Nottingham Maternity Research Network
University of Nottingham

Reducing Anxiety in Pregnancy: A pilot study of an intervention to support women with mild to moderate anxiety in pregnancy


It has been really beneficial to work with Network members. I have been able to strengthen my study protocol and recruitment plan and develop study materials that are coherent and useful to women. 
Dr Kerry Evans

Each year approximately 750,000 pregnant women use midwifery services in the UK, and it is estimated that 14% of women experience symptoms of anxiety in pregnancy. Anxiety disorders are associated with postnatal depression, low birthweight, premature birth and developmental and behavioural problems in children. For women with mild to moderate anxiety, psychological support may help reduce anxiety and prevent their symptoms becoming more severe. However, services have not been developed or rigorously tested in pregnancy.

This project aims to conduct a pilot study to test an innovative approach to care for pregnant women with symptoms of mild to moderate anxiety. The research is being proposed by Dr. Kerry Evans for funding from the National Institute for Health Research (NIHR) and Health Education England (HEE) as part of a Clinical Lectureship award.

Work completed as a doctoral study in 2017 included the development and feasibility testing of the new intervention. The intervention consists of groups sessions facilitated by a midwife, individual midwife support and self-help materials. A service-user reference group, including Network members, helped to decide the format of the groups and the range of self-help materials. Further refinements to the design were developed following feedback from Network members and women from minority ethnic groups. Engagement activities have led to changes in the recruitment plan, the location of groups and the way the study will be presented and introduced to women.

An advisory panel of Network members have agreed to support the study through the three-year process. 


Evans K, Spiby H & Morrell C J (2020). Non-pharmacological interventions to reduce symptoms of mild to moderate anxiety in pregnant women. Systematic Review and Narrative Synthesis of women’s views on the acceptability of and satisfaction with interventions. Archives of Women’s Mental Health 23(1): 11-28.[Open access]

Evans K., Morrell C J & Spiby H. (2018). Systematic review and meta-analysis of non-pharmacological interventions to reduce the symptoms of mild to moderate anxiety in pregnant women. Journal of Advanced Nursing, 74(2):289-309. [Open access version here]

Evans K, Morrell C J & Spiby H. (2016). Women’s views on anxiety in pregnancy and the use of anxiety instruments: A Qualitative study. Journal of Reproductive and Infant Psychology 35(1): 77-91 [Open access version here]

Evans K, Spiby H & Morrell C J (2015). A psychometric systematic review of self-report instruments to identify anxiety in pregnancy. Journal of Advanced Nursing. 71(9), 1986-2001.

Nottingham Maternity Research Network

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