MATERNAL MENTAL HEALTH & ART THERAPY

Maternal Mental Health &Art Therapy:
A Critical Focus for Perinatal and Postpartum Care

Madison Schwester
Department of Psychology, Counseling and Art Therapy
COUN 7560 - Advanced Research and Program Evaluation in Art Therapy
Pennsylvania Western University
Dr. Sheila Lorenzo de la Peña - ATR-BC, ATCS
August 9, 2024

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Abstract
This research examines the role of art therapy in supporting maternal mental health
during the perinatal and postpartum time periods in the United States, where societal pressures
and the underrepresentation of pregnancy-related mental health challenges are prevalent. Despite
the glamorization of pregnancy on social media, many women experience a wide range of
difficult emotions and symptoms that can lead to anxiety or mood disorders, with potentially
adverse effects on both maternal and infant health. Recent statistics indicate that one in five
women experience maternal mental health disorders during pregnancy, yet a staggering 80%
never have their mental health status checked by healthcare providers (Weiner, 2023; Zuloaga,
2023). This research introduces and evaluates a novel art therapy curriculum tailored to this
demographic, aiming to fill the gap in mental health care by providing early intervention and
support. By integrating art therapy into standard care practices, the research seeks to highlight its
efficacy in alleviating symptoms of anxiety and depression and enhancing overall maternal wellbeing. The findings suggest that art therapy offers a valuable complement to existing health
services, advocating for its broader implementation to improve the mental health outcomes for
mothers during these transformative stages of motherhood.

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Section I: Introduction
In the U.S., the idealization of pregnancy on social media often overshadows the complex
emotional and physical challenges women face during the perinatal and postnatal periods. With
one in five expecting mothers experiencing mental health disorders and insufficient screening,
the need for effective interventions is critical (Weiner, 2023; Zuloaga, 2023). This research
evaluates the role of art therapy in maternal mental health care as a means of bridging the gap
between physical health priorities and the often-neglected mental well-being of mothers during
and after pregnancy (Madell, 2015).
Problem to be Investigated
The prevalence of untreated maternal mental health disorders in the United States,
affecting over 600,000 women annually, underscores the urgent need for effective interventions
(Policy Center for Maternal Mental Health, 2023). With maternal mortality linked to mental
health disorders, particularly among Black and Native American women, there is a critical gap in
equitable access to mental healthcare during the perinatal and postnatal periods (Weiner, 2023).
This research paper examines the potential of art therapy to address this gap, improve maternal
mental health outcomes, and support a healthier transition into motherhood.
Purpose Statement
This research aims to advance understanding of maternal mental health during the
perinatal and postnatal periods, emphasizing the need for holistic, art therapy-based
interventions. A key component is the development of an accessible art therapy curriculum
tailored for new and expecting mothers during these critical life stages. By examining the

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complex factors influencing women's mental well-being, the study seeks to enhance early
detection, prevention, and management strategies (Qian et al., 2023). Through educating
healthcare providers about the efficacy of art therapy and providing a specialized curriculum for
art therapists, this project strives to improve access to care and promote the overall well-being of
mothers navigating the challenges and joys of the perinatal and postnatal journey.
Justification
Approximately 10% of expectant mothers and 13% of women who have just given birth
worldwide suffer from a mental illness, most commonly depression (Maternal Mental Health,
n.d.). In the United States, roughly one in five women experiences a mental health problem
during pregnancy, yet 75% go untreated or undiagnosed (Maternal Mental Health | AAMC, n.d.).
These alarming statistics underscore the critical need for targeted mental health interventions for
women during pregnancy and postpartum. As recognition of art therapy as a viable therapeutic
approach during the perinatal and postnatal periods evolves, this research aims to substantiate its
role in maternal mental health care. Existing studies by Manolova et al. (2023), Howard and
Khalifeh (2020), Rafferty et al. (2019), Hu et al. (2021), Moran et al. (2023), Qian et al. (2023),
and Harris et al. (2023) highlight a growing trend. By continuing to investigate, practice, and
integrate the creative and holistic approaches of art therapy into perinatal and postpartum care,
research has the potential to significantly improve women's mental health outcomes and wellbeing during pregnancy. This study seeks to explore and reinforce the evidence base for art
therapy's effectiveness, ultimately influencing healthcare practices and policies. By strengthening
the support system for women during these crucial stages of motherhood, we can enable better
mental health outcomes and improve overall well-being.
Terms related to the study

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Antenatal: The Collins dictionary (n.d.) defines antenatal as the period of time before birth,
present before birth, or throughout pregnancy.
Art Therapy: The American Art Therapy Association (2023) defines art therapy as “a mental
health profession that enriches the lives of individuals, families, and communities through active
artmaking, creative process, applied psychological theory, and human experience within a
psychotherapeutic relationship”.
Art Therapy Interventions: An art therapy intervention is a method that is employed in a session
to help the client explore and acquire understanding of their experiences through a creative
process (Developing Art Interventions for Your Client, 2023).
Estrogen: Estrogen is a hormone that promotes the growth of the uterus, keeps the lining of the
uterus healthy, controls other important hormones, and starts the development of the baby's
organs (Geddes & Geddes, 2023).
Gestational Age: Gestational age describes how far along a pregnancy is. It is calculated as the
number of weeks between the first day of the woman's most recent menstrual cycle and the
present. 38 to 42 weeks is the typical length of a pregnancy (Gestational Age: MedlinePlus
Medical Encyclopedia, n.d.).
Holistic Approach: Holistic approach in art therapy considers the interconnectedness of
physical, emotional, mental, and spiritual well-being. It adapts to individual needs, promoting
self-expression and resilience through art-making and therapy (Ornelas, 2023).
Maternal Mental Health: The National Alliance of Mental Illness (2023) defies maternal
mental health as the general emotional, social, and mental health of a mother before, during, and

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after pregnancy. They also state that perinatal mental health can also refer to maternal mental
health.
Perinatal: The perinatal phase, according to Helfer (1987), is the time frame from a year prior to
the child's birth to 18 to 24 months following.
Perinatal Anxiety: Anxiety that occurs during pregnancy and for up to a year after giving birth is
known as perinatal anxiety (PNA), however, can often be referred to as antenatal anxiety as well
(Silverwood et al., 2022)
Postpartum: Postpartum is defined by the Merriam Webster Dictionary (n.d.) as happening
during or being the period after childbirth.
Postpartum Blues: Low mood and mild depressed symptoms known as the postpartum "blues"
after childbirth usually start two to three days after delivery, peak over the next several days, and
go away on their own in two to three weeks (Balaram & Marwaha, 2023).
Postpartum Depression: Postpartum depression (PPD) is a type of severe depression
characterized by a combination of behavioral, emotional, and physical changes that may start as
soon as four weeks after giving birth (Bruce, 2022).
Postpartum OCD: Postpartum OCD symptoms are a type of postpartum anxiety disorder that
can be characterized by intrusive thoughts and behaviors that are in response to a mother's
newborn (Carberg, 2023).
Postpartum Psychosis: Postpartum psychosis is a severe mental health disorder that can be
characterized by profound disorientation, delusions, paranoia, disorganized thought processes,
and hallucinations (Raza & Raza, 2023).

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Postpartum PTSD: Postpartum PTSD is characterized by intrusive flashbacks or nightmares
related to a traumatic past event (which in this case may have been the actual event of childbirth)
(Postpartum Support International, 2024).
Preventative Measures: Routine medical treatment, which includes screenings, examinations,
and patient counseling to prevent illnesses, diseases, and other health issues, is referred to as
preventative measures, sometimes known as preventative services (Preventive Services Glossary, n.d.)
Pre-Existing Mental Health Disorders: A pre-existing mental health disorder is any mental
condition that a person has before getting a new health insurance coverage, or in this case, a
significant life event, such as pregnancy (At Risk: Pre-Existing Conditions Could Affect 1 in 2
Americans: | CMS; World Health Organization: WHO, 2022).
Progesterone: Progesterone is characterized as a reproductive hormone that is necessary for a
successful embryo implantation and that causes changes in the uterine lining's secretory patterns
(Dante et al., 2023).
Psychopharmacotherapy: The use of psychoactive medications to treat or manage mental
illnesses or psychiatric diseases symptomatically is known as psychopharmacotherapy
(Dictionary.com, n.d.).
Psychosocial Factors: Psychosocial factors are defined by the American Psychological
Association (2018) as environmental, social, and cultural circumstances and influences that have
an impact on behavior and mental health.

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Psychotherapy: Psychotherapy, according to the American Psychological Association (2023), is
any psychological service provided by trained professionals that primarily uses interaction and
communication techniques to assess, diagnose, and treat dysfunctional emotional responses,
thought processes, and behavioral patterns.

Conclusion
It is critical that expectant and new moms recognize the possible negative impacts
pregnancy may have on their mental health and take proactive measures to treat them. Equally
significant is the obligation healthcare professionals have to be familiar with the range of
conditions and symptoms that women may encounter during this period and how they may affect
a woman's mental health. Healthcare professionals should be aware of the risk factors linked to
mental health issues during pregnancy, be accountable for alerting women to these symptoms,
and act as a network of support, understanding, and encouragement for women by offering early
intervention for treatment. This research provides substantial information that can assist with

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meaningful mental health care treatment to better support women during the prenatal and
postnatal period, thereby addressing the significant gap in the current healthcare system
regarding maternal mental health care. This research aims to bring an awareness on the value of
art therapy as a treatment modality in the perinatal and postpartum stages, with the purpose of
integrating it into early intervention and a broader spectrum of maternal healthcare services.

