SavedAdd your journal

Journals / Ebelik ve Sağlık Bilimleri Dergisi / 2026 / Volume: 9 Issue: 3

Positive Mental Health in the Perinatal Period: Biopsychosocial Factors and Intervention Strategies

Özge Nur Muslu(KARADENİZ TEKNİK ÜNİVERSİTESİ, EDEBİYAT FAKÜLTESİ)0000-0002-1297-8669
Pages
—
Publication Date
2026-09-30
🏛️Bibliographic metadata and full text access for this article are provided via DergiPark.
DergiPark Record ↗
✨

AI Summary & Key Takeaways

AI Insight
⚡ TL;DR(Too Long; Didn't Read)

It was found that biological (hormonal changes, physical health conditions), psychosocial (social support, levels of stress and anxiety, individual resilience), and environmental (cultural norms, access to healthcare services, economic status) factors influence positive mental health in the perinatal period in a multidimensional manner.

📌 3 Key Takeaways

🎯
Objective & Hypothesis:The aim of this review is to examine the biological, psychosocial, and environmental factors affecting positive mental health during the perinatal period in light of current literature, and to identify effective intervention strategies for promoting positive mental health.
📊
Key Findings & Data:This narrative review was based on a structured literature search conducted in PubMed, Scopus, Web of Science, and CINAHL for studies published between 2000 and 2025.
💡
Conclusion & Impact:It was found that biological (hormonal changes, physical health conditions), psychosocial (social support, levels of stress and anxiety, individual resilience), and environmental (cultural norms, access to healthcare services, economic status) factors influence positive mental health in the perinatal period in a multidimensional manner.
🔬Design:Review & Systematic Survey
📍Scope:2000 Verileri
⚙️Variables:Perinatal period · Positive mental health · Positive psychology

Abstract

The aim of this review is to examine the biological, psychosocial, and environmental factors affecting positive mental health during the perinatal period in light of current literature, and to identify effective intervention strategies for promoting positive mental health. This narrative review was based on a structured literature search conducted in PubMed, Scopus, Web of Science, and CINAHL for studies published between 2000 and 2025. Keywords related to the perinatal period, positive mental health, well-being, resilience, social support, and interventions were used. Eligible studies published in English and Turkish were grouped by study design and synthesized thematically within a biopsychosocial framework. It was found that biological (hormonal changes, physical health conditions), psychosocial (social support, levels of stress and anxiety, individual resilience), and environmental (cultural norms, access to healthcare services, economic status) factors influence positive mental health in the perinatal period in a multidimensional manner. Furthermore, psychoeducation programs, mindfulness-based interventions, strengthening of social support systems, and positive psychology approaches were identified as effective in promoting perinatal mental well-being. Promoting positive mental health during the perinatal period is a critical priority for the health of both mother and child, as well as for public health. Interventions should adopt a biopsychosocial approach and emphasize the importance of early detection and comprehensive support programs. Additionally, it is recommended to develop community-based interventions that encourage paternal and family involvement.

Özet

The aim of this review is to examine the biological, psychosocial, and environmental factors affecting positive mental health during the perinatal period in light of current literature, and to identify effective intervention strategies for promoting positive mental health. This narrative review was based on a structured literature search conducted in PubMed, Scopus, Web of Science, and CINAHL for studies published between 2000 and 2025. Keywords related to the perinatal period, positive mental health, well-being, resilience, social support, and interventions were used. Eligible studies published in English and Turkish were grouped by study design and synthesized thematically within a biopsychosocial framework. It was found that biological (hormonal changes, physical health conditions), psychosocial (social support, levels of stress and anxiety, individual resilience), and environmental (cultural norms, access to healthcare services, economic status) factors influence positive mental health in the perinatal period in a multidimensional manner. Furthermore, psychoeducation programs, mindfulness-based interventions, strengthening of social support systems, and positive psychology approaches were identified as effective in promoting perinatal mental well-being. Promoting positive mental health during the perinatal period is a critical priority for the health of both mother and child, as well as for public health. Interventions should adopt a biopsychosocial approach and emphasize the importance of early detection and comprehensive support programs. Additionally, it is recommended to develop community-based interventions that encourage paternal and family involvement.

