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Referencing and citations

Advice and resources to support you with referencing and citations, and avoiding plagiarism.

At university you are expected to read and research, and then use the ideas, information, data and a range of other sources in your own academic work and assignments. However, it is important to make absolutely clear where each idea or piece of information comes from by referencing it (giving your sources) in your own work.

What is referencing? (PDF)

What is referencing? (Word rtf)

When done properly, reference adds credibility and strength to your arguments, as well as demonstrating the effort that you have put into research and reading. There is more information on using your reading and developing your argument in the Reading at university and Academic writing pages.

Reading at university

Academic Writing

Different subjects and disciplines use different referencing styles (or systems). You may even find that different assignments on a course use different styles, depending on the format of the assignment. The different styles, e.g. Harvard, Chicago, OSCOLA, look very different. But when and why you need to reference does not change. There is further information on Different styles in the Go further section of this page.

You need to make sure you know how you are being expected to do this and you should refer to your course, assignment, or programme information provided by your School about what style you are expected to use. If you are unsure, you need to ask someone who teaches you.

Citations vs references

In your work, you need to explicitly indicate and acknowledge when you have used or referred to someone else’s idea or data etc. However, if you were to include the full reference (or bibliographic details) of your evidence, it would disrupt the flow of your argument.

Instead, it is academic convention to give an abbreviated version of the reference details at the point it is being discussed. This is known as a citation or in-text citing. The citation should make an explicit link between the point being presented or discussed, and the evidence you are using.

A reference is the full bibliographic or publication details of a citation. Whilst the in-text citation tells your audience that there is evidence to support your point, the reference gives them all the information they would need to find that evidence and review it themselves. You may cite the same source several times in your argument, however it only needs one reference as it is the same source each time.

Typically, the references of all your citations are collated at the end of a piece of work. Depending on your discipline and the style you are using this may be called a reference list (or works cited ), or a bibliography . Everything you’ve cited in your work must be included in the references or bibliography. However, in some subjects, a bibliography may also include other sources which you have consulted but have not cited in your work. You need to check the information provided by your course or School about what is required.

Tips for accurate referencing (PDF)

Tips for accurate referencing (Word rtf)

Most word processing software has a citation or referencing function so you do not necessarily have to format them all yourself. However you will still need to check that the software has done it properly and in the style that is required. You should be able to find instructions on how to do this for your software in the Help section or by searching online.

It is your responsibility to ensure the accuracy and adequacy of your citations and references. You need to make sure that your citations unambiguously link to the correct reference. You also need to make sure that you have citations everywhere they are needed. If you forget or miss a citation, then the impression you are giving is that the work is your own, when it is in fact someone else’s.

This is called plagiarism and is a form of academic misconduct. Typically plagiarism is due to unintentional, inadequate referencing, but it can also be deliberate.

What is plagiarism? (PDF)

What is plagiarism? (Word rtf)

You should also read the University of Edinburgh’s official guidance and policy on plagiarism:

Academic Services – Plagiarism

The Good academic practice page has additional information and guidance on what’s expected, academic misconduct and support.

Good academic practice

Different styles

The way a reference is abbreviated into a citation, and the format of the bibliographic details at the end of your work differ, depending which style (or system) you are using. Styles generally fall into two categories and relate to what the in-text citation looks like:

• Author-date e.g. APA, Harvard,
• Numeric e.g. Chicago notes and bibliography (NB) format, OSCOLA and Vancouver.

Some styles also include footnotes, which have a distinct purpose and format depending on the style. Be sure to check course or assignment information on if and how to use footnotes.

Information Services provide access to Cite Them Right online, which offers guidance and examples of how to cite and reference different sources (e.g. journal articles, books, web pages) in different styles. If you are not on the University network, you may need to login in via your institution for full access.

Cite Them Right

Reference managers

Once you are accustomed to referencing (including when you need to do it and what it needs to look like), you could start to use a reference manager. Reference management software can automatically format citations and build a reference list or bibliography for you. They can also allow you to store, annotate and groups references in your own personal database. The Academic Support Librarians have put together a Referencing and reference management subject guide with information on the different tools and training available.

Referencing and reference management

This article was published on 2024-02-26

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Digitalisation of manufacturing systems: a literature review of approaches to assess the sustainability of digitalisation technologies in production systems.

Graphical Abstract

1. Introduction

2. background and scope of the research, 2.1. digitalisation technology in manufacturing systems, 2.2. sustainability as an assessment criteria for digitalisation technologies in manufacturing systems, 2.3. research questions.

• RQ 1: What is the importance of “digitalisation technologies (DTs and CPSs) and sustainability” in production environments in research?
• RQ 2: Which subjects are discussed in terms of “digitalisation technologies (DTs and CPSs) and sustainability”?
• RQ 3: How is the sustainability assessment of digitalisation technologies (DTs and CPSs) discussed in research?
• RQ 4: Which approaches exist to assess the economic and environmental benefits of digitalisation technologies (DTs and CPSs) in manufacturing systems?

3.1. Literature Review

3.2. data collection and analysis.