Section II: Review of Literature
In the United States, a large number of women struggle with their mental health both
during and after pregnancy. According to the National Alliance on Mental Illness (2023), one in
five women will have maternal mental health disorders during pregnancy, including mood and
anxiety disorders, which are the most common disorders associated with pregnancy, childbirth,
and the postpartum period. Among women with perinatal mental health conditions worldwide,
20% will experience suicidal thoughts or undertake acts of self-harm (World Health
Organization, 2019). Maternal deaths in the United States are primarily caused by disorders
related to perinatal mental health (PMH), accounting for 23% of all maternal deaths (Weiner,
2023). The Policy Center for Maternal Mental Health (2023) identified that less than 15% of
women will seek treatment for these mental health concerns. Numerous factors can contribute to

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the reasons why women may be reluctant to seek mental health support, both during and after
pregnancy. Some women may feel that mental health issues are a natural part of pregnancy, that
they are unable to get care or health care resources, or that they are driven to be independent or
self-sufficient during this time. Studies regarding maternal mental health indicate a recent
transition from postpartum mental health services to the importance of mental health care during
conception, including prenatal care, labor, and postpartum, as well as education about the
importance of mental health and its immediate and long-term effects on the mother and the baby
(Chauhan & Potdar, 2022). This review of the literature looks at the several factors that affect a
woman's mental health during pregnancy as well as the emotional, cognitive, and physical
symptoms of maternal mental health. It offers insight into how pregnancy, fetal development,
and the long-term consequences on a mother's mental health are affected. The most recent
screening and evaluation instruments, treatment plans, and therapeutic approaches are examined.
The review further delves into current art therapy interventions used in prenatal and postnatal
care, underscoring the therapeutic benefits that art therapy can have on maternal mental health.
This review highlights the critical need for comprehensive support and early intervention,
emphasizing the importance of improving maternal mental health care services to improve
immediate challenges and long-term outcomes for mothers and their children through creative
and supportive approaches such as art therapy.
Understanding Women's Mental Health During Pregnancy
The perinatal period is defined as the period from one year before the child's birth to 18
to 24 months after (Helfer, 1987). Maternal often refers to motherly characteristics, feelings, or
qualities associated with being a mom. Therefore, maternal mental health is the overall
emotional, social, and mental health of a mother before, during, and after pregnancy (NAMI,

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2023). Correspondingly, perinatal mental health and maternal mental health can be
interchangeable while discussing maternal mental health in this section. In modern-day
American society, social media tends to glorify and portray pregnancy as a beautiful time when
women are full of joy and enthusiasm about welcoming a new baby into the world. In a study
published in 2020 under the title The Relationship between Digital Media Use During
Pregnancy, Maternal Psychological Wellbeing, and Maternal-Fetal Attachment, Smith et al.
found that women used digital media to get health information and social and emotional support
for a variety of reasons, such as understanding the development of their fetus, knowing what to
expect during their pregnancy, and figuring out what symptoms were normal. The study
investigated how social media use affected pregnant mothers' psychological health and
discovered a connection between media use and higher levels of negative affect, self-criticism,
and lower social quality of life. (Smith et al., 2020). Women have increased social pressure to
experience a variety of positive emotions during their pregnancy, which can result in feelings of
guilt, shame, and low self-esteem when they don't. Anxiety, weariness, mood swings,
overwhelming surprise, and unexpected emotions are just a few of the emotions that come with
being pregnant. Although experiencing the ups and downs due to common feelings of worry and
anxiety during pregnancy is normal, managing these emotions can be difficult. High levels of
perinatal stress and anxiety have been linked to having an impact on a mother’s physical and
mental health, as well as increasing the risk of pregnancy and birth complications, which can
harm the health and development of the baby (Coussons-Read, 2013).
Perinatal Anxiety & Antenatal Anxiety
Perinatal anxiety (PNA), which is anxiety that appears during pregnancy and for up to a
year after giving birth, is estimated to affect up to 20% of women (Silverwood et al., 2022).

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Since this anxiety is experienced by women during or after pregnancy, the terms prenatal and
antenatal can be used interchangeably (Silverwood et al., 2022). The term "antenatal anxiety"
refers to excessive worries, anxieties, and fears over pregnancy, childbirth, the infant's health,
and future parental responsibilities (Bedaso et al., 2021) Antenatal anxiety is prevalent, with
estimates ranging from 14-59%, according to individual research (Bedaso et al., 2021). The
concept of perinatal anxiety is still relatively new, having received far less attention in research
than postpartum depression or anxiety in mothers, however, perinatal anxiety can arise due to a
variety of psychological, social, environmental, and biological factors (Oh et al., 2020). Common
feelings of anxiety during this time can be attributed to worry, fear, and stress during this period,
however, other factors that may also play a significant role include the lack of a social support
system, a history of abuse and domestic violence, a personal history of mental illness, an
unwanted or unplanned pregnancy, adverse life events, high levels of perceived stress,
complications from previous or current pregnancies, miscarriages, and having a medically
complex pregnancy (Silverwood et al., 2022). It's important to be mindful of the factors that can
lead to PNA, as the symptoms can emerge gradually or abruptly. Recognizing both the physical
and mental indicators of PNA is essential for timely intervention. These symptoms can be mild,
moderate, or severe and can vary between women and pregnancies (Collier, 2021). Symptoms
can include rapid breathing, difficulty sleeping, increased heart rate, nausea, sweating, trembling,
muscle tension, as well as mental symptoms such as difficulty focusing, feeling on edge,
frequent irritability, etc. (Collier, 2021). It is noteworthy that women who have pre-existing
mental health conditions may face elevated anxiety levels throughout the perinatal period. If
these symptoms are left untreated, anxiety may negatively affect both the mother and the baby.

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Anxiety increases the risk for preterm birth, low birthweight, and neurological disorders for the
baby, along with increased risk of long-term maternal mental health issues (Silverwood, 2022).
Considering these statistics, early intervention and treatment for perinatal anxiety disorders are
crucial in regulating the psychological and physical manifestations of stress and anxiety,
facilitating therapeutic methods for processing emotions, improving the mental health of the
mother, and stopping the development of more severe mental health issues.
Hormones
Beyond physical changes, pregnancy, and childbirth can also bring about other changes
in the body. The hormonal and physiological changes that women endure during pregnancy are
unique. Maternal physiological changes in pregnancy occur to accommodate the fetal needs as
the baby develops and prepares the mother for labor and delivery (Soma-Pillay et al., 2016).
These changes can happen in response to many factors, however, many of the adaptations are
secondary to hormonal changes in pregnancy which can cause a range of emotions and have an
impact on maternal mental health.
When women become pregnant, their levels of progesterone, estrogen, and many other
hormones rise significantly and continue to increase throughout the course of the pregnancy.
(Healthline, 2017). Because they are essential for sustaining pregnancy and promoting the
growth of the fetus, progesterone and estrogen are the most prevalent hormones in pregnant
women. To support healthy development of the baby, estrogen is necessary for the development
of the uterine lining and fetus, the regulation of important pregnancy hormones, and the growth
of the breasts during nursing. (Geddes, 2023). Progesterone promotes the uterine lining's
thickening in preparation for the fertilized egg's implantation and aids in the fetus's growth
during gestation (John Hopkins Medicine, 2024). The gestation period is the interval of time

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from conception until delivery, otherwise referred to as gestational age, and is frequently used
during pregnancy to indicate the stage of the pregnancy (Kaneshiro, 2021). During pregnancy,
the placenta releases progesterone to prevent the development of other eggs and focus the body’s
resources on the current pregnancy (Nichols, 2017). From the time of conception until the
mother gives birth, progesterone and estrogen hormones work together to establish the ideal
conditions for a safe and healthy pregnancy.
During pregnancy, women produce these hormones at a significant level, more than any
other time in her life (Robinson & Klien, 2012). As a result of this sudden hormonal imbalance
that women experiences during pregnancy, it can have a significant impact to or worsening
existing symptoms for maternal mental health (Borst, 2022). Some women may be more
vulnerable to changes in hormone levels, which could produce anxiety or depressive symptoms,
because these hormones are heightened throughout pregnancy and after birth (Borst, 2022). It is
important to remember that while hormone variations influence the ability to regulate emotion,
mood, and mental health, additional factors such as an individual's pre-existing mental health
disorders, stress levels, and overall health impact maternal mental health and well-being.
Stress
Stress during pregnancy is common and can range from mild to moderate to severe. Mild
stress during pregnancy can include normal concerns about the health of the baby as it grows,
parenting, childbirth, and daily responsibilities like taking care of the family, managing
household chores, juggling work, planning for maternity leave, and managing physical
discomforts like exhaustion, nausea, back pain, and difficulty falling asleep. Moderate levels of
stress can be caused by persistent worries about potential problems or birth defects, anxiety
related to labor and delivery, mood swings and difficult emotions brought on by hormonal

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changes, worry about how the baby will affect current relationships, and managing career
responsibilities, financial difficulties, or job loss with motherhood. Severe stressors, such as
handling pre-existing mental health issues, going through significant life changes and events,
feeling a great deal of anxiety about being able to care for the unborn child, living in an unsafe or
unstable environment, experiencing a traumatic event, can have a more profound impact on
maternal mental health.
While some stress can be normal, severe levels of stress can have significant effects on
maternal mental health and the development of the baby. A study that reviewed the outcomes of
experienced stress during pregnancy led to an increased risk of mental health problems such as
anxiety, depression, and stress-related disorders, and negatively impacted birth outcomes, the
duration of labor and delivery mode, caused preterm birth and low birth weight for the baby
(Abera et al., 2024). Insufficient social support, low income, being single parents, or having a
strained relationship with their partner can all put a woman's emotional well-being at greater risk.
(McLeish & Redshaw, 2017). According to reports, having social support during pregnancy can
lessen the strain of the physical and emotional changes that pregnant women go through, prevent
a psychological or physiological stress reaction from occurring when a potentially stressful event
occurs, and generally improve the well-being of both the mother and the unborn child (AlMutawtah, 2023). A mother's physical and emotional health can be negatively impacted by the
continuous pressure and strain she experiences, thus, to lessen these impacts and support her
mental health, society must emphasize providing support, resources, and care for mothers during
the peripartum period.
Impact of Psychosocial Factors

