Implementation-relevant characteristics of midwifery-led cognitive behavioural therapy-based interventions for perinatal mental health in primary care: a scoping review.

INTRODUCTION

Cognitive behavioural therapy (CBT) is an evidence-based approach for perinatal mental health, yet its integration into perinatal primary care remains limited. Midwifery-led CBT-based interventions may enhance continuity, accessibility, and acceptability within primary healthcare. To address the gap between evidence and practice, this scoping review mapped existing research on midwifery-led CBT-based interventions and synthesised implementation-relevant characteristics that facilitate their integration into primary care settings.

METHODS

We conducted a scoping review following the Arksey and O'Malley framework and PRISMA-ScR guidelines. Five databases, MEDLINE, CINAHL Complete, EMBASE, Web of Science, and Scopus, were searched for studies published between 2004 and 2024. We synthesised data narratively across three domains: contextual, provider-related, and intervention-specific characteristics. Study quality was appraised using the SIGN checklist.

RESULTS

Ten studies met the inclusion criteria. Recurring implementation-relevant characteristics were observed in target population selection, intervention timing, provider configuration, and delivery formats, while substantial heterogeneity was observed in baseline symptom severity, intervention intensity, and evaluation approaches across contexts.

DISCUSSION: The recurring patterns identified across studies are likely to reflect pragmatic considerations related to feasibility within routine maternity care settings. In contrast, heterogeneity across the literature appears to reflect differences in intervention aims and care contexts, particularly preventive versus treatment-oriented approaches.

CONCLUSION

This review provides a foundation for future research to support the integration of midwifery-led CBT-based interventions into perinatal primary care. It highlights the importance of clearly defining intervention intent, developing feasibility-informed implementation strategies, and improving reporting practices to enhance interpretability and comparability across studies.