• (1) Identification: In the first step, the search terms are defined. Based on the research questions, these terms focus on cyber–physical production systems (CP(P)Ss) and digital twins (DTs) in the production environment. To ensure no relevant literature is missed, no further restrictions were imposed regarding environmental or economic assessment. Therefore, the literature search used the terms “digital twin”, “cyber-physical (production) system” and “manufacturing” and connected them to the search terms (ALL = (manufacturing production “digital twin*”)) and (ALL = (manufacturing production “cyber physical system*” “cyber physical production system*”)) (used queries in “web of Science”: Query 1: manufacturing production “digital twin*”, Query 2: manufacturing production "cyber physical system*" “cyber physical production system*”).
• (2) Screening: In the second step, duplicates are removed and the remaining search results are filtered. To identify the articles that are relevant to the research problem, the titles and keywords of the papers are analysed first. All papers that obviously deal with another topic are excluded (no production background). Further, the abstracts of the remaining research results are analysed and assigned to the categories Industry 4.0, digital twins and cyber–physical systems (including CPPSs). Papers with another I4.0 background (Big Data, AI) are excluded. To identify and categorise the literature that deals with the cost and resource efficiency assessment of digitalisation technologies in production systems, the categories environmental and economical are added. Publications were considered that address environmental or economic issues in the context of CPSs or DTs. From this, papers can be derived that basically deal with the use of digitalisation technology to increase cost or resource efficiency. These categories are necessary to study the importance and dynamics of the research subject related to the search term (RQ 1 and RQ 2). These publications are classified according to the year of publication, the type of publication, the journal category (engineering, environmental, computer and other sciences), the most important journals, the frequency of keywords, the regions (countries) and the most important universities (institutes) of the publications.
• (3) Eligibility: In the third step, the existing methods for holistic assessment are filtered out of these results and evaluated in terms of whether they deal with (i) a holistic approach for an economic and/or environmental assessment, (ii) efforts (costs) and benefits associated with digitalisation technologies, (iii) a specific economic assessment and (iv) a specific environmental assessment (RQ 3). In addition, the cross-references of the literature examined are analysed in a snowball search and included in the LR. This is carried out based on the relevant literature, as it is assumed that other relevant literature is mentioned there. As a result, various subject fields are characterised to determine the relevance of the sustainability assessment of digitalisation technologies in research.
• (4) Selection: In the fourth step, the papers that meet the criteria are analysed in terms of content in relation to RQ 4 to identify the methods used for a holistic assessment of digitalisation technologies. It is essential to describe the status of the methods presented and to analyse them with regard to the consistency of the approach from problem description to decision-making. Other criteria are whether the assessment includes the entire life cycle from cradle to grave in the assessment methodology and whether it takes into account different impact categories and linear/non-linear cost–benefit functions. It is also of interest whether common assessment methods are applied and whether these consider economic and environmental sustainability dimensions.

4.1. Quantitative Results

4.1.1. identification and screening results, 4.1.2. chronological development, type and journal of publications, 4.1.3. keyword analysis, 4.1.4. publications per country and organisations, 4.1.5. characterisation by subject fields, 4.2. qualitative results, 4.2.1. content analysis, 4.2.2. analysis of the assessment methods, 5. discussion, 5.1. importance of digitalisation technologies and sustainability in research, 5.2. research subjects in the field of digitalisation technologies and sustainability, 5.3. sustainability assessment of digitalisation technologies in research, 5.4. approaches for the economic and environmental assessment of digitalisation technologies, 6. conclusions, author contributions, data availability statement, conflicts of interest.

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Tomaschko, F.; Reichelt, L.; Krommes, S. Digitalisation of Manufacturing Systems: A Literature Review of Approaches to Assess the Sustainability of Digitalisation Technologies in Production Systems. Sustainability 2024 , 16 , 6275. https://doi.org/10.3390/su16156275

Tomaschko F, Reichelt L, Krommes S. Digitalisation of Manufacturing Systems: A Literature Review of Approaches to Assess the Sustainability of Digitalisation Technologies in Production Systems. Sustainability . 2024; 16(15):6275. https://doi.org/10.3390/su16156275

Tomaschko, Florian, Lukas Reichelt, and Sandra Krommes. 2024. "Digitalisation of Manufacturing Systems: A Literature Review of Approaches to Assess the Sustainability of Digitalisation Technologies in Production Systems" Sustainability 16, no. 15: 6275. https://doi.org/10.3390/su16156275

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Intercontinental The George and Edinburgh College of Art unveil artwork in tribute to Susan Ferrier

The initiative, in collaboration with Edinburgh College of Art (ECA), the University of Edinburgh has culminated in a beautiful piece that will be permanently displayed in the new Ferrier Suite at InterContinental Edinburgh The George Hotel.

Following a competitive selection process involving numerous talented students from ECA, Ella Williams’ standout piece entitled ‘Studies from Ferrier's The Inheritance’ was chosen as the winning entry. The piece stood out for its creativity, depth and heartfelt homage to Susan Ferrier’s ‘The Inheritance’ and its contribution to Scottish literature, 200 years after being first published.

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The work by Williams, a third-year Fine Art student, features a collection of smaller narrative paintings that portray key elements and scenes from the novel, focusing on Ferrier’s critique of marriage in the novel. Her work laid bare the realities of the marriage market or the alternative of being an unwed women in 1824, the year of its publication.

The paintings also reference Ferrier’s connection to Edinburgh, specifically the InterContinental Edinburgh The George Hotel townhouse itself, where she once lived. The collected images seek to imply a narrative while remaining ambiguous to inspire curiosity amongst its audience about Ferrier’s work.

Williams’ intention was to illustrate the novel’s protagonist, Getrude St. Clair, and her journey largely through symbolism, representing the strong female character navigating the constraints of the period setting. Leaning into aspects of romantic imagery, Williams was intrigued by Ferrier’s use of the romance genre as a subversive means to comment on the position of women in society.

Williams explained: “Several of the paintings illustrate key settings within the novel, while others represent Gertrude’s journey of self-discovery in pursuit of a suitor that is her equal, symbolised by the clasping of hands and elements of romantic imagery such as roses.”

The figurative paintings are framed to exclude the faces of each subject, avoiding too literal an interpretation of the characters and allowing the viewers imagination to take precedence, deciding if Ferrier or Gertrude in the subject.

Williams continued: “I sought to nod to Ferrier’s residency in the building portraying elements of the hotel that would be recognisable to guests such as Ferrier looking out the window of the suite and a tea set that matches those available to guests.

“I’m delighted to have won this art project and can’t wait to see my piece displayed within the hotel and being enjoyed by visitors to the city.”

Jonathan Dawson, General Manager at InterContinental Edinburgh The George Hotel, said: “We are thrilled to showcase Ella Williams’ stunning piece within the hotel. Her work not only honours Susan Ferrier’s literary achievements but adds another piece to our already rich cultural heritage. This partnership with Edinburgh College of Art has been incredibly rewarding, and we looking forward to seeing how Ella’s work will inspire our guests.”

Susan Mowatt, Head of Art, Edinburgh College of Art, said: “Ella Williams’ artwork is a testament to the talent and creativity nurtured at our institution. We are proud to support initiatives that connect our students with the community and celebrate our city’s historical figures.”

As well as becoming part of the hotel’s heritage, Williams also received a purchase price of £3,500 for her artwork, an overnight stay in the Ferrier Suite and dinner in the hotel’s restaurant Le Petit Beefbar .

Artistic runners up from ECA include Chengyi Xu Xu and Amy Sema who each won an overnight stay and dinner in Le Petit Beefbar.