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Psychosocial factors are traits or aspects that affect a person's mental health and behavior;
they can also be used to characterize a person in relation to their environment, culture, and social
interactions (American Psychological Association, 2018). Pregnancy is associated with certain
psychosocial stress indicators; in the year before becoming pregnant, 39% of women
experienced a stressful life event (Eick et al., 2020). An elevated risk of developing mental
health issues in mothers can be attributed to psychosocial factors, including but not limited to
social and relationship support, financial stability, socioeconomic class, healthcare access,
experiences of trauma or violence, and major life changes like job loss, bereavement, or moving.
The persistence of differences in adverse birth outcomes across socioeconomic and racial
and ethnic groups may be attributed to psychosocial stress and reactions to stress during
pregnancy (Eick et al., 2020). The intersections of race, ethnicity, gender, and financial status
can exacerbate the stress and marginalization experienced by minority women. An investigation
into the health disparities in maternal physical and mental health outcomes during the perinatal
period and an analysis of the literature on maternal health and its application to intersectionality
revealed that gendered racialized stress is a distinct type of psychosocial stress associated with a
higher prevalence of depressive symptoms in pregnant Black women (Hoang & Wong, 2022). In
comparison to White women, Black, American Indian and Alaska Native (AIAN), Native
Hawaiian and Other Pacific Islander (NHOPI), and Native Hawaiian and Other Pacific Islander
(NHOPI) women experience significantly higher levels of psychological stress, increased birth
risk factors and birth outcomes, and a higher pregnancy mortality rate (Hill et al., 2022).
Healthcare professionals must adopt patient-centered, accessible, culturally competent care
approaches, implement routine screenings, educate new or experienced mothers about factors
affecting their mental health, advocate for policies that reduce health disparities, refer patients to

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appropriate services, and work with community organizations to reach underserved populations
throughout their pregnancy in order to mitigate these disparities and various psychosocial factors
that impact the mental health of mothers from diverse backgrounds (Loeb et al.,2021).
Impact of Pre-existing Mental Health Disorders
Pre-existing mental health disorders present significant challenges for pregnant women
and can have a significant impact on their maternal mental health. The maternal-fetal medicine
specialist at Brigham and Women's Hospital (2024) recognized while treating patients with
psychiatric and prenatal conditions that pregnancy-related hormone swings, diet, exercise, sleep
patterns, and stress levels can worsen pre-existing mental health conditions and trigger the onset
of new mental health symptoms. These conditions put women at higher risk for complications
and adverse outcomes during pregnancy and childbirth, such as preterm birth and delivery,
difficulties nursing and bonding with the baby, and a higher risk of developing a substance use
disorder (Psychiatric Disorders During Pregnancy, 2022).
Making decisions regarding managing mental health issues without medication or
locating alternative kinds of treatment to manage symptoms of a mental health diagnosis presents
a substantial barrier for pregnant women with pre-existing mental health disorders. Many women
may think about abruptly stopping their medicine, considering the health of their unborn child,
without first seeing a doctor; nevertheless, stopping medication suddenly can have major
consequences. The benefits of starting or continuing therapy during pregnancy must be
considered, together with the risks of the mother's untreated mental illness and the risks of
exposing the fetus to certain medications (Psychiatric Disorders During Pregnancy, 2022). Given
the potential implications that could result from a mother's mental illness, it is not always safe to
stop taking medication or to withhold it during pregnancy. Considering this, it is imperative that

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pregnant women with pre-existing mental health disorders receive early intervention, suitable
care, and support from their medical professionals to reduce risks, modify prescribed
medications, and put therapeutic interventions and practices into place in order to enhance both
the mother's and the unborn child's wellbeing.
Impact on Fetal and Infant Development
Research indicates that stress, depression, and anxiety in pregnant women can impact the
fetus, potentially leading to long-term consequences for the child’s mental health and socialemotional outcomes (Monk, 2019). The Children’s National Hospital (2022) indicated that
elevated maternal stress, anxiety, and depression symptoms have been proven to modify key
fetal brain traits, which raises the possibility that these changes may affect the child's behavior,
cognitive development, and present an increased risk of children developing a mental health
disorder in the future. Stress hormones, such as cortisol, that are released by the mother can alter
the baby's nervous system and neurological development after crossing the placenta, making the
infant more reactive (Monk, 2022). Maternal stress and mental health can affect a mother's
ability to build a strong bond with her child and provide the loving care that babies need for
optimal development, which in turn can affect mother-infant bonding. Excessive distress during
pregnancy has been linked to an increased risk of preeclampsia, low birth weight, and premature
delivery, which can lead to numerous consequences and developmental difficulties for the child
(Zietlow et al., 2019). Preterm birth increases the danger that the baby won't survive or will have
long-term developmental difficulties since several internal organs, including the brain, lungs, and
liver, are still developing even in the last weeks of pregnancy (U.S. Department of Health and
Human Services, 2023). These effects emphasize how crucial it is to address a mother's stress,

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anxiety, and general mental health during her pregnancy to promote the best possible fetal and
newborn development.
Mental Health Review of Postnatal Symptoms
According to data from the World Health Organization (2019), approximately 10% of
pregnant women and 13% of women who have just given birth, worldwide suffer from a mental
illness, most commonly depression. Together with postpartum symptoms, hormonal changes that
happen during and after pregnancy might pose serious risks to a mother's mental health.
Postpartum symptoms that women commonly have after giving birth to their newborn include
mood swings, anxiety, depression, irritability, feeling overwhelmed, worried, drained of energy,
and experience trouble sleeping. Taking care of a baby can be emotionally and physically taxing,
and it can also raise stress levels, particularly for mothers who don't have support from others.
Additional factors that might affect a mother's mental health include sleep loss, changes in body
image, and adjusting to the new role and responsibility of being a mother. It's also critical to
remember that every pregnancy and postpartum experience a woman has can provide a different
set of difficulties and needs. The pressures of taking care of several children, balancing
responsibilities, and attending to each child's needs can raise stress levels and raise the risk of
mental health issues. These might also, however, be contributing elements to more severe mental
health problems, such as postpartum depression (PPD), which can result in intense feelings of
hopelessness, anxiety, or sadness and make it challenging for a woman to care for her family or
herself (Centers for Disease Control and Prevention, 2023). Early detection of postpartum
symptoms is essential for timely intervention and support, which could prevent serious mental
health concerns from worsening for the mother and lessen detrimental effects on the baby’s
development. Recognizing the signs of postpartum depression, anxiety or other mental health

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disorders can help women access the necessary resources and treatment options. Therefore, the
sections below give a summary of the postpartum symptoms that women encounter and how they
may affect their mental health.
Postpartum Blues
Often referred to as "baby blues," postpartum blues is a moderate, temporary mood
disorder that many moms may suffer following childbirth. However, the likelihood of developing
postpartum blues increases markedly in women who experience mood or anxiety symptoms
during pregnancy (Balaram & Marwaha, 2023). According to the Mayo Clinic (2022), women
may experience symptoms such as fluctuations in mood, crying episodes, anxiety, and trouble
sleeping with postpartum blues. After delivery, these symptoms can begin in the first two to
three days and can persist for up to two weeks (Mayo Foundation for Medical Education and
Research, 2022). According to Johns Hopkins Medicine (2023), these emotions are thought to be
brought on by the sudden changes in hormones that occur after childbirth and can be categorized
as a type of depression that resolves when hormone levels return to normal. Although the baby
blues are normal and typically go away on their own, it's crucial to recognize if these symptoms
increase or persist because they may indicate a more serious illness like postpartum depression.
Postpartum Depression
Postpartum depression (PPD) is a complicated combination of emotional, behavioral, and
physical changes that affects some women days or even months after giving birth (Bruce, 2022).
U.S. Department of Health & Human Services (2024) estimates that in the year following
childbirth, 1 in 8 women report having PPD symptoms. As mentioned by WebMD (2022), the
duration of time between delivery and the onset of depression as well as the intensity of the
depression are factors in the diagnosis of postpartum depression. Postpartum depression

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symptoms include depressed mood or severe mood swings, difficulty bonding with the baby,
withdrawal from friends or family, inability to sleep or excessive sleep, irritability, feelings of
shame or guilt, restlessness, panic attacks or severe anxiety, and intrusive thoughts; all of which
can make it difficult for a mother to care for her baby or handle daily tasks (Mayo Foundation for
Medical Education and Research, 2022). PPD can affect moms in many ways, as well as their
newborns, families, and other intimate relationships. PPD symptoms can result in long-term
mental health problems, such as persistent depression, if they are not treated.
Postpartum Psychosis
Postpartum psychosis is a rare but serious mental health condition that can occur after
childbirth. Hallucinations, delusions, strong mood swings, confusion, disorganized thinking, and
thoughts of harming oneself or their child are among the signs of postpartum psychosis,
according to the Mayo Clinic (2022). These symptoms indicate a severe disturbance in a
woman's thoughts, emotions, and behaviors. Due to the significant risk of suicide and injury to
the child, postpartum psychosis is a mental emergency that needs to be treated immediately
(Osborne & Standeven, 2023).
Postpartum PTSD
Postpartum Post-Traumatic Stress Disorder (PTSD) can occur after a traumatic
childbirth experience or severe stressful events that occur during the postpartum period. Some
examples of traumatic events that may cause postpartum PTSD include, a difficult labor and
delivery, an unplanned Cesarean section (c-section), emergency medical attention, the baby
needing NICU care (Postpartum Post-Traumatic Stress Disorder, 2024). According to
Postpartum Support International (2024), the mother's capacity to bond or attach to her newborn
may be impaired by postpartum PTSD symptoms such as physical symptoms, avoidance

