Samenvatting

Prevalence rates and the health problems related to maternal
distress instigated the development of an intervention to prevent and
reduce maternal distress during pregnancy. Intervention Mapping
served as a framework for the intervention development. A needs
assessment using the PRECEDE model and the results of a crosssectional
study among healthy pregnant women, showed factors that
are significantly related to women’s vulnerability or development of
maternal distress - for which midwives need to screen. A systematic
review and meta-analysis showed evidence for use of selective and
indicated prevention strategies in midwifery practice. Interviews and
a survey among midwives exploring their behavioral intentions of
antenatal management of care of maternal distress, showed midwives’
educational needs for screening. All these factors were taken on board
while developing, producing and implementing the intervention. The
intervention consisted of a training and toolkit for midwives and a
tailored web-based program for women. A non-randomized pre-post
intervention study was conducted to evaluate the intervention for
its effect. The intervention was shown to be effective in preventing
and reducing maternal distress during pregnancy, albeit to take the
limitations of the respective separate studies into account.