‘Studies from Ferrier's The Inheritance’ will be displayed in InterContinental Edinburgh The George’s Club InterContinental lounge over the summer, before being put on permanent display in the hotel’s Ferrier Suite in celebration of the author’s unique connection to the hotel.

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• Schools & departments

English Literature and Scottish Literature at Edinburgh

Find out what you'll study and where, and explore opportunities to get creative and make friends.

What you will study 

We offer multiple degree programmes in English Literature and Scottish Literature.

You can take a single honours programme in either English Literature or Scottish Literature, combine both in a joint honours programme, or take either with one of a wide range of other subjects, including English Language and a number of European languages. 

Degree Finder gives you a year-by-year overview of what you will study on each of our programmes.

Browse our literature programmes on Degree Finder

Degree structure

You’ll complete a four-year Master of Arts (MA) honours degree.

Each year, you will study courses that give you a total of 120 credits.

Your first two years will be your pre-honours years. They will give you a good grounding in your subject(s). For example, they will introduce you to the essential skills needed for the critical close reading of the core literary genres of poetry, drama and prose. 

On most programmes, you will build up your pre-honours credits by taking a mix of compulsory and optional courses. This is likely to involve choosing courses from other subject areas. Typically, single honours students choose more optional courses than joint honours students.

Your final two years will be your honours years. This is when you will specialise in the aspects of your subject(s) that interest you most.

Discover a world of languages

One of the benefits of taking a four-year degree is the chance to study different subjects in your first two years. Most of our degree programmes have this flexibility.

There are lots of benefits to learning a language, from making the most of time abroad to enhancing your social life in Edinburgh and increasing your employability.

We have a very wide range of languages to choose from, either as:

• part of your programme
• a short evening course with the Centre for Open Learning
• part of a social, student-led activity

The majority are suitable for complete beginners - no previous experience required!

Discover a world of languages on our dedicated website

Degree Programme Tables

The detailed content of degree programmes for students starting in September 2024 is now available in our Degree Programme Tables (DPTs).

The Degree Programme Table will give you a more in-depth insight into the compulsory courses and optional courses on your degree programme. Find out about a particular course, including:

• the syllabus
• methods of assessment
• modes of feedback
• learning outcomes

To get started with a DPT, choose your programme from the alphabetical list of undergraduate programmes in literatures, languages and cultures.

Find DPTs for the 2024/25 academic year

Where you will study

When you are on campus, you can expect to spend most of your time in the University of Edinburgh's Central Area - in class, in the library, or in one of the University’s many social and support spaces.

The Central Area is located on the edge of Edinburgh's historic Old Town, surrounded by lots of green space.

The University holds many literary treasures in its extensive collections. These include a truly exceptional collection of early Shakespeare quartos and other early modern printed plays, and the Corson Collection of works by and about Sir Walter Scott.

Modern literature and poetry are particularly well represented, with the W.H. Auden collection and the libraries of Lewis Grassic Gibbon, Hugh MacDiarmid and Norman MacCaig.

Explore with a Virtual Visit

Take a look around our School, and the wider University, with our Virtual Visit.

Look inside 50 George Square (where English Literature and Scottish Literature are based), check out the campus libraries and points of interest, and get a feel for what it's like to study and live in Edinburgh.

Virtual Visit - English Literature and Scottish Literature

In the city

A UNESCO World City of Literature, Edinburgh is a remarkable place to study, write, publish, discuss and perform prose, poetry and drama.

In addition to a fantastic range of publishing houses, bookshops, theatres, and cinemas, you will study near the:

• National Library of Scotland
• National Museum of Scotland
• Edinburgh Central Library
• Scottish Poetry Library
• Scottish Storytelling Centre
• Writers’ Museum

We have strong links with the Edinburgh International Book Festival, which annually welcomes around 1,000 authors to our literary city.

The four-year experience

Our degree programmes are designed to include four years of study to give you a broader and more flexible education.

This means, in most cases, you'll have the chance to try a range of subjects before specialising. Even if you know exactly what you want to do, you can study additional subjects and add depth to your education.  We believe this will give you the best chance of success in your future career. 

Learn more about the four-year experience

Applied for a joint honours degree?

Don’t forget to look at the information for each of your subjects. Navigate to the information for all subject areas at the link below. Choose the School your subject belongs to and explore your other subject.  Not sure which School your other subject belongs to? There is also a handy list of which School owns which subject below.

Explore your subjects

Living and studying abroad can broaden your horizons, transform your academic perspective, and help you to get the very most from your time as an undergraduate.

If you're studying a joint degree with a European language,  you will spend time abroad. Where possible, our joint degree with Persian also involves a period of study abroad. In all cases, this will be in the  2026 to 2027 academic year, your third year as an Edinburgh student. It will be your chance to turn classroom learning into living engagement with other cultures, developing lots of skills that you will use after university and that employers love to see. 

If you are not studying a joint degree with a language, study abroad is entirely optional. But if you do choose to go abroad for a full year, it will be the  2026 to 2027 academic year, your third year as an Edinburgh student. There are also opportunities to go abroad for a much shorter time, including on work placement or for summer school.

Find out more about Go Abroad opportunities at the University of Edinburgh and hear from our Study and Work Away Team

Get creative and make friends with literature

Across the University, there are lots of opportunities to get involved in:

• reading and writers' groups
• poetry slams
• creative writing and publishing
• student theatre

We also have a fantastic Writer in Residence who organises talks and workshops by visiting writers and runs our annual writing prizes. Their drop-in sessions give you the chance to:

• share your work
• get feedback
• meet other student writers
• get inspiration and prompts for new work

Our Peer Support Group, LitPALS, is also a great way to make friends, as well as to get help with your learning. Supported by Edinburgh University Students’ Association, it is one of the University's largest Peer Support groups.

Find out more about LitPALS

Why study English Literature and Scottish Literature at Edinburgh

Marta Vicarelli, led a literature review investigating hazard mitigation of Nature-based Solutions

A new global assessment of scientific literature led by Marta Vicarelli and researchers at the University of Massachusetts Amherst finds that nature-based solutions (NbS) are an economically effective method to mitigate risks from a range of disasters—from floods and hurricanes to heatwaves and landslides—which are only expected to intensify as Earth continues to warm. 

Crotty Hall 412 North Pleasant Street University of Massachusetts Amherst, MA 01002 413-545-2590

SYSTEMATIC REVIEW article

Resilience and mental health among perinatal women: a systematic review.