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behavior, intense anxiety and panic attack-like symptoms, flashbacks or nightmares concerning
the delivery, and social isolation.
Impact of Pregnancy Loss
The American Psychological Foundation (2018) noted that miscarriages account for 10 to
20 percent of confirmed pregnancies, which is a tragically common cause of perinatal loss.
Furthermore, ten percent of women who lose a pregnancy show symptoms of diagnosable
disorders like anxiety, depression, or post-traumatic stress disorder; up to thirty percent of
women may have major emotional reactions after losing a pregnancy; and up to twenty percent
of women may have long-lasting adjustment problems (Weir, 2018). The grief that comes with
losing a pregnancy is distinct and can be quite intense and traumatic; it is frequently neglected
and not recognized by society, which can make emotions of loneliness, grief, guilt and shame,
depression, and inadequacy worse (Leis-Newman, 2012). These women suffer in silence as a
result, which makes them more susceptible to other mental health conditions and increases their
risk of depression and anxiety throughout subsequent pregnancies. Their loss may have an
impact on their confidence and sense of self-worth, along with making them fearful of another
miscarriage in the future.
Postpartum OCD
As many as 3-5% of new moms are expected to develop symptoms of postpartum obsessivecompulsive disorder (OCD), according to Postpartum International (2024). According to the
International OCD Foundation (2023), recurrent, unwanted thoughts known as obsessions and
compulsive actions or behaviors that a person feels driven to perform, usually in response to the
obsessions of the newborn or infant, are signs of postpartum OCD. The effects of postpartum
OCD can be significant, impacting not only the individual but also their ability to care for their

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baby as well as the relationships and interactions that they have with others. Postpartum OCD is
associated with a number of common obsessions, such as contamination (the fear that the baby
will become ill or die), unwanted sexual thoughts about the baby, harming the baby
unintentionally or intentionally, perfectionism-related obsessions, losing control, religious
obsessions, and comparing oneself to other mothers (Gorbis, 2023). Postpartum compulsions can
involve doing repetitive tasks or rituals a certain number of times, avoiding places or things
where the baby is present, checking on the baby frequently, keeping a log of the baby's actions
and bodily functions, excessive reassurance-seeking, and neglecting the baby (What is perinatal
OCD, 2023).
Postpartum Influence on Identity
Postpartum is a significant period in a woman’s life that can influence her identity in
various ways. The transition to motherhood is accompanied by additional duties, responsibilities,
and difficulties. No matter how many children a woman has, every pregnancy and postpartum
experience is different, and having another baby can present new difficulties and changes. Some
women may feel a change in themselves as they learn to manage the emotional and physical
changes that follow childbirth, adjust to changes in their bodies, and deal with the responsibilities
of caring for a newborn. Many women experience low self-esteem as a result of how they feel or
look after becoming pregnant or giving birth, but how well they are able to cope with these
changes depends on a number of factors, including how well they accept themselves, how others
validate and accept them, and the values they attach to their physical appearance (Cammaroto,
2009). Research indicates that moms frequently draw comparisons between their real-life
experiences and the idealized representations of motherhood on social media. These
representations include the speed at which a woman's pre-pregnancy body recovers, the

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satisfaction she derives from being a mother, the level of skills she possesses with her newborn,
and the degree of support she receives from her relationships (Kirkpatrick & Lee, 2024).
Mothers may face significant obstacles during this period as they reestablish the role with their
partner as a couple with a newborn, navigate the complexity of their current relationships, and
adjust to changes in family dynamics. Because the first few months after giving birth can have
significant effects on a woman's mental health, it's critical that new moms feel loved, supported,
and understood by the people and resources in their lives. Due to its effectiveness in fostering
emotional support, influencing the use of coping mechanisms, encouraging the seeking of mental
health treatment, and upholding a good sense of self, perceived social support has been related to
a substantial protective factor for maternal mental health (Inekwe & Lee, 2022). It is highly
advised that women seek mental health treatment if they suffer any of the postpartum or
peripartum symptoms, though, as not everyone may have access to a support system which has
an extra impact on the mental health of postpartum mothers. The section below provides
information on available treatments and current screening for these symptoms.
Current Screening & Treatment Strategies
Despite the high prevalence of mental health disorders for mothers in the U.S., research
indicates that 1 in 7 pregnant and perinatal women suffer from anxiety and depressive disorders
(Waqas et. al, 2022). Of these women, only half seek mental healthcare due to a lack of
awareness about mental health issues, fear of stigma, lack of resources, or lack of coordination
among healthcare providers (Waqas et. Al, 2022). Women should receive information regarding
mental health services at the earliest opportunity, ideally during their initial prenatal
appointment. Likewise, ongoing discussions about mental health care should continue
throughout the pregnancy and the postpartum phase. Unfortunately, because medical

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practitioners consider many women's physical and mental symptoms to be normal aspects of
pregnancy, these symptoms are frequently overlooked, underdiagnosed, and untreated (Webb et
al., 2023). According to a review of insurance data, less than 20% of perinatal patients claimed
that they were questioned about their mental health (Weiner, 2023). While prenatal and postnatal
care appointments aim to protect the health and well-being of the mother and the child before
and after delivery, there is a lack of understanding in the healthcare system regarding the mental
health of the mother during this time (Madell, 2015). However, through advocacy and research
initiatives to integrate early intervention of perinatal and postpartum mental health care into
healthcare systems, the significance of perinatal and postpartum mental health care is gradually
obtaining more recognition and the attention it deserves globally (Manolova et al., 2023; Howard
& Khalifeh, 2020; Rafferty et al., 2019). Providing support and resources to women as soon as
possible is essential to implementing early intervention for maternal mental health care. This can
include screening for mental health issues during prenatal and postpartum visits, providing
counseling or art therapy services, and connecting women with appropriate community
resources. The following sections will go over the current screening applications and treatments
used to identify and treat mental health concerns in mothers during pregnancy and the
postpartum period.
Screening
The use of screening tools in prenatal and postnatal care is essential for early detection
and treatment of mental health disorders in mothers. The American College of Obstetricians and
Gynecologists recommends screening at key intervals: initial visit, 24-28 weeks gestation, 4th
trimester visit, and periodically postpartum (American College of Obstetricians and
Gynecologists, n.d.). Screening tools are vital for proactively identifying women who may need

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additional mental health support during the perinatal period. They help detect the onset of
symptoms in late pregnancy or early postpartum and allow for periodic monitoring of mental
health conditions throughout this critical time. Several validated tools are available for healthcare
providers. The Patient Health Questionnaire (PHQ) is offered in PHQ-2 and PHQ-9 versions and
widely used to screen for depression severity in the perinatal period (American Psychological
Foundation, 2020). The Perinatal Anxiety Screening Scale (PASS) measures four types of
anxiety in pregnant women, helping identify acute anxiety, general worry, perfectionism, control
and trauma, and social anxiety (Nonacs, 2019). The Perceived Prenatal Maternal Stress Scale
(PPNMSS) effectively identifies pregnancy-related stress and depression early in pregnancy
(Gangadharan & Jena, 2019). The Edinburgh Postnatal/Perinatal Depression Screen (EPDS),
originally for postpartum depression, also assesses anxiety symptoms and can be used
throughout the perinatal period (Oliveira et al., 2022). The Generalized Anxiety Disorder GAD-7
is recommended by the American College of Obstetricians and Gynecologists as a
comprehensive tool for evaluating anxiety and perinatal mental health (American College of
Obstetricians and Gynecologists, n.d.). By assessing symptoms of anxiety and depression, these
tools help healthcare providers make informed referrals to specialists, develop personalized care
plans, and ensure pregnant and postpartum women receive the appropriate interventions.
Treatment Strategies
According to The American College of Obstetricians and Gynecologists (2024), mental
health screening should be conducted with protocols in place to guarantee prompt access to
evaluation and diagnosis, efficient treatment, and appropriate monitoring and follow-up,
depending on severity. Women can be greatly empowered to make decisions about their mental
health care by having open communication about treatment options and talking about the

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potential risks, benefits, and outcomes of different treatment approaches (Implementing Perinatal
Mental Health Screening, 2024). Open communication between women and healthcare
professionals fosters a collaborative approach that increases a women's understanding of
available treatment options, gives them a voice to ask questions and concerns, and ensures that
treatment is tailored to each woman's unique needs, preferences, and values (Modak et al., 2023).
All these factors work together to lessen the stigma attached to mental health treatment.
Depending on the specific needs and severity of the presenting symptoms and concerns
of the individual, healthcare professionals offer a variety of treatment options for maternal
mental health. Individualized treatment plans consider the individual's symptoms, medical
history, comorbidities, pregnancy status, nursing status, and any possible adverse effects (Modak
et al., 2023). The current list of maternal mental health care treatment options is provided by
Modak et al. (2023) in A Comprehensive Review of Motherhood and Mental Health. These
treatment options come in a variety of forms, but they all aim to provide comprehensive support
by utilizing evidence-based interventions such as psychotherapy, medication, and appropriate
services like peer counseling and support groups. The following gives a brief overview of
different therapeutic approaches is given here, as it is crucial that women and healthcare
practitioners have an awareness of these options to decide the appropriate course of action that
best fits the individual needs and experiences of each mother.
Psychotherapy. Numerous strategies for supporting a mother's mental health during the
prenatal and postpartum phases are available in psychotherapy. Psychoeducational interventions
can be successful in controlling common prenatal mental disorders by fostering problem-solving,
coping skills, and the reframing of problematic thought patterns (Thomas et al., 2018). Cognitive
Behavioral Therapy (CBT) assists women in acknowledging and changing negative and