🔖

Cite This Article

Muslu, Ö. N. (2026). Positive Mental Health in the Perinatal Period: Biopsychosocial Factors and Intervention Strategies. Ebelik ve Sağlık Bilimleri Dergisi, Volume: 9 Issue: 3. https://doi.org/10.62425/esbder.1686834

📄 Full Text PDF Viewer

📄

PDF görüntüleyici hazırlanıyor...

References (67)

  1. Anyanwu, I. S., & Jenkins, J. (2024). Effectiveness of digital health interventions for perinatal depression: A systematic review and meta-analysis. Oxford Open Digital Health, 2, oqae026. 10.1093/oodh/oqae026.
  2. Ayers, S. (2004). Delivery as a traumatic event: Prevalence, risk factors, and treatment for postnatal posttraumatic stress disorder. Clinical Obstetrics and Gynecology, 47(3), 552–567. https://doi.org/10.1097/01.grf.0000132522.97952.6d
  3. Bannink, F. P. (2014). Positive CBT: From reducing distress to building success. Journal of Contemporary Psychotherapy, 44(1), 1–8. https://doi.org/10.1007/s10879-013-9242-8
  4. Bastani, F., Hidarnia, A., Montgomery, K. S., Aguilar-Vafaei, M. E., & Kazemnejad, A. (2006). Does relaxation education in anxious primigravid Iranian women influence adverse pregnancy outcomes?: a randomized controlled trial. The Journal of Perinatal & Neonatal Nursing, 20(2), 138-146. 10.1097/00005237-200604000-00005.
  5. Biaggi, A., Conroy, S., Pawlby, S., & Pariante, C. M. (2016). Identifying the women at risk of antenatal anxiety and depression: A systematic review. Journal of Affective Disorders, 191, 62–77. https://doi.org/10.1016/j.jad.2015.11.014
  6. Bloch, M., Daly, R. C., & Rubinow, D. R. (2003). Endocrine factors in the etiology of postpartum depression. Comprehensive Psychiatry, 44(3), 234–246. https://doi.org/10.1016/S0010-440X(03)00034-8
  7. Bornstein, M. H. (2013). Cultural approaches to parenting. Psychology Press. https://doi.org/10.4324/9780203772676
  8. Britton, J. R. (2008). Maternal anxiety: Course and antecedents during the early postpartum period. Depression and Anxiety, 25(9), 793–800. https://doi.org/10.1002/da.20325
  9. Collins, C. H., Zimmerman, C., & Howard, L. M. (2011). Refugee, asylum seeker, immigrant women and postnatal depression: Rates and risk factors. Archives of Women's Mental Health, 14(1), 3–11. https://doi.org/10.1007/s00737-010-0198-7
  10. Corno, G., Espinoza, M., & Baños, R. M. (2019). A narrative review of positive psychology interventions for women during the perinatal period. Journal of Obstetrics and Gynaecology, 39(7), 889–895. https://doi.org/10.1080/01443615.2019.1581735
  11. Cox, J. L., Holden, J. M., & Sagovsky, R. (1987). Detection of postnatal depression: Development of the 10-item Edinburgh Postnatal Depression Scale. British Journal of Psychiatry, 150(6), 782–786. https://doi.org/10.1192/bjp.150.6.782
  12. Dennis, C.-L., & Letourneau, N. (2007). Global and relationship-specific perceptions of support and the development of postpartum depressive symptomatology. Social Psychiatry and Psychiatric Epidemiology, 42(5), 389–395. https://doi.org/10.1007/s00127-007-0180-0
  13. Dunkel Schetter, C., & Tanner, L. (2012). Anxiety, depression and stress in pregnancy: Implications for mothers, children, research, and practice. Current Opinion in Psychiatry, 25(2), 141–148. https://doi.org/10.1097/YCO.0b013e3283503680
  14. Edge, D., & MacKian, S. C. (2010). Ethnicity and mental health encounters in primary care: help-seeking and help-giving for perinatal depression among Black Caribbean women in the UK. Ethnicity & Health, 15(1), 93-111. 10.1080/13557858.2009.484461.