• 1 Department of Psychiatry, Maddawalabu University, Shashemene, Ethiopia
• 2 Department of Midwifery, Maddawalabu University, Shashemene, Ethiopia
• 3 Department of Psychiatry, College of Health Sciences, Mattu University, Mattu, Ethiopia
• 4 Department of Nursing, College of Health Sciences, Mattu University, Mattu, Ethiopia
• 5 Department of Midwifery, College of Health Sciences, Mattu University, Mattu, Ethiopia
• 6 Department of Midwifery, Institute of Health Sciences, Wollega University, Nekemte, Ethiopia

Objective: This review aimed to assess the current evidence on the relationship between resilience and mental health employed in response to the impacts of mental health.

Method: This review was conducted in accordance with the Preferred Reporting Items for Systematic Review and Meta-analysis (PRISMA). The protocol of this review was registered on the International Prospective Register of Systematic Reviews (PROSPERO: CRD42023470966). Three authors searched peer-reviewed articles using several electronic databases, including Scopus, PubMed/MEDLINE, Psych Info, EMBASE, and Web of Science, from September to October 2023 and included all the studies from any time until November 1, 2023. The review included all eligible quantitative observational and qualitative studies, irrespective of geographical boundaries.

Result: Depression, anxiety, and post-traumatic stress disorders were found to be the most common, but not the only, mental health disorders during the perinatal period, and higher maternal resilience during perinatal periods was found to reduce mental health disorders. It was also found that pregnant women were more resilient to mental health disorders than postpartum women. Tolerance of uncertainty and a positive cognitive appraisal, women’s self-behavior and family functioning, and protective psychosocial resources such as dispositional optimism, parental sense of mastery, self-esteem, gratitude, and forgiveness were found to be the most common mechanisms of resilience among perinatal women. Older age, having an adolescent partner, family income, and distress were found to affect resilience.

Conclusion: Noting that women’s resilience is an important tool to prevent perinatal mental health disorders, maternal healthcare providers need to counsel perinatal women on resilience-boosting mechanisms, such as applying self-behavior and having social support or close family relationships. It is recommended to counsel or provide psychosocial interventions for the woman’s companion or partner to give strong support for the woman in each of the perinatal periods.

Systematic review registration: https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=470966 , identifier CRD42023470966.

Introduction

Mental health is the backbone of other health, defined as a state of mental well-being that permits individuals to cope with stress conditions, realize their abilities, and be productive in their communities. It’s a fundamental human right of an individual and a milestone in personal, community, and socioeconomic development ( 1 ).

Resilience is the ability to bounce back from struggling or challenging life experiences with a successful outcome, mainly through mental, psychological, and behavioral flexibility and adjustment to external and internal demands ( 2 ). Every person will experience difficulties or challenges in their life. However, the main concern is the ability to respond to these difficulties without serious harm because it allows them to overcome negative experiences and helps them to learn from them ( 2 , 3 ).

Nowadays, mental health disorders (MHDs) are a worldwide burden of diseases. As described from the updated data in the 2019 global burden of diseases reports, mental disorders account for more than 14% of years lost due to disability for about 30 years ( 4 ). Furthermore, globally, more than 300 million and 280 million individuals suffer from anxiety and depression, respectively ( 4 , 5 ).

Perinatal mental disorders (PMDs) are mental and behavioral disorders that occur during pregnancy and postpartum period. It affects more than 20% of perinatal women ( 6 ). Depression and anxiety are among the common mental disorders that occur during the perinatal period, followed by posttraumatic stress disorder and postpartum psychosis ( 7 ). Those mental disorders during the perinatal period may occur as a result of experiences associated with childbirth, neonatal loss, malformation birth, intimate partner violence, previous history of abuse, unwanted pregnancy, complications in labor, and higher perceived stress ( 8 – 10 ).

Mental disorders during the perinatal period result in many devastating impacts on both mothers and their newborns unless they are detected early and managed accordingly ( 11 ). The negative consequences of mental disorders include maternal morbidity and mortality associated with increased risk of maternal suicide and impaired motherhood capability that extremely affect the physical, emotional, social, and cognitive development of their newborns ( 12 , 13 ). Furthermore, perinatal mental disorders have a huge economic burden; for instance, in the United Kingdom (UK), an estimated £75,728 and £34,840 expenditure per woman for perinatal depression and anxiety, respectively, with an aggregate cost of £6.6 billion ( 14 ).

Despite the perinatal period being the most challenging time with a lot of psychological, physical, and social changes for women, most women adapt to the situation and care for their family members by accepting the change as exciting and joyous ( 15 ). Besides this, several women experience a wide range of negative emotions, which can result in biopsychosocial distress ( 15 , 16 ). Thus, perinatal resilience is crucial for the woman’s well-being, family balance, adaptation, or acceptance when faced with stressors, challenges, or adversity during the perinatal period ( 17 ).

Some of the studies show the impact of resilience in overcoming mental disorders like depression, anxiety, and post-traumatic stress disorders ( 15 , 18 – 20 ). As identified in different literature, mechanisms of resilience that help to recover from perianal mental disorders are mastery, optimism, spirituality, social support, adequate financial resources, and a healthy perinatal environment ( 20 – 22 ). In addition to this, cognitive behavioral therapy and mindfulness interventions are also identified as mechanisms for coping with mental disorders during the perinatal period ( 23 ). In other ways, various studies assessed resilience specifically for anxiety, depression, and posttraumatic stress disorders in different perinatal periods. Thus, there is no consistent finding on the mechanism of resilience to the perinatal period of mental disorders. Therefore, this review aimed to assess the current evidence on the relationship between resilience and mental health employed in response to the impacts of mental health.

Materials and methods

Study protocol and registration.

The protocol of this review was registered on the International Prospective Register of Systematic Reviews (PROSPERO) with the accession number (CRD42023470966). This review was conducted in accordance with the Preferred Reporting Items for Systematic Review and Meta-analysis (PRISMA).