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unhelpful thought patterns and behaviors which can contribute to feelings of anxiety and
depression (Perinatal Depression, n.d.). Interpersonal Therapy (IPT) concentrates on enhancing
interpersonal connections and communication, which is very helpful for new mothers adjusting
to new roles (Perinatal Depression, n.d.). To support mothers' mental health and well-being, art
therapy combines psychological theory and the creative process of creating art that can be
applied to a variety of settings (American Art Therapy Association, n.d.). Benefits for mothers
include enhanced self-esteem, improved self-awareness, stress reduction, emotional expression,
and coping strategy development (Noble, 2023). Mindfulness-based therapies, including
Mindfulness-Based Cognitive Therapy (MBCT), use techniques like yoga, breathing exercises,
and meditation to help individuals become more conscious of their thoughts and feelings while
also lowering stress and anxiety. (Psychology Today, 2022). Interventions based on mindfulness
have been linked to decreased perinatal anxiety and may also be useful in lowering typical
mental health issues that arise during pregnancy (Shi & MacBeth, 2017).
Psychopharmacotherapy. Using medication to treat mental health issues is known as
psychopharmacotherapy. When it comes to maternal mental health, this means that throughout
pregnancy and postpartum, psychiatric drugs for the treatment of disorders including depression,
anxiety, bipolar disorder, and psychosis must be carefully chosen and managed (Treatment and
Management of Mental Health Conditions During Pregnancy and Postpartum, n.d.). Guidelines
for the treatment and management of mental health disorders during pregnancy and the
postpartum period is provided by the American College of Obstetricians and Gynecologists
(n.d.), which emphasizes the value of informing women about the advantages and disadvantages
of psychopharmacotherapy when medically necessary. Medical professionals need to assess the
efficacy and safety of psychiatric medications while considering the mother's and the child's

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well-being, individualized treatment plans, the severity of the patient's mental health problem,
and the potential consequences of not seeking treatment (Modak et al., 2023).
Support Groups. Support groups are especially beneficial for improving maternal
mental health treatment during the prenatal and postpartum periods by offering connections and
support. These support groups provide an environment of comfort where moms can talk about
their experiences and express their thoughts without worrying about being criticized, which helps
lessen feelings of isolation and foster a sense of belonging. (Modak et al., 2023). These groups
can also empower moms by raising knowledge and self-efficacy levels and provide a resource
for exploring and developing coping strategies (Modak et al., 2023).
Self-Care & Lifestyle Interventions. Maternal mental health might benefit greatly from
self-care strategies during the prenatal and postpartum periods. Enhancing maternal mental,
emotional, and physical health can be achieved by various methods and activities such as
maintaining a healthy diet and nutrition, getting regular exercise, practicing stress management,
improving sleep hygiene, and interacting with social supports (Modak et al., 2023; Nguyen et al.,
2022).
Barriers to Seeking Help
To inform national research and policy on maternal mental health care disorder
prevention, access, and treatment, the Policy Center for Maternal Mental Health (2022) gathered
197 responses from women via an online survey that examined the barriers and facilitators to
maternal mental health care access. Using a qualitative analysis, this study identified common
themes among the reported obstacles to accessing healthcare in the US. These obstacles included
lack of paid maternity leave, health care providers' lack of knowledge and awareness of
specialized care for maternal mental health disorders, and stigma and perceived judgment of

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seeking services (Wang & Johanek, 2022). Unpaid maternity leave presents women with
additional financial pressures and perpetuates disparities which can increase stress, anxiety, and
exacerbate mental health symptoms (Johnson, 2021). The possibility for women to focus on
recovery and seek help is reduced when they are denied paid maternity leave because they may
not have the funds to pay for mental health services or because they must return to work (Wang
& Johanek, 2022). Women may not have access to a qualified healthcare professional; therefore,
they may receive care from someone who lacks training, misinterprets symptoms, or
underestimates the severity of mental health issues (Rafferty et al., 2019). If a provider fails to
identify symptoms through screenings, connect women with the appropriate specialists, or fail to
provide support services, women that voice their concerns about their mother's mental health
may feel ignored or invisible (Wang & Johanek, 2022). Women who are stigmatizing themselves
for having mental health problems and who are already feeling fear, humiliation, embarrassment,
and guilt about it may lose faith in the healthcare system if their healthcare practitioners fail to
respond appropriately (Webb et al., 2023). That said, these barriers highlight the need for
increased awareness, education, and support systems to improve access to maternal mental health
care. Addressing these barriers is crucial to ensure that women feel supported and have the
opportunity in seeking care and have access to a variety of readily available options.
Current Resources Available
There are a number of available resources that provide comprehensive support for women
that are navigating the various aspects of maternal mental health difficulties during the perinatal
and postpartum periods. The following lists organizational services, items, and educational
resources that aim to improve the mental health of mothers.

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National Maternal Mental Health Hotline. The National Maternal Mental Health
Hotline (2023) provides free, confidential, round-the-clock and daily support that is available to
women before, during, and after pregnancy. This hotline offers access to tools, resources, and
real-time support from professional counselors that speak English and Spanish. Additionally, this
resource offers 60 different language interpretation services.
The American Hospital Association (AHA). The AHA (2024) highlights tools and
educational resources from national organizations recognized for improving maternal mental
health.
Centers for Disease Control Prevention (CDC). The CDC (2023) offers a range of
resources related to maternal mental health that are intended to increase knowledge, offer
assistance, and direct care for mental health issues. These resources include research and
statistics, educational materials, support resources, and informational pages.
Online Platforms. Websites and forums such as Mom’s Mental Health Matters (n.d.)
and Maternal Mental Health Now (2024) provide information to increase awareness of mental
health symptoms and how to receive help, support services and hotlines, community engagement
and awareness campaigns, as well as resource directories to organizations and services that offer
additional support for maternal mental health.
Support Groups and Counseling Services. Referrals to local support groups,
community programs, art therapy services and groups, and telehealth providers are available
through various services, which can be an affordable and convenient option. Counseling services
for maternal mental health can be offered by hospitals and community health centers; however,
state-specific resources may differ.

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The Art Therapy Project. a nonprofit that offers group art therapy to anyone in need of
mental health services—including maternal mental health—in a welcoming environment. The
Art Therapy Project (2024) allows people to participate in remote art therapy sessions by
providing them with the ability to participate in virtual TeleArt Therapy sessions via Zoom and
by shipping the necessary art supplies to the client.
The Art Therapy Nest. Provides virtually live, interactive, online art therapy groups and
workshops at a small sliding-scale cost (Virtual Collective —the Art Therapy Nest, n.d.). They
offer a range of creative arts therapies, including art therapy, which is beneficial for the mental
health of mothers.
Art Therapy & Maternal Mental Health
Art therapy is a form of therapy that integrates the creative process of making art and
applies psychological theory to improve a person's physical, mental, and emotional well-being
(American Art Therapy Association, n.d.). Art therapy provides a nonverbal communication of
one's thoughts, feelings, and experiences through artistic expression, which is different from
standard therapy practices. Art therapy can help women process their emotions, experiences, and
challenges related to pregnancy, childbirth, and motherhood (Jeffs, 2021). There is a growing
body of research on the use of art-based therapies in prenatal and postnatal care to enhance the
psychological health of pregnant and postpartum mothers (Qian et al., 2023). According to a
recent study, Art-Based Interventions for Women's Mental Health in Pregnancy and Postpartum
(2023) art-based therapies have been linked to successfully lowering anxiety during labor and
pregnancy, lowering postpartum depression, and promoting mother-child attachment. According
to Jeffs (2021), a systematic review was conducted to evaluate the efficacy of art therapy
interventions during the three periods of pregnancy: before birth, during labor, and after birth.

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The results indicated that art therapy was successful in reducing symptoms of anxiety and
depression. Existing art therapy interventions facilitated self-awareness, positivity and healing,
the maternal bond, self-development, wider opportunities and connections, and facilitated
engagement, according to an integrative review that focused on the Experiences and Impacts of
Visual Art-Based Interventions on Perinatal Well-Being (2023). Following this, a holistic blog
review of The Benefits of Art Therapy at the Prenatal and Post-Partum Stages (2022), art
therapy may be quite helpful in addressing problems like postpartum depression, anxiety before
childbirth, and major life transitions. While these studies and research indicate that art therapy is
not completely novel in the context of maternal mental health, research into its full potential and
practical applications to maternal mental health is still ongoing.
Art Therapy Interventions & Approaches
There are many different types of art therapy interventions and approaches for prenatal
and postpartum mental health, that can be customized to meet the needs of moms during this
period. Women can explore their emotions, relieve stress, and develop an understanding of their
needs through engaging in a variety of art directives and mediums, including sculpting, drawing,
painting, textiles, fiber arts, and collage. Visual art-based interventions, such as journaling,
painting, card-making, yoga, photography, and drawing, can help women process their
experiences related to childbirth and explore their feelings about motherhood (Harris et al., 2023;
Crane et al., 2021). Using tactile art forms such as sculpting through clay, provide a sensory
experience that can be grounding and cathartic, helping women to navigate the emotional
complexities of motherhood (Roulleau, 2023). Sezen and Unsalver (2019) found that in art
therapy, mandala and collage activities helped pregnant women reduce fear and anxiety
surrounding childbirth, improve mood, foster autonomy and calmness, and offered a reflective