  15. Enatescu, V.-R., Bernad, E., Gluhovschi, A., Papava, I., Romosan, R., Palicsak, A., Munteanu, R., Craina, M., & Enatescu, I. (2017). Perinatal characteristics and mother’s personality profile associated with increased likelihood of postpartum depression occurrence in a Romanian outpatient sample. Journal of Mental Health, 26(3), 212–219. https://doi.org/10.3109/09638237.2016.1149802
  16. Fan, X., Wu, N., Tu, Y., Zang, T., Bai, J., Peng, G., & Liu, Y. (2024). Perinatal depression and infant and toddler neurodevelopment: A systematic review and meta-analysis. Neuroscience & Biobehavioral Reviews, 159, 105579. https://doi.org/10.1016/j.neubiorev.2024.105579
  17. Felder, J. N., Roubinov, D., Bush, N. R., Coleman‐Phox, K., Vieten, C., Laraia, B.,. & Epel, E. (2018). Effect of prenatal mindfulness training on depressive symptom severity through 18‐months postpartum: A latent profile analysis. Journal of Clinical Psychology, 74(7), 1117-1125. 10.1002/jclp.22617.
  18. Feldman, R. (2015). Sensitive periods in human social development: New insights from research on oxytocin, synchrony, and high-risk parenting. Development and Psychopathology, 27(2), 369–395. https://doi.org/10.1017/S0954579415000048
  19. Feldman, R., Weller, A., Zagoory-Sharon, O., & Levine, A. (2007). Evidence for a neuroendocrinological foundation of human affiliation: Plasma oxytocin levels across pregnancy and the postpartum period predict mother-infant bonding. Psychological Science, 18(11), 965–970. https://doi.org/10.1111/j.1467-9280.2007.02010.x
  20. Fonseca, A., & Canavarro, M. C. (2018). Exploring the paths between dysfunctional attitudes towards motherhood and postpartum depressive symptoms: The moderating role of self‐compassion. Clinical Psychology & Psychotherapy, 25(e96–e106). https://doi.org/10.1002/cpp.2145
  21. Fredrickson, B. L. (2001). The role of positive emotions in positive psychology: The Broaden-and-Build Theory of positive emotions. American Psychologist, 56(3), 218–226. https://doi.org/10.1037/0003-066X.56.3.218
  22. Fuertes, M., Ribeiro, C., Gonçalves, J. L., Rodrigues, C., Beeghly, M., Lopes-dos-Santos, P., & Lamônica, D. A. C. (2020). Maternal perinatal representations and their associations with mother–infant interaction and attachment: A longitudinal comparison of Portuguese and Brazilian dyads. International Journal of Psychology, 55(2), 224–233. https://doi.org/10.1002/ijop.12577
  23. Glover, V. (2014). Maternal depression, anxiety and stress during pregnancy and child outcome; what needs to be done. Best Practice & Research Clinical Obstetrics & Gynaecology, 28(1), 25–35. https://doi.org/10.1016/j.bpobgyn.2013.08.017
  24. Grigoriadis, S., Graves, L., Peer, M., Mamisashvili, L., Tomlinson, G., Vigod, S. N., & Dennis, C.-L. (2018). Maternal anxiety during pregnancy and the association with adverse perinatal outcomes: Systematic review and meta-analysis. Journal of Clinical Psychiatry, 79(5), 17r12011. https://doi.org/10.4088/JCP.17r12011
  25. Hajure, M., Alemu, S. S., Abdu, Z., Tesfaye, G. M., Workneh, Y. A., Dule, A., Hussen, M. A., Wedajo, L. F., & Gezimu, W. (2024). Resilience and mental health among perinatal women: A systematic review. Frontiers in Psychiatry, 15, 1373083. https://doi.org/10.3389/fpsyt.2024.1373083
  26. Heron, J., O’Connor, T. G., Evans, J., Golding, J., & Glover, V. (2004). The course of anxiety and depression through pregnancy and the postpartum in a community sample. Journal of Affective Disorders, 80(1), 65–73. https://doi.org/10.1016/j.jad.2003.08.004
  27. Howard, L. M., Molyneaux, E., Dennis, C.-L., Rochat, T., Stein, A., & Milgrom, J. (2014). Non-psychotic mental disorders in the perinatal period. The Lancet, 384(9956), 1775–1788. https://doi.org/10.1016/S0140-6736(14)61276-9
