Starting before birth: Preventing maternal mental health problems via a virtual and partner-inclusive intervention

Postpartum depression is one of the most common complications of pregnancy. About 15% of new mothers have clinically severe levels of depressive symptoms and about 20% have mild to moderate symptoms. Over 300 studies and 15 meta-analyses have documented short- and long-term effects of postpartum depression on both mother and child. In Canada, since the start of the COVID-19 pandemic in March 2020, pregnant women have reported levels of depression 2-3 times higher than pre-pandemic levels. We are facing an unprecedented need for psychological support for an already vulnerable population. Accordingly, we have adapted an evidence-based program for the prevention of perinatal depression to a virtual and partner-inclusive format appropriate for social distancing. Our objective is to test the efficacy of the virtual Parents & Babies intervention, a prevention program based on workbook and/or online exercises as well as weekly telephone calls. The program begins in pregnancy and continues until the first 3 months after the baby's birth. We will enrol 640 women for whom an intervention is indicated; i.e. those presenting symptoms of depression in early pregnancy. Our program recognizes the importance of partner support for maternal mental health, and partner participation is encouraged. Our multidisciplinary team includes researchers/clinicians from public health, psychiatry, psychology, obstetrics, nursing, and economics, with extensive clinical expertise in perinatal mental health and child development. We have already completed a pilot study. The clinical team and research infrastructure are ready and in place. Virtual, or remote, care is a promising solution to longstanding barriers to treatment. If effective, the intervention offered at a critical period in maternal, fetal and infant development and during a stressful pandemic period, could become a population-based health promotion tool for Canadian families and implemented elsewhere in the world.