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space to share their experiences and enhance connection with their unborn child. Mandala
drawing serves as a meditative practice, promoting relaxation and alleviating stress and anxiety,
while collage-making facilitates the expression and processing of complex emotions associated
with pregnancy and motherhood, aiding in emotional management (Rajamani, n.d.; Sezen &
Unsalver, 2019). Group-based art therapy has been found to foster social connections, decrease
feelings of isolation by providing community and support for mothers with similar challenges,
and enhances communication, validation, and empowerment (Harris et al., 2023).
Art therapy interventions that have been found to support the mental and emotional wellbeing for new and expectant mothers, include Positive Affirmation Cards (Tedeschi, 2023),
Creating Self-Portraits during Pregnancy and Motherhood (Tedeschi, 2023), and Mother-Child
Art Therapy Drawings (Eunkyung, 2020) by promoting emotional resilience, self-esteem, and
confidence through creative expression. Positive Affirmation Cards use uplifting phrases to
empower mothers with handling the challenges of motherhood (Tedeschi, 2023). Creating SelfPortraits offers a reflective space for mothers to express their evolving identities and complex
feelings surrounding this transformation (Tedeschi, 2023). Mother-Child Art Therapy Drawings
deepen the maternal bond and facilitate nonverbal emotional exchange, contributing to improved
mental health and family dynamics (Eunkyung, 2020). Together, these interventions and art
therapy practices offer therapeutic avenues to reduce anxiety, depression, and various mental
health conditions during the transformative experiences during pregnancy and postpartum
periods.
Implementing Art Therapy in Maternal Mental Health Care
As a holistic approach, art therapy provides a safe and supportive space for women to
express their emotions, gain insight, and build self-confidence. Art therapy provides a promising

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and innovative way to support the mental health of pregnant and postpartum women. By offering
a creative outlet and safe space for expression, art therapy can help overcome barriers to care and
bridge the gaps in existing mental healthcare. Early intervention is key, and art therapy can play
a vital role in detecting mental health issues early and providing timely support. A non-verbal
and expressive outlet like art therapy can have a positive impact on women's mental health in a
way that traditional types of therapies may not always be available or beneficial for every
individual (Aarestrup, 2020). Art therapy provides a powerful approach to addressing the
emotional and psychological needs of women during this critical period through a creative outlet
that is both safe and inviting (Qian et al., 2023).
Women may encounter a variety of difficult symptoms throughout the perinatal and
postpartum periods, which can be effectively treated and improved through the application of art
therapy techniques. The creative process can be tailor-made to an individual's needs, making art
therapy a flexible and empowering tool for mental health support. The effect of the creative
process on perinatal well-being was demonstrated by research published in the International
Journal of Art Therapy (2023). Based on this research, it was found that creating art with the
help of a licensed therapist promoted relationships, parent-infant bonding, self-awareness, and
healing (Harris et al., 2023). Furthermore, art therapy groups can foster a sense of community
and belonging, counteracting feelings of isolation that many pregnant and postpartum women
may experience. Parents who participated in group art therapy were also able to cultivate new
friendships and connections that contributed to decreased feelings of loneliness and social
isolation (Harris et al., 2023).
Research supports the effectiveness of art therapy in reducing anxiety and depression
during the perinatal period. A meta-analysis of randomized controlled trials found that art-based

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interventions were effective for women's mental health during pregnancy and postpartum, and a
study specifically found that art-based intervention was associated with significantly reducing
anxiety during labor and pregnancy, as well as postpartum depression (Qian et al. 2023). These
findings suggest that art therapy has the potential to be a valuable addition to the mental health
care landscape for pregnant and postpartum women. By incorporating art therapy into early
intervention programs, healthcare providers can offer a more holistic and inclusive approach that
is both cost-effective, engaging, and securing to support and address maternal mental health
alongside pharmacological treatments, when appropriate (Hu et al., 2021; Qian et al., 2023).
Conclusion
The use of art therapy for maternal mental health care and early intervention is a growing
field. Art-based therapies have been shown to be beneficial in lowering a variety of symptoms,
most prevalently, anxiety and depression in pregnant and postpartum women, according to recent
research and meta-analyses (Hu et al., 2021; Moran et al., 2023; Qian et al., 2023; Harris et al.,
2023). Unlike traditional therapies, art therapy integrates medical care with psychological and
social support to address the multifaceted needs and expectations of mothers in an effective and
valuable way (Hu et al., 2021). Given that art therapy has a great deal of potential for treating
physical, emotional, and mental aspects of mental health, as well as being an approachable and
affordable method available in a range of settings, healthcare professionals should consider
incorporating it into comprehensive treatment plans for maternal mental health. (Noble, 2023).
Combining art therapy techniques with a collaborative care model approach can result in a
holistic approach to maternal health by giving women a personalized, supportive mental health
care experience that integrates care from many healthcare providers. (McKinney, 2023) The
integration of art therapy into maternal mental health programs and early intervention offers a

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promising avenue for improving maternal mental health care. It may also prevent the escalation
of mental health issues by improving symptoms and lowering barriers that prevent women from
seeking treatment (Qian et al., 2023). As a result, this approach could yield improved results for
mothers' overall mental health and well-being, which is crucial for the development of their
child, the bond they build with them, and the improvement of family and relationship dynamics.
(Modak et al., 2023)

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Section III: Methodology
This section explores an art therapy curriculum tailored to support new and expecting
mothers who are navigating symptoms of anxiety and depression during the perinatal and
postpartum periods. Intended as early intervention to enhance maternal mental health, the
curriculum offers flexibility for individual therapy sessions but primarily thrives in a group
setting. The curriculum spans 11 weekly sessions, each lasting between 1.5 to 2 hours, the
program aligns with the second and third trimesters and extends into the postpartum phase—a
time acknowledged as pivotal for mental health support by the American College of
Obstetricians and Gynecologists and recent studies (Qian et al., 2023). Delivered by mental
health professionals with specialized training in art therapy or by certified art therapists, the
curriculum is designed to cultivate a community of support through therapeutic art directives that
are tailored to address the emotional and psychological needs of expectant and new mothers.
Target Audience
This art therapy curriculum is specifically designed for licensed or board-certified art
therapists who possess specialized training or experience in perinatal and postpartum mental
health. The curriculum is intended for practitioners working with new or expecting mothers in
medical, outpatient, or group community settings, who are experiencing symptoms of anxiety
and depression during their perinatal and postpartum periods. This includes those facilitating
open art therapy groups, where mothers can find support and connection with others navigating
similar experiences. Ideal participants are art therapists who are part of, or have access to, a
multidisciplinary team and are equipped with the appropriate facilities for conducting sensitive
and confidential art therapy sessions. It is crucial that these professionals demonstrate cultural

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competence and are sensitive to the diverse backgrounds of the new and expecting mothers they
serve.
Curricular Structure
The development of this art therapy curriculum for perinatal and postpartum women is
informed by a comprehensive review of existing art therapy approaches that have shown efficacy
in supporting women during the perinatal and postpartum periods. Drawing upon group art
therapy techniques, cognitive behavioral strategies, mindfulness practice, and relationshipbuilding exercises, this curriculum integrates essential components from well-researched
interventions (Perinatal Depression, n.d; Psychology Today, 2022; Qian et al., 2023;
Experiences and Impacts of Visual Art-Based Interventions on Perinatal Well-Being, 2023;
Harris et al., 2023; Crane et al., 2021). Importantly, the curriculum is designed to accommodate
the dynamic nature of open groups, where participants may join or depart at various points. The
cycle of an open group is considered, with initial sessions focused on building trust and
community, middle sessions on deeper exploration and expression, and later sessions on
integration, reflection, and preparation for continued growth beyond the group. The curriculum is
designed with an evidence-based framework, incorporating best practices and innovative
methods tailored to meet the unique psychological needs of new and expecting mothers. The
resulting curriculum aims to provide this population of women with a comprehensive,
empathetic, and practical approach to art therapy and mental health care.
Curricular Outline
The art therapy curriculum is a structured 11-week group program tailored for new and
expecting mothers to address perinatal and postpartum anxiety and depression. Each weekly
session, lasting up to 2 hours, progresses through themes of building trust, self-expression,

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managing anxiety, enhancing bonding, fostering resilience, enhancing empowerment, and
planning for the future. The curriculum incorporates a diverse range of art materials and
techniques, with a focus on mindfulness, emotional expression, and community support.
Furthermore, supplemental resources and future directions are provided to extend the program's
benefits beyond the group setting.
Art Therapy Curriculum Content for New and Expecting Mothers
Week 1: Building Trust and Safety
Group Objectives: Establish a foundation of trust and safety within the group through
introductions, setting of group norms and confidentiality, engaging in ice breaker activities, and
introduction to the art space and materials.
Art Objectives: Facilitate the development of a cohesive and collaborative group
environment where participants feel comfortable engaging with one another. Provide a
collaborative art directive tailored to what trust and safety mean to the participants. Participants
will contribute to creating a collective art piece using paint, paint brushes, markers, pens, and
other mixed media materials, incorporating words, symbols, or images that represent their
individual concepts of trust and safety.
Debrief/Discussion: Facilitate a discussion on the participants' experiences creating the
'trust and safety' piece and any emotions it evoked. Explore how the visual representation of the
group's commitment to trust and safety impacts their sense of security within the space.
Collaboratively identify steps the group can take to preserve and build upon the established
atmosphere of trust.
Week 2: Self Expression and Identity