  28. Howard, L. M., & Khalifeh, H. (2020). Perinatal mental health: A review of progress and challenges. World Psychiatry, 19(3), 313–327. https://doi.org/10.1002/wps.20769
  29. Johnson, D. M., Tzilos Wernette, G., Miller, T. R., Muzik, M., Raker, C. A., & Zlotnick, C. (2020). Computerized intervention for reducing intimate partner victimization for perinatal women: A multisite randomized clinical trial protocol. Contemporary Clinical Trials, 93, 106011. https://doi.org/10.1016/j.cct.2020.106011
  30. Kelman, A. R., Evare, B. S., Barrera, A. Z., Muñoz, R. F., & Gilbert, P. (2018). A proof-of-concept pilot randomized comparative trial of brief Internet-based compassionate mind training and cognitive-behavioral therapy for perinatal and intending to become pregnant women. Clinical Psychology & Psychotherapy, 25(4), 608–619. https://doi.org/10.1002/cpp.2185
  31. Keyes, C. L. M. (2002). The mental health continuum: From languishing to flourishing in life. Journal of Health and Social Behavior, 43(2), 207–222. https://doi.org/10.2307/3090197
  32. Lancaster, C. A., Gold, K. J., Flynn, H. A., Yoo, H., Marcus, S. M., & Davis, M. M. (2010). Risk factors for depressive symptoms during pregnancy: A systematic review. American Journal of Obstetrics and Gynecology, 202(1), 5–14. https://doi.org/10.1016/j.ajog.2009.09.007
  33. Lazarus, R. S., & Folkman, S. (1984). Stress, appraisal, and coping. Springer.
  34. Leach, L. S., Poyser, C., & Fairweather‐Schmidt, K. (2015). Maternal perinatal anxiety: A review of prevalence and correlates. Clinical Psychologist, 21(1), 4–19. https://doi.org/10.1111/cp.12058
  35. Leahy-Warren, P., McCarthy, G., & Corcoran, P. (2012). First-time mothers: Social support, maternal parental self-efficacy and postnatal depression. Journal of Clinical Nursing, 21(3–4), 388–397. https://doi.org/10.1111/j.1365-2702.2011.03701.x
  36. Leach, D. M., Marino, C., & Nikčević, A. V. (2019). An evaluation of the contribution of maladaptive attitudes specific to motherhood and metacognitions in perinatal depression. Psychiatry Research, 274, 159–166. https://doi.org/10.1016/j.psychres.2019.02.012
  37. Lennard, G. R., Mitchell, A. E., & Whittingham, K. (2021). Randomized controlled trial of a brief online self‐compassion intervention for mothers of infants: Effects on mental health outcomes. Journal of Clinical Psychology, 77(3), 473-487. https://doi.org/10.1002/jclp.23189
  38. Li, Q., Yang, S., Wang, Y., & Sansiriphun, N. (2025). Fathers' experience in supporting the mother and infant during the postpartum period: A qualitative systematic review. Midwifery, 147, 104429. https://doi.org/10.1016/j.midw.2025.104429
  39. Lindgren, K. (2001). Relationships among maternal-fetal attachment, prenatal depression, and health practices in pregnancy. Research in Nursing & Health, 24(3), 203–217. https://doi.org/10.1002/nur.1023
  40. Mandl, S., Alexopoulos, J., Doering, S., Wildner, B., Seidl, R., & Bartha-Doering, L. (2024). The effect of prenatal maternal distress on offspring brain development: A systematic review. Early Human Development, 192, 106009. https://doi.org/10.1016/j.earlhumdev.2024.106009
  41. Nath, S., Pearson, R. M., Moran, P., Pawlby, S., Molyneaux, E., Challacombe, F. L., & Howard, L. M. (2019). The association between prenatal maternal anxiety disorders and postpartum perceived and observed mother-infant relationship quality. Journal of Anxiety Disorders, 68, 102148. https://doi.org/10.1016/j.janxdis.2019.102148
  42. Nombela, E., Marchena, C., Duque, A., & Chaves, C. (2025). The efficacy of psychological interventions on well-being during the perinatal period: A systematic review. General Hospital Psychiatry, 93, 40–51. https://doi.org/10.1016/j.genhosppsych.2025.01.006