Article search strategies

Three authors searched peer-reviewed articles using several electronic databases including Scopus, PubMed/MEDLINE, Psych Info, EMBASE, and Web of Science, from September to October 2023, and included all the studies from any time until November 1, 2023. In addition, they searched for different relevant gray literature using Google Scholar. Boolean operators ‘OR’ and ‘AND’ were used in between the articles’ keywords and the medical subject heading terms (MeSH). The keywords used were ‘resilience’ OR ‘coping’ AND ‘antenatal’ OR ‘prenatal’ OR ‘during pregnancy’ OR ‘pregnant women’ OR ‘intrapartum’ OR ‘during birth’ OR ‘during labor’ OR ‘during childbirth’ OR ‘postpartum’ OR ‘postnatal’ OR ‘after birth’ AND ‘depression’ OR ‘anxiety’ OR ‘suicide’ OR ‘substance’ OR ‘post-traumatic stress disorder (PTSD)’ OR ‘general psychological distress’.

Definition of terms

Since there is no agreed-upon definition of resilience, authors have instead defined it as it is also described as a circular process towards a greater wellbeing in the form of personal growth, family balance, adaptation or acceptance when faced with stressors, challenges, or adversity during the perinatal period ( 15 ).

Perinatal period

refers to the period between pregnancy and the first 12 months following delivery ( 24 ).

Eligibility criteria

All full-length articles published in English, irrespective of time and geographical boundary, were selected according to Mattos TC. et al.’s PICO/PECO format (Patient/Problem/Population; Intervention/Exposure; Comparison and Outcomes) ideal questions intended to solve a clinical problem ( 25 ). Accordingly, this review included all original studies conducted among perinatal (prenatal, intranatal, and postnatal) women (P). The resilience of perinatal women was the exposure (E) status of the review. The outcome (O) interests of this review were the mental health outcomes, including depression, anxiety, suicide, substance use, post-traumatic stress disorder, and general psychological distress. Even if the current review primarily targeted the above-stated mental health conditions, it was not restricted to this but rather included mental health conditions affecting women in the perinatal period, such as sleep disorders, child psychiatric disorders, and lifetime trauma.

In addition, in this review, all published and unpublished studies in the English language that have a clear outcome of interest and are available in full text were included, including all published and unpublished randomized controlled trials (RCTs), observational studies, and qualitative studies. The review included all eligible quantitative observational and qualitative studies, irrespective of geographical boundaries. For the inclusion of qualitative studies, a discussion guide with queries related to mental health should be available. However, it excluded editorials, corrigendum, case studies, reviews, commentaries, conference abstracts, reports, and any articles published in languages other than English that were not published in full-length and utilized designs other than RCT, observational, and qualitative studies.

Screening and article selection process

Two authors (MAH and WG) conducted the data extraction and article section from October 13 to 16, 2023. The third author (SS) was enlisted to settle disagreements among authors about whether to include or exclude manuscripts from the review process. The full texts of every study that was included were compared again to the specifications, and any discrepancies were resolved by the authors. The data were extracted based on the article’s author name, year of publication, study setting and period, study design, sample size, perinatal period, data collection methods, population demography, magnitude of mental health conditions, mechanism of resilience employed, association of resilience with mental health, and risk impacts or determinants of resilience/future implications. The extracted articles were transferred to Endnote version X9 to manage references and duplications. Then the extracted articles were independently screened by the three authors.

Critical appraisal of the studies

Two independent reviewers (SS, YA) evaluated the quality of the included studies using the Joanna Briggs Institute (JBI) and the Mixed-Methods Appraisal Tool (MMAT). The reviewers discussed any discrepancies in the evaluation until they could come to a consensus and when a disagreement arose, the third reviewer (ZA) took the study into consideration and mediated a settlement.

The methodological qualities of the quantitative observational studies were appraised using the JBI Systematic Reviews Checklist for Systematic Reviews and Research Syntheses. The modified JBI checklist has nine ( 9 ) items to which a response of “yes” or “no” is possible. For this review, the checklist was converted to a scale. A total quality score, ranging from 0 to 18, was obtained by adding the scores of each item, which were assigned a value of 2 (excellent), 1 (good), or 0 (not available, unclear, or poor) ( 26 ). In other ways, the Mixed Approaches Appraisal Instrument ( 27 ), a critical appraisal instrument, was employed to assess the quality of the mixed studies included because papers using a variety of approaches were included in this study, and they have been validated and demonstrated to have good reliability ( 28 ). The MMAT has five quality criteria and wasutilized to evaluate the possibility of bias in the results and to give an insightful description of overall quality. Quality assessment of mixed-methods research was conducted both in the contexts in which the quantitative and qualitative components were employed, and in their own context ( 29 ).

In order to find pertinent literature for our review, we employed a variety of databases as search engines, including PubMed/MEDLINE, Scopus, Embase, PsychInfo, and the Web of Science database. Gray literature has also been checked for in other places, such as Google Scholar. As a consequence, 2,840 articles were initially sourced from various sources, including five databases. 1,770 studies were still available for further review after being screened for duplicates and irrelevant themes. Then, 1,714 studies were discarded after title and abstract verification. Afterward, 56 studies had become candidates for full-text review. The authors finally included 28 papers that fulfill the methodological or eligibility requirements to conduct systematic review ( Figure 1 ).

Figure 1 PRISMA flow chart displaying the selection process of identified studies.

Characteristics of included studies

Regarding the study settings, the majority of the included studies were conducted in developed nations, with Asia following in second. Accordingly, the USA reported nine of the studies, followed by China with seven studies. Additionally, three and two studies came from Australia and India, respectively. For this review, single studies were donated from a variety of other nations, including Spain, Poland, Brazil, Ecuador, Saudi Arabia, Nigeria, and Ethiopia Table 1 .

Table 1 Characteristics of included studies, 2024.

Twenty-three of the studies were quantitative observational, and five were mixed-methods research. Nine of the observational quantitative studies were carried out during the COVID-19 era, and twenty-two studies equally shared eleven cross-sectional and longitudinal cohorts amongst them. A total of 17,453 sample sizes were included, with the minimum and maximum sample sizes in the current review evidenced in the USA ranging from 30 to 4412 ( 31 , 52 ).

Almost all the studies included in the current review used standard and cross-culturally validated instruments to assess mental health outcomes. Accordingly, the Connor-Davidson Resilience Scale-10 and 25 items (CD-RISC) were the most commonly used instruments in more than 45% of the retrieved reviews (13 out of 28 studies) ( 21 , 30 , 32 , 35 , 40 , 42 , 43 , 51 – 56 ) for measuring resilience, followed by the Brief Resilience Scale (BRS) ( 33 , 39 , 57 , 58 ) and the Wagnild Young Resilience Scale ( 37 , 40 , 41 ). The other instruments used for the assessment of resilience include the Resilience Measure Questionnaire (KOP26), the Ego Resilience Scale, the Brief Risk and Resilience Battery, and the Resilience Scale for Adults (RSA). Even if the study period was undertaken during the perinatal period from conception to the postnatal period, eleven studies were exclusively undertaken during pregnancy, while the rest of the studies were done during both the pregnancy and postpartum periods. Considering the mental health conditions examined for their association with resilience, depression, and anxiety take a leading role in most of the studies, followed by perceived stress.