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Group Objectives: To facilitate a deeper understanding among group participants by
encouraging self-exploration and sharing personal narratives through art. Explore and express
various facets of the individuals' identities, particularly about their shifts into motherhood.
Art Objectives: Start by having a quick conversation about the various identities and
responsibilities that each member possesses and how these may have changed since becoming a
mother. Participants will create an abstract self-portrait or mask that captures elements of their
inner world, using color, form, and symbolism, and collage to express aspects of their
personality, feelings, and experiences that are not usually visible to others.
Debrief /Discussion: Can you describe your experience and any significant choices you
made while creating your self-portrait? How did it feel to express your inner self through art?
What self-discoveries did you make during this activity? Did you resonate with the elements that
another group member had included in their portrait?
Week 3: Expressing and Building Awareness of Emotions
Group Objectives: To create a personal emotional landscape to recognize, communicate,
and share a variety of feelings to improve emotional understanding and self-awareness.
Art Objectives: Participants will create a visual representation of their emotional
experiences using colors, shapes, and images to depict the various emotions they are navigating
during the perinatal or postpartum period.
Debrief/Discussion: How did you feel while creating your emotional landscape? Were
there any surprises? What did you discover about your current emotional state through this
activity? Which features of your landscape best capture the emotions that you feel regularly?
How might acknowledging and expressing these emotions be beneficial in your

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perinatal/postpartum journey? In what ways can visualizing your emotions as a landscape help
you navigate them more effectively?
Week 4: Managing Anxiety with Mindfulness
Group Objectives: To cultivate mindfulness and self-reflection as tools for managing
anxiety, using a visual journal as a means to record and observe personal experiences and
emotions in the present moment.
Art Objectives: Participants will create a visual journal entry that captures their current
emotional state, thoughts, or surroundings, focusing on the act of creating as a form of
mindfulness meditation. Participants will take their visual journals home to document their
feelings to promote mindfulness, emotional release, and containment for strong emotions.
Debrief/Discussion: How did the process of creating your visual journal entry affect your
mindfulness and anxiety? What did you notice about your thoughts and feelings while you were
engaged in the activity? How might using a visual journal support your anxiety management in
daily life?
Week 5: Mind-Body Awareness and Acceptance
Group Objectives: To cultivate a deeper connection with the body and foster acceptance
through the meditative practice of creating mandalas, enabling participants to reflect on their
physical experiences with pregnancy (Crane et al., 2021)
Art Objectives: Participants will design mandalas using colors and symbols that
symbolize various parts of their body and how they feel about them. The mandala's circular
shape will act as a metaphor for wholeness along with the self, encouraging body acceptance and
integration.

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Debrief/Discussion: How did the process of creating your mandala reflect your feelings
towards your body? What did you notice about your body awareness while engaging in the
mandala activity? How might this mandala-making practice help you in nurturing body
acceptance and awareness?
Week 6: Bonding and Attachment
Group Objectives: Through the symbolic act of weaving, participants can examine and
deepen the special bond between a parent and their unborn child or expectant child while
thinking back on the fundamentals of attachment and raising this new relationship.
Art Objectives: Participants will create a small, tactile woven piece that represents their
connection with their infant, using the sensory experience of listening to music and weaving to
reflect on the development of their bond and the emotions it evokes (Crane et al., 2021).
Debrief/Discussion: How do the chosen materials reflect your bond with your baby?
What did you feel while weaving? How might this weaving process relate to your baby's sensory
bonding? In what ways might this activity help you in your daily interactions to foster an
attachment with your baby?
Week 7: Building Community and Support
Group Objectives: Create a visual representation of the support network and resources
available to pregnant and postpartum women in the community, promoting awareness and
accessibility of these supports through a group collaborative project.
Art Objectives: Participants will collaborate on a network-themed mural, with each
person adding elements symbolizing resources, support, or personal stories linked to pregnancy
and postpartum care. The mural's interconnected design will represent the community's robust
support system.

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Debrief/Discussion: How has the tapestry broadened your knowledge of resources for
pregnant and postpartum women? In what ways could the tapestry assist others in finding
support? What have you learned about the value of support during pregnancy and postpartum?
How can we further develop and fortify community support networks?
Week 8: Strengths and Fostering Resilience
Group Objectives: To identify and visually portray personal strengths and resilience
factors that support participants during challenging times.
Art Objectives: Participants will create individual collages that depict their unique
strengths and sources of resilience, symbolizing these as foundational pillars that provide
stability and support. Participants will share how these factors and coping skills contributed to
their ability to persevere through challenges. Storytelling among the group can be a source of
encouragement and a reminder of their inner resources during difficult times (Crane et al., 2021)
Debrief/Discussion: How do the images and words in your collage represent your
strengths and resilience? What did you discover about yourself while creating your pillar? Did
you find any similarities between your pillar and what other members have included or shared in
their artwork? How can you use this visual representation to remind you of your resilience in the
future? In what ways can your strengths support you in overcoming challenges?
Week 9: Empowerment with Creativity
Group Objectives: To inspire participants to recognize and celebrate their individual
empowerment through artistic creation. This art directive fosters a supportive environment for
participants to acknowledge and express their personal strengths and the capacity to direct their
own lives.

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Art Objectives: Participants will create a personal symbol that represents their sense of
empowerment, using mixed media to express the qualities and characteristics that make them
feel strong, empowered, determined, and confident.
Debrief/Discussion: How does your symbol represent your personal empowerment?
What choices did you make during the creative process that felt empowering? How did the act of
creating reinforce your sense of self-efficacy? How can you use your symbol as a reminder of
your empowerment in your daily life?
Week 10: Preparation for Future
Group Objectives: The goal is to empower new mothers to use creative mapping to see
their future selves and to plan for a healthy and wholesome journey of motherhood that includes
self-care, care for their baby, and role adaptation.
Art Objectives: Participants will create a visual representation of their postpartum
journey, highlighting their goals for personal health and wellness, baby milestones that they are
looking forward to, and strategies for managing the transition into motherhood.
Debrief/Discussion: How does your map outline your postpartum goals and self-care
plans? How did you balance personal wellbeing with baby care on your map? What support
systems are included in your map for postpartum challenges? How will your map help you
manage motherhood's demands?
Week 11: Closure and Celebration
Group Objectives: To provide postpartum women with an opportunity to reflect on their
transition into motherhood, acknowledge the challenges they've faced, the strengths they've
gained, and celebrate their journey of personal growth and achievements throughout the therapy
process.

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Art Objectives: Participants will create a personalized Motherhood Milestone Keepsake
Box - a decorated box that holds symbolic items or art pieces representing their therapeutic
journey, reflections, and artwork that symbolizes their unique experiences of motherhood and
their accomplishments. This box can serve as a container for future reflections and as a reminder
of what they had learned throughout their time in group art therapy.
Debrief/Discussion: What aspects of your motherhood journey are highlighted in your
keepsake box? How did you select items and designs for your capsule, and what do they mean to
you? What does your keepsake box represent about your therapeutic journey? Reflecting on your
postpartum period, how do you feel about your growth and experiences at this point in your
journey? In what ways might you use this box in the future to remember and celebrate your
growth?

Conclusion
The methodology outlined in this paper presents a structured and evidence-based art therapy
curriculum that can be tailored to address the mental health needs of women during the perinatal
and postpartum periods. With a clear framework for session content, therapeutic goals, and
material use, this curriculum aims to provide a holistic and supportive intervention to maternal
mental health and well-being. The group therapy structure of this curriculum provides women
with a sense of community, understanding of sensitive experiences, and empowerment to use
creative tools learned for managing the symptoms of anxiety and depression that new and
expecting mothers endure during this transformative period.

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Section IV: Curriculum
This section presents a comprehensive, adaptable handbook tailored for art therapists
working with perinatal and postpartum women's mental health (Please see Appendix A). While
designed for open groups with new and expectant mothers experiencing anxiety and depression,
the 11-week program can be seamlessly adapted for closed groups or individual sessions.
Aligned with the second and third trimesters and postpartum phase, each 1.5-2 hour session
balances check-ins, themed art therapy directives, and processing. The handbook emphasizes
flexibility, creative engagement, community support, and responsiveness to unique participant
needs, maximizing therapeutic benefits. The complete ready-to-implement guide in the appendix
supports practitioners in delivering impactful art therapy.
Conclusion
In conclusion, this curriculum addresses a critical gap in perinatal and postpartum mental
health care by providing a structured, adaptable, and evidence-based framework for practitioners.
By emphasizing community building, mindfulness, and creative expression, the curriculum
empowers new and expectant mothers to navigate anxiety and depression. As the importance of
early intervention during this pivotal life phase continues to gain recognition, this comprehensive
guide equips practitioners to deliver impactful art therapy. With its focus on flexibility and
responsiveness, this curriculum not only empowers practitioners to deliver transformative art
therapy but also has the profound potential to reshape maternal mental health outcomes for the
future.

