A new study reveals that therapy during pregnancy can significantly reduce the chances of postpartum depression and anxiety by addressing anxiety in expectant mothers.
The study, involving 1,200 pregnant women in Pakistan, found that those who received Cognitive Behavioral Therapy (CBT)—a form of talk therapy that helps change negative thought patterns—had an 81% lower risk of developing postpartum depression or moderate-to-severe anxiety compared to those who received standard care. Only 12% of women in the therapy group developed postpartum depression, compared to 41% in the control group.
Led by Pamela Surkan from Johns Hopkins University, in collaboration with the University of Liverpool and the Human Development Research Foundation Pakistan, the research highlights the importance of mental health during pregnancy. Surkan emphasized, “We hope this research leads to real-world changes. Every pregnant woman deserves the opportunity to thrive, and mental health must be recognized as a core part of maternal health everywhere.”
In addition to reducing depression, the therapy also had positive effects on pregnancy outcomes. Women who attended five or more therapy sessions had a 39% lower risk of having a low-birth-weight baby (under 2.5 kg) and a 32% lower chance of delivering a smaller-than-expected baby.
The study’s approach was designed to be both affordable and scalable. Therapy sessions were provided by trained, non-specialist counselors at a public hospital in Rawalpindi, making the intervention accessible to health systems even without specialized clinicians.
In Pakistan, up to 49% of pregnant women experience anxiety, yet mental health care remains difficult to access. Prenatal anxiety is often overlooked in public health systems, despite its long-term impact on both mothers and children.
The research partnership, which started at a global mental health conference in Washington, D.C. in 2012, continued through a seven-year collaboration, with findings from the main trial published in March 2024. The project has produced one of the world’s largest datasets on prenatal anxiety in low- and middle-income countries, and it includes a comprehensive intervention manual for broader use.
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