  43. O’Hara, M. W., & Wisner, K. L. (2014). Perinatal mental illness: Definition, description and aetiology. Best Practice & Research Clinical Obstetrics & Gynaecology, 28(1), 3–12. https://doi.org/10.1016/j.bpobgyn.2013.09.002
  44. O’Mahony, J. M., Donnelly, T. T., Bouchal, S. R., & Este, D. (2013). Cultural background and socioeconomic influence of immigrant and refugee women coping with postpartum depression. Journal of Immigrant and Minority Health, 15(2), 300–314. https://doi.org/10.1007/s10903-012-9663-x
  45. Pilkington, P. D., Milne, L. C., Cairns, K. E., Lewis, J., & Whelan, T. A. (2015). Modifiable partner factors associated with perinatal depression and anxiety: a systematic review and meta-analysis. Journal of Affective Disorders, 178, 165-180. https://doi.org/10.1016/j.jad.2015.02.023
  46. Razurel, C., & Kaiser, B. (2015). The role of satisfaction with social support on the psychological health of primiparous mothers in the perinatal period. Women & Health, 55(2), 167–186. https://doi.org/10.1080/03630242.2014.979969
  47. Recto, P., & Champion, J. D. (2020). Psychosocial factors associated with paternal perinatal depression in the United States: a systematic review. Issues in Mental Health Nursing, 41(7), 608-623. https://doi.org/10.1080/01612840.2020.1714011
  48. Sambrook Smith, M., Lawrence, V., Sadler, E., & Easter, A. (2019). 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, 9(1), e024803. https://doi.org/10.1136/bmjopen-2018-024803
  49. Singla, D. R., Silver, R. K., Vigod, S. N., Schoueri-Mychasiw, N., Kim, J. J., La Porte, L. M.,. & Meltzer-Brody, S. (2025). Task-sharing and telemedicine delivery of psychotherapy to treat perinatal depression: a pragmatic, noninferiority randomized trial. Nature Medicine, 1-11. https://doi.org/10.1038/s41591-024-03482-w
  50. Somerville, S., Dedman, K., Hagan, R., Oxnam, E., Wettinger, M., Byrne, S., & Doherty, D. (2014). The Perinatal Anxiety Screening Scale: Development and preliminary validation. Archives of Women’s Mental Health, 17(5), 443–454. https://doi.org/10.1007/s00737-014-0425-8
  51. Southwick, S. M., Bonanno, G. A., Masten, A. S., Panter-Brick, C., & Yehuda, R. (2014). Resilience definitions, theory, and challenges: Interdisciplinary perspectives. European Journal of Psychotraumatology, 5(1), 25338. https://doi.org/10.3402/ejpt.v5.25338
  52. Stein, A., Pearson, R. M., Goodman, S. H., Rapa, E., Rahman, A., McCallum, M.,. & Pariante, C. M. (2014). Effects of perinatal mental disorders on the fetus and child. The Lancet, 384(9956), 1800-1819. https://doi.org/10.1016/S0140-6736(14)61277-0
  53. Stein, M. B., Siefert, C. J., Stewart, R. V., & Hilsenroth, M. J. (2011). Relationship between the Social Cognition and Object Relations Scale (SCORS) and attachment style in a clinical sample. Clinical Psychology & Psychotherapy, 18(6), 512-523. https://doi.org/10.1002/cpp.721
  54. Tay, C. T., Teede, H. J., Boyle, J. A., Kulkarni, J., Loxton, D., & Joham, A. E. (2019). Perinatal mental health in women with polycystic ovary syndrome. Journal of Clinical Medicine, 8(12), 2070. https://doi.org/10.3390/jcm8122070
  55. Tessema, M., Abera, M., & Birhanu, Z. (2025). Improving postnatal social support using antenatal group-based psychoeducation: a cluster randomized controlled trial. Frontiers in Global Women's Health, 5, 1510725. https://doi.org/10.3389/fgwh.2025.1510725