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Section V: Discussion
The provided research underscores the critical need for holistic, accessible interventions
addressing maternal mental health during the perinatal and postpartum periods. The findings
support art therapy as a promising approach to bridge the gap between physical health priorities
and the often-neglected mental well-being of mothers. The development of an accessible art
therapy curriculum tailored for new and expecting mothers is a key component in enhancing
early detection, prevention, and management strategies for maternal mental health disorders.
This section will delve into the key findings of the research, highlighting the efficacy of art
therapy in addressing maternal mental health during the perinatal and postpartum periods. The
discussion will then explore what these findings mean in the context of the broader field,
examining the contributions and implications of the research for practice, policy, and future
investigation.
A critical component of the discussion will be an examination of the limitations of the
research and the accompanying art therapy curriculum. Acknowledging the potential restrictions
and areas for improvement will provide a nuanced understanding of the research, enhancing the
validity and applicability of the findings. The discussion will conclude by offering
recommendations for future research, outlining potential avenues for further investigation and
ways to build upon the current study. These suggestions will aim to advance the field's
understanding of art therapy in perinatal and postpartum care, ultimately working towards
improving maternal mental health outcomes.
Summary of Research

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This research highlighted the complex emotional and physical challenges women face
during the perinatal and postpartum periods, emphasizing the need for holistic, accessible
interventions. Within the United States, the idealization of pregnancy on social media was
identified as a potential contributor to feelings of guilt, shame, and low self-esteem. The high
prevalence of perinatal anxiety, affecting up to 20% of women, underscored the importance of
early intervention (Silverwood et al., 2022). The significant hormonal and physiological changes
during pregnancy were noted as potentially impacting mental health, with some women being
more vulnerable to these fluctuations.
The study emphasized stress as a common experience during pregnancy, with high levels
negatively affecting maternal mental health and fetal development (Coussons-Read, 2013). The
importance of social support in alleviating stress and promoting well-being was highlighted.
Psychosocial factors, including experiences of trauma and socioeconomic disparities, were
recognized as impacting maternal mental health outcomes, with intersections of race, ethnicity,
gender, and financial status exacerbating stress and marginalization for minority women (Hoang
& Wong, 2022). Research indicated that maternal stress, depression, and anxiety can impact fetal
development, potentially leading to long-term consequences for child mental health and socialemotional outcomes (Monk, 2019; Children's National Hospital, 2022). The importance of
addressing stress, anxiety, and overall mental health during pregnancy to promote optimal fetal
and newborn development was emphasized. Pre-existing mental health disorders during
pregnancy pose significant challenges, with the need for careful management of medications and
collaborative care underscored.
The postnatal period was recognized as critical, with up to 13% of women experiencing a
mental illness, most commonly depression (World Health Organization, 2019). Early detection

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of postpartum symptoms is essential to prevent the worsening of mental health concerns. The
research underscored the need for accessible, inclusive interventions, such as art therapy, to
support maternal mental health during the perinatal and partum periods.
Art therapy emerged as a promising approach to address the complex needs of women
during this time (Hu et al., 2021; Moran et al., 2023; Qian et al., 2023; Harris et al., 2023). The
non-verbal, expressive nature of art therapy can transcend language and cultural barriers,
promoting inclusivity in mental health services. The creative process can foster self-expression,
empowerment, and resilience, mitigating the risk of mental health disorders (Integrative Review,
2023). Art therapy can provide a healthy coping mechanism for navigating hormonal and
physical changes, as well as associated emotions (Qian et al., 2023). The stress-reducing benefits
of artmaking can promote relaxation and mindfulness, decreasing anxiety and feelings of
overwhelm (Shi & MacBeth, 2017; Noble, 2023). Group art therapy can offer a sense of
community and support, combating the isolation many new mothers experience (Harris et al.,
2023).
The art therapy curriculum developed through this research aims to enhance early detection,
prevention, and management of maternal mental health disorders. By educating healthcare
providers about the efficacy of art therapy and providing a specialized curriculum, the project
seeks to improve access to care and promote the overall well-being of mothers navigating the
challenges and joys of the perinatal and postnatal journey. The curriculum addresses the complex
factors influencing women's mental health, including hormonal changes, stress, psychosocial
factors, and the impact of pre-existing mental health disorders (Borst, 2022). The curriculum
provides art therapy exercises and techniques tailored to the unique needs of new and expecting
mothers, promoting self-expression, empowerment, and resilience. Together, the research and

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curriculum provided underscore the potential of art therapy as a holistic, accessible intervention
to support maternal mental health during the perinatal and postnatal periods. By integrating art
therapy into standard care, we can promote the well-being of mothers, enhancing their ability to
navigate the challenges of this significant life transition. Further research and funding are needed
to ensure the widespread implementation of art therapy in perinatal and postnatal care settings.
Potential Limitations
While this research underscores the potential benefits of art therapy for maternal mental
health during the perinatal and postnatal periods, several limitations must be acknowledged to
inform future research and implementation. First, misconceptions surrounding maternal mental
health may deter women from seeking help or participating in art therapy groups. Stigma, beliefs
that symptoms will pass with time, or reliance on partners/family/friends for support may prevent
women from accessing the care they need. Normalizing mental health support during the
perinatal period through public awareness campaigns and education is crucial for encouraging
early intervention. The curriculum, while addressing common themes, may not fully
accommodate the unique needs and circumstances of every participant, such as those with severe
mental health diagnoses or complex trauma. Adaptations and additional resources may be
necessary to ensure inclusivity. Cultural factors must also be carefully considered to avoid
unintentionally creating barriers or misunderstandings. Cultural competency training for
facilitators and thoughtful selection of art materials and directives are essential.
Practical barriers, such as childcare, location, transportation, and financial constraints,
may limit access to art therapy groups. Telehealth options can help address some of these
barriers, but equitable access to technology must be ensured. For new mothers, breastfeeding
schedules, nap times, and the baby's unpredictability can make committing to regular sessions

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challenging. Normalizing self-care and providing flexible scheduling options can help mitigate
these challenges. Pregnancy loss presents a specific limitation for open art therapy groups
focused on pregnancy or postpartum. While the curriculum's interventions can help manage
anxiety and depression, content focused on pregnancy, birth, and mothering may be distressing
for women who have experienced loss. Separate support groups for women who have
experienced pregnancy loss, facilitated by a trained provider, are necessary to ensure a safe and
supportive environment for all participants. Follow-up support after the group concludes is
critical for sustained well-being. Ensuring participants have connections to ongoing resources
and support, such as individual therapy, support groups, and helplines, is vital. Collaboration
with healthcare providers and community organizations can facilitate warm handoffs to
continued care.
Despite these limitations, the potential benefits of integrating art therapy into perinatal
care are clear. By acknowledging and proactively addressing these limitations, we can work
towards ensuring all women have access to the support they need during the perinatal and
postnatal periods. Further research and implementation efforts are needed to widely integrate art
therapy into standard perinatal care, promoting the well-being of mothers and enhancing their
ability to navigate this significant life transition.
Future research
Future research and implementation efforts are needed to ensure the widespread
integration of art therapy into standard perinatal care, ultimately promoting the well-being of
mothers and enhancing their ability to navigate the challenges and joys of this significant life
transition. Studies examining the effectiveness of art therapy for diverse populations of women,
including those from low-income backgrounds and women of color, are needed to ensure the

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intervention is accessible and equitable. The development of art therapy curricula tailored to the
unique needs of different subgroups of women during the perinatal period, such as those with
pre-existing mental health disorders or those experiencing pregnancy loss, is an important area
for future research. Investigating the feasibility and acceptability of delivering art therapy in
different settings, such as community centers and online platforms, can inform strategies for
improving access to care. Research on the benefits and logistics of offering sessions that include
fathers and partners is needed, as well as developing modules specifically supporting women
who have experienced perinatal loss.
Policy research is needed to examine the impact of different state and national policies on
access to perinatal mental health care, including art therapy. Advocacy efforts should focus on
promoting legislation that mandates perinatal mental health screening and insurance coverage of
early intervention services, including art therapy. The integration of art therapy into existing
perinatal care structures is a critical area for future research and implementation. Studies
examining models for interdisciplinary collaboration between art therapists, healthcare providers,
and community organizations can inform strategies for providing comprehensive, coordinated
care. The development of training programs for healthcare providers on the benefits and
implementation of art therapy is needed to ensure referral to these services.
The normalization of mental health support during the perinatal period is essential for
encouraging early intervention and reducing stigma. Public awareness campaigns and education
initiatives for women, families, and healthcare providers can play a key role in promoting mental
health as a priority during this time. Creating specialized training programs and competencies for
therapists delivering the curriculum will ensure they have the needed skills and knowledge,
making more therapists accessible to working with this population if they are interested.

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Future research should continue to investigate the efficacy of art therapy as a preventive
intervention, reducing the risk of severe mental health conditions during this period. Qualitative
research exploring women's experiences with art therapy during the perinatal period can provide
rich insights into the benefits and challenges of implementing this intervention. Longitudinal
studies examining the long-term impact of perinatal art therapy on maternal mental health and
mother-child bonding are warranted. Investigating the specific art therapy techniques and
exercises most beneficial for addressing different aspects of maternal mental health, such as
anxiety, depression, and stress, can inform the refinement of the curriculum.
Ensuring the curriculum is adaptable to diverse cultural backgrounds and is sensitive to
the unique needs of different populations of women is critical. The feasibility and acceptability
of delivering the curriculum in different settings, such as in-person groups, online platforms, and
individual therapy, should be examined. Strategies for addressing practical barriers, such as
childcare, transportation, and financial constraints, must be developed to improve access to care.
The importance of follow-up support and connections to community resources after the
conclusion of the formal therapy program must be emphasized to promote sustained well-being.
Conclusion
This research illuminate's art therapy's potential as a transformative intervention for
perinatal and postpartum mental health. The findings underscore the critical need for early,
integrated, and accessible interventions that prioritize maternal mental health during this
vulnerable period. The curriculum provides a framework for delivering art therapy groups that
can be adapted to diverse populations of women, fostering self-expression, empowerment, and
resilience.

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The research informs the refinement of the curriculum to address the unique needs of new
and expectant mothers experiencing anxiety and depression, paving the way for early
intervention programs in maternal mental health care. Future research and implementation efforts
are crucial to ensure the widespread integration of art therapy into standard perinatal care,
promoting the well-being of mothers and enhancing their ability to navigate this significant life
transition.
The curriculum offers a promising approach for addressing the complex needs of women
during the perinatal period. As we advance, this work will guide further research and
implementation, solidifying art therapy's role in transforming maternal mental health care and
outcomes. Early intervention and integrated perinatal care are paramount; this research
underscores the urgency of prioritizing maternal mental health from conception through the
postpartum stage.

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