Self-management of mild to moderate anxiety in women who have recently given birth: development and acceptability of a theoretically sound complex intervention

The postnatal period confers a high risk for anxiety in women, but few life stagespecific resources are available. This is despite public health policy recommendations for universal screening for mental health problems. Using the first two steps of the fourstep United Kingdom Medical Research Council (UKMRC) guidance and with input from consumers, we developed and piloted a supported self-help psychoeducation resource for the management of syndromal or subsyndromal generalised postnatal anxiety. The theoretically sound What Am I Worried About (WAWA) resource uses cognitive behaviour therapy and mindfulness in a seven-module programme supported by a 30-min telephone consultation with a mental health professional during each module. Results of an open pilot confirm acceptability, safety, non-stigma, feasibility and preliminary efficacy. Subject to successful completion of Step 3 of the UKMRC guidance, WAWA can be provided for anxiety management to women in a stepped-care model in primary postnatal health services.