The Edinburgh Postnatal Depression Scale (EPDS) was commonly used for assessing postpartum depression in the current review (8 of the 28 studies) ( 18 , 21 , 30 , 32 , 34 , 38 , 57 , 59 ), followed by the Epidemiologic Studies Depression Scale (CES-D) in about four studies (3/28) ( 36 , 40 , 43 ), and Patient Health Questionnaire-2 (PHQ-9)(2/28) ( 52 , 58 ) Moreover, the Beck Depression Inventory (BDI-2) ( 59 ) and the Depression, Anxiety, and Stress Scales (DASS-21) ( 33 ) were also employed to measure depression in the retrieved reviews. Of the 28 studies, eight were completed between 2009 and 2019 ( 21 , 34 – 36 , 38 , 40 , 52 , 54 ), and twenty were undertaken between 2021 and 2023 ( 18 , 30 , 31 , 33 , 37 , 39 , 41 – 43 , 49 – 51 , 53 – 60 ) Table 1 .

Regarding risk of bias, we utilized the Joanna Briggs Institute (JBI) criteria to assess the quality of the quantitative research, and we discovered that twenty one of the studies had low risk bias ( 18 , 21 , 30 – 37 , 39 – 43 , 51 – 54 , 57 , 59 ), two had medium risk ( 38 , 57 ), and no study reported had high risk. The MMAT was another method used to assess the quality of the mixed research. According to previously published systematic literature reviews as well as recommended practices for using the MMAT to communicate the quality of the study, overall quality rating scores have been given. Accordingly, four studies, each two of them scored 60% and 80%, respectively, and one study scored 100% Supplementary File 1 .

Mental health outcome of study respondents

According to the studies reviewed in this review, there are differences in the types and degree to which different mental health problems are associated with resilience. This includes depression, which is the most commonly studied common mental health condition in more than 50% of the studies (16/28 studies) ( 18 , 21 , 30 – 32 , 34 – 36 , 38 , 40 , 43 , 49 , 50 , 52 , 56 , 58 , 59 ), followed by anxiety disorders (8/28 studies) ( 30 , 31 , 36 , 38 , 49 , 51 , 56 , 58 ). The third commonly investigated mental health condition is perceived pregnancy stress (7/28 studies) ( 18 , 37 , 39 , 41 , 42 , 53 , 60 ). Post-traumatic stress disorder was another condition commonly reported (3/28) ( 34 , 35 , 56 ), followed by psychological distress ( 31 , 54 ) and sleep disorders ( 31 , 55 , 57 ). Besides, opioid use disorders, lifetime trauma, childhood maltreatment and fear of childbirth were the least reported in the current review ( 32 , 35 , 50 , 55 ). The magnitude of depression has been reported in about 13 studies in various settings, ranging from 6.5% in India ( 21 ) to 75% in Saudi Arabia ( 57 ), both for antenatal and postnatal depression, and the report seems lower as to anxiety disorders comparatively (ranging from 11.1% to 60%). Additionally, more perceived pregnancy stress was reported than any other condition, ranging from 16.2% in China to 89% in Ethiopia.

Association of mental health with resilience

Studies have shown that resilience can protect us from psychological disorders, and this could take different forms, such as directly reducing the impacts of the condition or offsetting determinants that increase the risk of mental health conditions. Particularly during the perianal period, numerous circumstances affect the resilience of individuals living with mental health conditions, which might vary depending on the perinatal period (pregnancy and postnatal), parity, individual capability, sociocultural, environmental, and other significant attributes.

Accordingly, the current review highlighted the highest resilience scores for pregnancy compared to the postpartum period, specific to psychological disorders such as depression and PTSD. Resilience was found to decrease 34% of depression and 49% of post-traumatic stress disorder in the postpartum period, whereas 35% of depression and 56% of post-traumatic stress disorder occurred during pregnancy ( 33 ). In line with the current findings, a lower score of resilience was found to have an association with the highest score of depression and PTSD in the presence of a maternal history of childhood maltreatment ( 35 ). Psychological distress was the other mental health outcome and was 41.6% explained by resilience ( 55 ). In our review, the lowest score of resilience among pregnant women ranges from 36% in Saudi Arabia ( 57 ) to 77.2% in Nigeria ( 40 ), with the highest score evidenced among nulliparous women compared to those in the pregnant and postnatal periods ( 52 ). In sum, studies in the current review reported a higher resilience score with reduced mental health outcomes, including depression and anxiety ( 18 , 21 , 30 , 31 , 33 , 34 , 36 , 38 , 43 , 51 , 56 , 58 , 59 ), PTSD ( 34 , 35 , 56 ), stress ( 18 , 37 , 39 , 42 , 53 ), psychological distress ( 31 ), and sleep disturbance ( 54 , 57 ). In contrast to this, study from Massachusetts, USA, among pregnant women show neither anxiety nor substance use was associated with resilience ( 52 ), and similarly, resilience did not significantly mediate the association of lifetime trauma and postpartum depression ( 32 ). This might be explained from dose response relationship in which low exposure to adversity help them to learn on how to cope with or become resilient to negative experiences and thereby improve their mental health. Conversely, individuals who face hardships on a regular basis could give up on hope for better results, while those who never face difficulties are unable to acquire coping mechanisms, increasing their chance of developing mental health conditions. Moreover, a study found that the absence of a relationship between anxiety and resilience might be related to the study’s use of self-reported anxiety ( 20 ) rather than a validated measure ( 61 ).

