title: Reducing maternal anxiety and stress in pregnancy: what is the best approach?
abstract: OBJECTIVE
  To briefly review results of the latest research on approaching antenatal maternal anxiety and stress as distinct constructs within a broad spectrum of maternal antenatal distress and the preventive strategic role of the maternal healthcare practitioner.
  
  
  RESULTS
  Maternal antenatal anxiety and stress are predominant contributors to short and long-term ill health and reduction of these psychological constructs is evident. Anxiety and stress belong to a broad spectrum of different psychological constructs. Various psychometric instruments are available to measure different individual constructs of antenatal maternal emotional health. Using multiple measures within antenatal care would imply a one-dimensional approach of individual constructs, resulting in inadequate management of care and inefficient use of knowledge and skills of maternity healthcare practitioners. A case-finding approach with slight emphasis on antenatal anxiety with subsequent selection of at-risk women and women suffering from maternal distress are shown to be effective preventive strategies and are consistent with the update of the National Institute for Health and Care Excellence guideline 'Antenatal and postnatal mental health'. Educational aspects of this approach are related to screening and assessment.
  
  
  CONCLUSIONS
  A shift in perception and attitude towards a broad theoretical and practical approach of antenatal maternal mental health and well-being is required. Case finding with subsequent selective and indicated preventive strategies during pregnancy would conform to this approach and are evidence based.
authors.affiliation: Department of Midwifery Science, Midwifery Education and Studies Maastricht-ZUYD, Maastricht, The Netherlands.
authors.forename: Yvonne
authors.initials: Y
authors.lastname: Fontein-Kuipers
mesh_terms: D000328:Adult; D001007:Anxiety / Q000175:diagnosis* / Q000209:etiology / Q000628:therapy; D005260:Female; D006801:Humans; D008427:Maternal Health Services / Q000458:organization & administration*; D008603:Mental Health; D017410:Practice Guidelines as Topic; D011247:Pregnancy; D011248:Pregnancy Complications / Q000175:diagnosis* / Q000517:prevention & control / Q000628:therapy; D011295:Prenatal Care; D012307:Risk Factors; D013315:Stress, Psychological / Q000175:diagnosis* / Q000209:etiology / Q000628:therapy