The evidence

Partners to Parents is an evidence-informed resource. This means the recommendations we provide are not just the opinions of a few individuals – they are based on careful research.

The peer-reviewed journal articles behind Partners to Parents are listed below.

P2P usability paper

Partners to Parents: development of an on-line intervention for enhancing partner support and preventing perinatal depression and anxiety

Pamela Pilkington · Holly Rominov · Lisa C. Milne · Rebecca Giallo · Thomas A. Whelan

Couples-based interventions to prevent perinatal depression and anxiety are needed to optimise parental well-being and infant mental health. Current interventions are limited by their focus on maternal mental health, postnatal outcomes, and a reliance on professionals for their delivery. This article describes the development of Partners to Parents (, an online intervention for preventing perinatal depression and anxiety focused on enhancing partner support. Individual usability testing sessions were conducted with 12 parents in the perinatal period (7 women and 5 men) to assess the quality of the website. A deductive coding scheme was applied using NVivo 10 to identify comments relating to system and content quality of the website, as well as positive and negative comments. The results of the usability testing yielded more than 250 comments on system and content quality, potential barriers to accessing the website, and suggestions for improvement. This feedback was used to update the design of the intervention. The usability testing sessions suggested that the majority of the mothers and fathers involved perceived the website to be a useful new resource. Consultation with potential users of the website enabled refinement of the content and design of the Partners to Parents website.





Enhancing reciprocal partner support to prevent perinatal depression and anxiety: a Delphi consensus study


Systematic reviews have established that partner support protects against perinatal mood problems. It is therefore a key target for interventions designed to prevent maternal and paternal depression and anxiety. Nonetheless, the extant literature is yet to be translated into specific actions that parents can implement. Prevention efforts aiming to facilitate reciprocal partner support within the couple dyad need to provide specific guidance on how partners can support one another to reduce their vulnerability to perinatal depression and anxiety. Two panels of experts in perinatal mental health (21 consumer advocates and 39 professionals) participated in a Delphi consensus study to establish how partners can support one another to reduce their risk of developing depression and anxiety during pregnancy and the postpartum period. A total of 214 recommendations on how partners can support each other were endorsed by at least 80% of both panels as important or essential in reducing the risk of perinatal depression and anxiety. The recommendations were grouped under the following categories: becoming a parent, supporting each other through pregnancy and childbirth, communication, conflict, division of labor, practical support, emotional support, emotional closeness, sexual satisfaction, using alcohol and drugs, encouraging self-care, developing acceptance, and help-seeking. This study established consensus between consumers and professionals in order to produce a set of guidelines on how partners can support each other to prevent depression and anxiety during pregnancy and following childbirth. It is hoped that these guidelines will inform the development of perinatal depression and anxiety prevention efforts.


Modifiable partner factors associated with perinatal depression and anxiety: a systematic review and meta-analysis


Perinatal distress is a significant public health problem that adversely impacts the individual and their family. The primary objective of this systematic review and meta-analysis was to identify factors that partners can modify to protect each other from developing perinatal depression and anxiety. In accordance with the PRISMA statement, we reviewed the risk and protective factors associated with perinatal depression and anxiety symptoms that partners can potentially modify without professional assistance (PROSPERO reference CRD42014007524). Participants were new or expectant parents aged 16 years or older. The partner factors were sub-grouped into themes (e.g., instrumental support) based on a content analysis of the scale items and measure descriptions. A series of meta-analyses were conducted to estimate the pooled effect sizes of associations. We included 120 publications, reporting 245 associations with depression and 44 with anxiety. Partner factors with sound evidence that they protect against both perinatal depression and anxiety are: emotional closeness and global support. Partner factors with a sound evidence base for depression only are communication, conflict, emotional and instrumental support, and relationship satisfaction. This review is limited by the lack of generalizability to single parents and the inability to systematically review moderators and mediators, or control for baseline symptoms.The findings suggest that future prevention programs targeting perinatal depression and anxiety should aim to enhance relationship satisfaction, communication, and emotional closeness, facilitate instrumental and emotional support, and minimize conflict between partners.



A review of partner-inclusive interventions for preventing postnatal depression and anxiety

Pamela D. Pilkington · Thomas A. Whelan · Lisa C. Milne

Preventing perinatal mood problems is critical because of the adverse consequences for the individual and their family. Partner support is an ideal target for prevention efforts as it is a protective factor for both perinatal depression and anxiety and is modifiable. This review explores the current evidence and future directions for interventions that aim to reduce the risk of perinatal mood problems by addressing partner support. A systematic search of electronic databases was conducted to identify relevant peer-reviewed studies. Interventions were eligible for inclusion if they aimed to facilitate partner support or strengthen the couple relationship, and included perinatal depression or anxiety as an outcome variable. A number of prevention efforts have been developed that include a partner component, and these have reported some benefits. Even so, not all of these interventions were delivered to both mothers and fathers, and research evaluating their effects on paternal mental health is lacking. In addition, current prevention strategies tend to be limited by low attendance rates. Future research should focus on developing interventions that provide more opportunities for the active involvement of both partners. Alternatives to psycho-education groups should be explored to increase accessibility and enable scalability.


Maternal crying and postnatal distress: The moderating role of partner support

Pamela D. Pilkington · Thomas A. Whelan · Lisa C. Milne

This study aimed to investigate maternal crying as a signal of distress and request for support in the postpartum period. The development of postpartum mental illness may be prevented if spouses can recognize their partner’s distress and respond supportively. A cross-sectional survey of primiparous mothers (N =137) was conducted to determine whether partner support moderates the association between maternal crying frequency and postpartum depression, anxiety, and stress symptom severity. Regression analyses indicated that, as hypothesized, women who reported more frequent crying and low partner support reported higher levels of depression. Women who reported more frequent crying and low partner support reported higher levels of depression. Conversely, women who reported frequent crying in the context of high partner support reported lower levels of depression. The expected moderation effect was not present in the analyses examining postpartum anxiety and stress symptoms as outcome variables. In keeping with the well-established finding that partner support is a protective factor for postpartum mood problems, the results indicated that the presence of a supportive partner moderates the association between crying and depression.

Last reviewed 25 May 2016