  56. Verreault, N., Da Costa, D., Marchand, A., Ireland, K., Dritsa, M., & Khalifé, S. (2014). Rates and risk factors associated with depressive symptoms during pregnancy and with postpartum onset. Journal of Psychosomatic Obstetrics & Gynecology, 35(3), 84–91. https://doi.org/10.3109/0167482X.2014.947953
  57. Vieten, C., & Astin, J. (2008). Effects of a mindfulness-based intervention during pregnancy on prenatal stress and mood: Results of a pilot study. Archives of Women’s Mental Health, 11(1), 67–74. https://doi.org/10.1007/s00737-008-0214-3
  58. Wang, X., Xu, H., Liu, X., Yan, J., Chen, C., & Li, Y. (2023). Evaluating the effect of psychoeducational interventions on prenatal attachment and anxiety/depression in pregnant women and partners: A systematic review and meta-analysis. Journal of Affective Disorders, 342, 33–44. https://doi.org/10.1016/j.jad.2023.08.131
  59. Waters, C. S., Annear, B., Flockhart, G., Jones, I., Simmonds, J. R., Smith, S., Traylor, C., & Williams, J. F. (2020). Acceptance and Commitment Therapy for perinatal mood and anxiety disorders: Feasibility study. British Journal of Clinical Psychology, 59(4), 460–478. https://doi.org/10.1111/bjc.12261
  60. World Health Organization. (2023). Analysis and use of health facility data: guidance for maternal, newborn, child and adolescent health programme managers. World Health Organization.
  61. World Health Organization. (2005). Promoting mental health: concepts, emerging evidence, practice: a report of the World Health Organization, Department of Mental Health and Substance Abuse in collaboration with the Victorian Health Promotion Foundation and the University of Melbourne. In Promoting mental health: concepts, emerging evidence, practice: a report of the World Health Organization, Department of Mental Health and Substance Abuse in collaboration with the Victorian Health Promotion Foundation and the University of Melbourne.
  62. Yazıcı, E., Mutu Pek, T., Uslu Yuvacı, H., Köse, E., Cevrioglu, S., Yazıcı, A. B.,. & Aydın, N. (2019). Perinatal Anxiety Screening Scale validiy and reliability study in Turkish (PASS-TR validity and reliability). Psychiatry and Clinical Psychopharmacology, 29(4), 609-617. https://doi.org/10.1080/24750573.2018.1506247
  63. Yim, I. S., Tanner Stapleton, L. R., Guardino, C. M., Hahn-Holbrook, J., & Dunkel Schetter, C. (2015). Biological and psychosocial predictors of postpartum depression: Systematic review and call for integration. Annual Review of Clinical Psychology, 11, 99–137. https://doi.org/10.1146/annurev-clinpsy-101414-020426
  64. Felder, J. N., Roubinov, D., Bush, N. R., Coleman‐Phox, K., Vieten, C., Laraia, B.,. & Epel, E. (2018). Effect of prenatal mindfulness training on depressive symptom severity through 18‐months postpartum: A latent profile analysis. Journal of Clinical Psychology, 74(7), 1117-1125. 10.1002/jclp.22617.
  65. Singla, D. R., Silver, R. K., Vigod, S. N., Schoueri-Mychasiw, N., Kim, J. J., La Porte, L. M.,. & Meltzer-Brody, S. (2025). Task-sharing and telemedicine delivery of psychotherapy to treat perinatal depression: a pragmatic, noninferiority randomized trial. Nature Medicine, 1-11. https://doi.org/10.1038/s41591-024-03482-w
  66. Stein, A., Pearson, R. M., Goodman, S. H., Rapa, E., Rahman, A., McCallum, M.,. & Pariante, C. M. (2014). Effects of perinatal mental disorders on the fetus and child. The Lancet, 384(9956), 1800-1819. https://doi.org/10.1016/S0140-6736(14)61277-0
  67. Yazıcı, E., Mutu Pek, T., Uslu Yuvacı, H., Köse, E., Cevrioglu, S., Yazıcı, A. B.,. & Aydın, N. (2019). Perinatal Anxiety Screening Scale validiy and reliability study in Turkish (PASS-TR validity and reliability). Psychiatry and Clinical Psychopharmacology, 29(4), 609-617. https://doi.org/10.1080/24750573.2018.1506247