Mechanism of resilience and mental health outcome

Physiological, neurobehavioral, and psychological factors are highlighted in models of psychological resilience as important contributors to safeguarding resilience. Psychological factors, including optimism, self-efficacy, high IQ, and the application of responsive emotional regulation techniques, have all been demonstrated in the earlier report to make a positive contribution to resilience ( 62 – 65 ). Resilience is a risk factor for some clinical diseases, such as suicide, as well as a protective factor against the onset of mental disorders. The available data from research studies indicates that resilience is a controllable factor, which creates opportunities for several novel psychosocial and biological therapies.Likewise, numerous mechanisms or techniques of resilience from perinatal mental health outcomes have been identified in the current review, including financial or psychological support ( 30 , 52 , 55 , 57 ), behavioral coping strategies (passive coping strategies (screen time, social media, and intake of comfort foods), and active coping strategies (social support) ( 21 , 31 , 32 , 34 , 36 , 39 – 41 , 51 , 56 , 57 ) and self-care). A study revealed women with active coping skills and high coping profiles were more likely to have greater educational attainment compared to those with passive coping ( 31 ). According to a study, women who practice active coping strategies, including situational adjustment, accommodation, and symptom reduction, are more likely to maintain their social networks, take care of themselves, stay away from harmful material that could affect their health, and spend less time vegging out. Passive coping pregnant women avoided social interaction, concealed their feelings from others, and seldom employed self-stimulation or diversion during stressful situations such as COVID-19. Moreover, avoidance was the least common prenatal coping strategy, while prayer was the most commonly used, and higher levels of uncertainty were associated with lower emotional well-being, less positive interpretation, less social support, and greater avoidance during pregnancy ( 31 , 66 ). A study revealed that pregnant women benefit intellectually and emotionally from psychological support, which also eases their transition to parenting and they may feel more stress and worry related to childbirth if they don’t have psychological support ( 67 ).

In the context of a secure existence with family or society, low resilience was substantially linked with reduced depressive symptoms and anxiety connected to childbirth. Also, the provision of psycho-education strengthens the negative impact of resilience on mental health conditions among pregnant and postpartum women ( 36 , 59 ). Depending on the social context in which it was placed, a particular stressor may intensify or lessen, and it may also be viewed as posing varying degrees of perceived stress or requiring varying levels of resilience. In addition, being able to tolerate uncertainty and having a positive cognitive appraisal ( 33 ) were also protective measures for explaining resilience during the perinatal period. Consequently, it was discovered that women with lower resilience, lower uncertainty tolerance, a negative cognitive evaluation, and greater objective suffering were more likely to have postpartum anxiety. Only a neutral or positive cognitive appraisal was able to considerably lessen the impact of subjective discomfort on anxiety. Women with high resilience are more likely to turn to positive reinforcement or seek out social support than to use negative coping methods linked to depression after childbirth. A neutral or positive cognitive appraisal significantly mitigated the influence of subjective distress on anxiety ( 33 ).

Implementation of person-centered strategies including mindfulness and self-compassion ( 60 ), regulating emotions ( 58 ), self-reliance and non-hostile interactions ( 38 ), tenacity and strength ( 53 ), and offering early evidence stress interventions ( 42 ), has been demonstrated to influence resilience in pregnant women. This supported the idea that resilience shows a robust link by playing a mediating role in the influence of pregnancy stress on prenatal anxiety. Positive attitudes and resilience attributes can safeguard both the mother and the child from psychological suffering ( 42 , 53 ).

In the context of severe psychosocial stressors or crises such as the COVID-19 pandemic, women reported the use of online communication platforms, engaging in self-care behaviors ( 49 , 56 , 58 )(e.g., adequate sleep, physical activity, and healthy eating), seeking partner emotional support, being outdoors, practicing gratitude, and adhering to structures and routines shown to enhance resilience. Furthermore, a study conducted in the USA examined the effectiveness of a recovery-oriented intervention among postpartum women with opioid use disorder utilizing the Substance Abuse and Mental Health Service Administration (SAMHSA) framework. It has been demonstrated to have a positive impact on resilience and facilitate recovery ( 50 ).

Numerous studies have provided explanations for coping strategies that lessen the adverse effects of mental health disorders on prenatal populations, one of which is social support.

Consequently, a study by Prabha S et al. found that social support, rather than resilience, mediated the link between life events and depression during the first trimester of pregnancy. This demonstrates that resilience alone cannot avoid depression ( 21 ). Likewise, the scenario also applies to the postpartum phase, where resilience was unable to statistically buffer the correlation between lifetime trauma and postpartum depressive symptoms, and social support negatively mediated the relationship. It is important to offer social support to expectant mothers in order to build resilience in our adolescent population ( 40 , 41 ). Social support and resilience demonstrated an inverse association with anxiety ( 51 ) and will be improved by adjusting our relationship with technology, particularly during the COVID-19 pandemic ( 56 ).

Another resilience approach that affected the mental health outcomes of pregnant and postpartum women was practicing self-care behaviors, such as getting enough sleep, following routines, being grateful, exercising, eating healthily, spending time outside, and praying ( 49 , 56 , 58 ). Given this, women who struggle with family and work-related issues and who score poorly on resilience and adaptation appear to be more vulnerable to psychological disorders.

Additionally, social media use is expected to enhance social connectivity, which in turn increases anxiety symptoms. Family functioning is the extent to which a family functions as a unit to manage circumstances, events, outside stimuli, or activities that produce stress. In the current review, family functioning ( 35 , 51 ), specifically a woman’s positive relationship with her own mother ( 43 ), followed by a sister ( 49 ) was shown to inversely affect anxiety and depression and promote well-being among pregnant women. Resilience in mothers is linked to a decrease in psychopathology and an increase in general well-being. While there was no evidence of resilience having a moderating effect on childhood trauma, resilience and trauma were predictive of postpartum family functioning. It also acts as a protective barrier against mental health conditions that arise from childhood trauma ( 35 ).

It has been shown that spirituality and a variety of psychosocial resources, such as dispositional optimism, parental sense of mastery, self-esteem, gratitude, and forgiveness, positively correlate with resilience and affect the mental health outcomes of perinatal women. According to a study, among postpartum women, depression was predicted by optimism and mastery but not by spirituality. The only resilience resource that can moderate the association between the number of stressful life experiences and postpartum depression symptoms with a small effect size is mastery ( 18 , 52 , 53 ).

