target and repair an epigenetically inhibited gene using simple psychological trauma-healing techniques (e.g., Eye Movement Desensitization and Reprocessing (EMDR)). Importantly, we also show how to find the causes of psychological disorders, other diseases of unknown etiology, and the relevant inhibited genes of these disorders and diseases. Together, this means that a psychotherapist, using simple trauma-healing techniques, can target and quickly eliminate a specific psychological disorder in their clients. Most importantly, we can now treat disorders that were not treatable before. In this paper, part two of a three-part series, we derive the subcellular psychobiology theory by examining the biology of the primary cell (Lykkegaard et al., 2024). Using prenatal regression to observe the cell interior, we find that traumatic memories are accessed in ribosomes inside the primary cell. In turn, we show how epigenetically damaged gene coatings are the source of the traumatic feelings found in these memories. Effective trauma-healing techniques take advantage of this intracellular biology. We also discuss some safety issues with research using psychobiology techniques that interact with or change the primary cell’s intracellular biology. Part three of this paper (published in JOPPPAH Summer 2025) gives three examples of practical applications of the subcellular psychobiology theory: dizziness, hearing voices, and Asperger’s Syndrome.
Postpartum depression (PPD) is defined as a depressive episode occurring within the first year after delivery. This study aims to identify risk factors associated with higher Edinburgh Postpartum Depression Scale (EPDS) scores and evaluate the impact of a 3-week postpartum telehealth appointment on these scores. A retrospective chart review was conducted on 252 patients who delivered at a single academic center, with 114 deliveries occurring before and 138 after the implementation of the telehealth visit. Of these, 106 patients completed the telehealth visit. Data on patient demographics, pregnancy, maternal health, and delivery were collected. Statistical analyses were performed using ANOVA and student’s t-test, with a significance threshold of p < 0.05. The results showed no significant correlation between EPDS scores and maternal or gestational age at delivery, parity, type of delivery, complications, or NICU admission. However, Black patients had significantly higher EPDS scores compared to other racial groups (p = 0.038). Patients with any mental health diagnosis (p < 0.01) and those with a history of postpartum depression (p < 0.01) also had significantly higher EPDS scores. Implementing the postpartum telehealth visit did not result in a significant decrease in EPDS scores, nor was there a significant difference between patients who completed the visit and those who did not. This study underscores the need for additional or alternative interventions to reduce the risk of postpartum depression effectively.
The visual arts serve as a valuable means for accessing prenatal experiences, including the representation of traumas within the framework of prenatal aesthetics using the model of Laplanche’s fundamental anthropological situation and Lacan’s paradigm of the real, imaginary, and symbolic aspects of psychological reality. This study examines the drawings of thirteen patients suffering from somatoform pain through the lens of prenatal experiences. They participated in an art therapy group, creating various drawings, with psychoanalytical interviews conducted before and after the drawing sessions. The drawings were analyzed using Visual Grounded Theory, while the interviews underwent Content Analysis. Specifically, details related to the inner garden topic were examined under the category container-position relation (that reflects the relational position of elements within a container) to reveal insights into prenatal experiences, followed by a co-occurrence analysis to determine additional categories associated with these pictorial details. This analysis identified frequent supplying elements alongside others reflecting corporeality or bodily boundaries. Many of these representations were negative, portraying the container (mother) as a grave or coffin and the contained element (baby) as defenseless and dark in color. Fragmentation observed in the drawings suggests an expression of a fragmented body, with some details coded under trauma-related categories (e.g., position field). The findings indicate a potential link between pictorial references to prenatal traumas and the pain experienced by participants, which may inform approaches in both psychotherapy and art therapy.
The postpartum period is associated with a high prevalence of maternal mortality and morbidity, particularly among rural communities. This study aimed to identify differences in the perceived benefit of the postpartum visit among participants in rural and non-rural counties. This cross-sectional study recruited postpartum mothers from counties in north-central Florida. Participants completed an online survey focused on experiences during pregnancy, birth, and postpartum. Eligibility criteria included being at least 18 and giving birth to a healthy, full-term, singleton infant in the past year. Mann-Whitney U and Fisher's exact tests were used to compare the differences in mothers from rural versus non-rural counties. Participants (N = 91) lived in rural (n = 18) and non-rural counties (n = 73), and most attended the postpartum visit (93.8% of rural and 97.2% of non-rural participants). Rural participants reported higher scores in receiving information on health services (4.24 vs. 3.6, p = 0.02), physical health (4.24 vs. 3.43, p = 0.01), and mood changes (3.71 vs. 3.21, p = 0.14) compared to non-rural participants. Rural participants perceived greater benefits from the postpartum visit than non-rural participants, highlighting the need to explore why attendance rates at this visit are often low for mothers from rural counties. These results support the need to restructure postpartum care to meet the needs of mothers from all areas and make policy changes to support mothers. Future research should explore the individual barriers and facilitators to postpartum care for those in rural versus non-rural areas.
Adverse childhood experiences (ACEs) are associated with numerous adverse health outcomes, including risky sexual behaviors and sexually transmitted infections (STIs) in non-pregnant individuals. However, limited data exist on the relationship between high ACE scores (≥ 4) and STIs during pregnancy. This study evaluated the association between high ACE scores and STI positivity among 855 pregnant and postpartum individuals. Using logistic regression, we assessed STI diagnoses (lower genital tract infections, HIV, syphilis, HSV, and hepatitis C) relative to ACE scores. Results indicated that high ACE scores were associated with increased odds of lower genital tract infection during pregnancy in univariate analysis but not in adjusted models. Additionally, no significant association was found between high ACE scores and overall STI positivity or hepatitis C infection. While high ACE scores were prevalent in the cohort (37%), further research is needed to determine if ACE scores can be used in screening for STIs during pregnancy. Keywords: pregnancy, adverse childhood experiences, ACE score, sexually transmitted infections, STI, lower genital tract infection, risky sexual behaviors, maternal health, hepatitis C
