Young pregnant women express strong interest in nature-based green and social prescriptions to support their mental health and well-beingYoung pregnant women are especially vulnerable to mental health challenges. Preliminary research suggests that exposure to nature and social support are linked to reduced risk of depression and improved mental health symptoms during pregnancy. This study examines the potential of green and social prescribing to support mental health and well-being among young pregnant women. Green prescriptions are an intervention in which a healthcare professional refers a patient to participate in nature-based activities to support health and well-being. Similarly, social prescriptions refer patients to community-based activities that facilitate social connection. This study examined the availability, implementation processes, and appropriateness of nature-based group activities as potential green and social prescribing interventions aimed at supporting the mental health of young pregnant women.
The study was conducted in the East Midlands region of the U.K. Data was collected through: 1) a mapping exercise of nature-based activity providers within the region, and 2) focus groups with recently pregnant young women (under the age of 25 years) and nature-based activity providers. The mapping exercise aimed to identify social, nature-based services and activities available to young pregnant women (aged 16–24 years). To be included, the services and activities had to be nature-based, involve a social component, be inclusive of young pregnant women, and aim to support mental health and well-being. The researchers developed an online survey to explore the nature-based activities offered, organizational aspects (including evaluation, impact, and funding), and service user aspects (including referrals and access). The survey was sent to all identified nature-based activity providers (125 organizations) and shared on social media and with green prescribing networks. Survey data were combined to provide a descriptive summary of findings. Four focus groups were conducted with 11 recently pregnant young women. The focus groups examined the women’s interest in nature-based activities during pregnancy. Two focus groups were also conducted with six providers of nature-based activities who had completed the mapping survey. The focus groups explored their experiences of providing nature-based activities, involvement with green prescribing, and suitability of the activities for young pregnant women. Focus group data was analyzed thematically.
Mapping exercise surveys were completed by 68 organizations. The offered activities were largely designed to promote mental health and well-being, and most were free or subsidized for attendees. Activities offered included gardening, mindfulness practices, forest bathing, walking groups, arts-based activities, and animal activities. Most activities were held in the organization’s own nature setting, and to a lesser degree in public areas. Nearly 80% of organizations reported conducting evaluations of their programs. Most organizations indicated interest in expanding their activities, however about half stated their activities were at risk due to a lack of funding. The majority of organizations received referrals from social or green prescribing networks or other healthcare professionals. Over half of the organizations indicated that their activities were appropriate for young pregnant women and many others were interested in adapting their programs to serve women before and after birth.
The women’s focus groups revealed positive perceptions about nature-based activities and nature’s benefits for mental and physical health during and after pregnancy. The women valued opportunities for social interactions and viewed group-based nature activities as a way to form friendships and expand support networks. The women raised concerns about transportation, appropriate facilities (such as restrooms), as well as social anxieties about attending. They also felt that discussions to enhance understanding of nature’s mental health benefits would encourage attendance. Focus groups held with activity providers revealed their perspectives of the positive impacts for participants, which included learning skills, self-esteem, resilience, relaxation, and other benefits related to connecting with nature. Transportation was viewed as a barrier that constrained participation. On the other hand, providers felt participation could be facilitated through high quality pamphlets or in-person communication that aimed to reduce participant anxiety. Providers reported mixed experiences with green prescribing. Negative experiences were often the result of inappropriate patient referrals. The lack of funding to support infrastructure and program costs needed to provide green prescribing activities were also cited as a central concern. In general, providers felt that only minimal changes would be needed to adapt their current programs for pregnant women. Further, providers “expressed that involvement in nature-based activities during pregnancy could also have positive impacts on women’s parenting styles and their children’s relationship with nature.”
The study offers insight to the priorities and needs of young pregnant women and nature-based organizations that can be used to inform the development of nature-based green and social prescribing interventions. Findings suggest that a variety of nature-based activities are available for prescribing, that most activities are perceived to be suitable during pregnancy, and that young women are interested in participating in the activities and feel it would benefit their mental well-being. The study also reveals the concerns of nature-based organizations, which were mainly related to the lack of funding to enable green and social prescribing program implementation. Future research is needed to examine the feasibility of implementing nature-based prescriptions designed to support mental health for pregnant women.
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