Early intervention for increased antenatal anxiety associated with foetal development risk.

Evidence is growing, documenting the adverse effect of prolonged heightened states of maternal anxiety on the developing foetus. Recent Government recommendations require a shift toward early identification and intervention for 'at risk' mothers. Following the successful development of the postnatal mental health and attachment care pathway in North Somerset in 2006, a new pilot was undertaken to create an antenatal pathway to embrace these recommendations. Midwives were given a tool to identify women with high levels of anxiety, a menu of suitable options for specialist referral, and basic Mental Health training. Current services and potential additions were assessed to inform future planning. The tool was found effective in highlighting 'at risk' women, and midwives recommended changes in implementation. Midwives reported increased confidence in addressing maternal anxiety following training and receipt of a clear pathway. A higher number of women requiring intervention were identified than anticipated, and a geographic inequity of service identified. A pilot extension will address these issues and develop formal handover to health visitors by linking the antenatal and postnatal pathways.