Determinants of resilience among women in the perinatal period

Various factors influence perinatal women’s resilience in terms of mental health outcomes. Even the worst situations can occasionally have a silver lining, and many people bounce back from traumatic experiences with resilience. In the current review, resilience was associated with among older ( 34 , 36 , 37 , 41 ), white ( 34 ), residence area ( 34 , 36 ), educational level ( 37 ), employment status ( 36 , 37 , 56 ), northeast region ( 37 ), having an adolescent partner ( 37 , 40 ) family income ( 36 , 37 ), and receiving public antenatal care ( 37 ), household food-security, distress, and increased physical activity ( 39 ), and women having a partner while experiencing higher extreme weather events (storms), especially one involving threat, sickness, or trauma, was linked to poorer resilience ( 34 , 36 ).

Compared to women without a history of depression, women with a history of depression had considerably lower median resilience ratings. Lower resilience was also linked to a prior history of using medication for depression, anxiety, or sleeplessness before becoming pregnant (median). Belonging to religion and having sufficient finances were connected with higher resilience ( 38 ).

Moreover, preterm delivery ( 40 ) and poor sleep quality ( 53 ) were related to a higher risk of lower resilience. Psychological distress was much lower in pregnant women with strong resilience and low fear of childbirth than in those with poor resilience and high fear of childbirth. Significant relationships were found between the fear of childbirth and negative childhood experiences, as well as resilience and negative childhood experiences ( 55 ).

Five of the retrieved reviews used mixed methods, and the qualitative results from these contributed to clarifying and amplifying the quantitative conclusions. As a result, the results of qualitative data suggests that positive family relationships suggested are protective factors and have the tendency to reduce anxiety and depression among perinatal women ( 49 ). Furthermore, Jacqueline A. et al.’s study, 2021 ( 60 ), conducted during the COVID-19 pandemic, examined resilience in prenatal mothers into four main qualitative themes, which are as follows: The first theme clarified a rise in psychological distress (stress, anxiety, and/or depression), especially during the period of acute constraint and family absence. The absence of in-person services, uncertainty about where to get them, and lack of information about hospital admission restrictions fall under theme two. Separation from friends and family, a greater need for assistance and guidance, and favorable outcomes (such as time-bound and flexible work schedules) fall under theme number four. In sum, women stated that throughout this period of their lives, support from peers, family, and friends, getting adequate information ( 58 ), being thankful for changing priorities, and using self-care techniques ( 56 ), were found crucial in helping them become resilient in the face of stressors like COVID-19 ( 49 ), which also explains the role of recovery in building resilience among substance users ( 50 ).

Over the past few years, policymakers, medical professionals, and researchers have shown an increased interest in the concept of resilience. This interest stems primarily from the potential benefits of resilience for happiness, health, and quality of life ( 68 ). Earlier research ( 36 , 68 – 71 ) focused on the rare trajectories of the presence of difficulties or trauma, such as intimate partner violence or adolescent pregnancy, for the investigation of resilience during the perinatal period.

Furthermore, previous reviews on perinatal resilience-focused primarily on explaining how women’s resilience has been conceived and defined in scientific studies ( 72 ), while the current review aims at the evidence that connects resilience to common mental health outcomes like depression, anxiety, suicide, stress, sleep quality, substance abuse, and PTSD.

Comprehending the risk and promoting features of resilience provides many stakeholders with an opportunity to guarantee the well-being of mothers and children. In addition, the review investigated the specific resilience mechanisms used to mitigate the effects of mental health and related variables.

The current review conceptualizes resilience integration for evaluating its impact on perinatal women’s mental health outcomes, and nearly all of the studies (26/28) consider resilience to have a negative impact on mental health conditions and to promote well-being, regardless of the degree of association. However, the studies from Massachusetts, the USA, and India, where anxiety, substance use, and lifetime trauma lack associations with resilience, did not support this finding ( 32 , 41 ). In other ways, studies among abstinent individuals with substance use disorder show resilient people disclose more about themselves, easily recover ( 50 ), and are less likely to relapse into alcohol use ( 73 , 74 ).

The associations between mood disorders, trauma-related disorders, and resilience have been investigated in our reviews. Subsequently, higher scores of depression were shown to have an association with lower resilience scores. Resilience was found to decrease depression and post-traumatic stress disorder during the postpartum and pregnancy periods by 34% and 49% and 35% and 56%, respectively ( 34 ).

Moreover, resilience explained psychological distress by about 41.6% ( 55 ) and negatively affected other mental health disorders, including stress, sleep, and PTSD. This could be because psychological resilience enables individuals to build strong coping mechanisms, seek assistance when necessary, and apply their abilities to overcome obstacles in their mental health conditions. Besides, as a protective characteristic, resilience has been demonstrated to substantially decrease the correlation between risky exposure in life and depression, thereby functioning as a safeguard against adverse consequences including anxiety, depression, and post-traumatic stress disorder ( 75 ).

Family functions and social support are several instances of resilience mechanisms or coping strategies that have been invoked to explain mental health among pregnant women. As a result, previous reports indicate that women with depression and anxiety during the perinatal period received poorer social support ( 76 ), despite the fact that most of the retrieved reviews tested the provision of this support to buffer perinatal maternal adaptation to mental health outcomes and improve well-being. In other ways, Sexton et al. ( 35 ) hypothesized that the key components of lowering psychological distress are that resilient people are more likely to have supportive peers and to share their opinions.

It has also been demonstrated that family functioning negatively affects depression and anxiety while enhancing pregnant women’s well-being. Previous literature supported these findings ( 77 , 78 ). This may result from the beneficial influence of fathers on their offspring as well as the cortisol responsiveness of newborns after a stressful event, which is partly mediated by a lower risk of antenatal depression and more optimistic mother-infant interactions ( 79 ).

In the current review, mastery was one of the resilience resources that have been shown to be essential for controlling the association between the number of stressful life events and postpartum depression symptoms. Women who experience a high sense of mastery are less vulnerable to the psychological impacts of stress because they are more likely to believe they can manage or control life’s obstacles ( 80 ).

Several factors impact the resilience of women in the perinatal period. For instance, older age was positively associated with resilience. According to particular situations and contexts, adaptive behavior rather than necessarily a progressively continuous quality might explain resilient behavior among older adults ( 81 , 82 ). Lower family income and unemployed status among perinatal women were less likely to become resilient in response to mental health suffering compared to their counterparts. Employment is one significant factor in fostering mental wellness. It has a significant role in determining identity and self-worth. It can offer chances for relationships as well as a sense of fulfillment, and in most cases, their primary source of income comes from their job ( 83 , 84 ). Therefore, increasing standards for employment and enhancing working conditions may help to reduce health inequalities and enhance wellbeing.

Limitations of the study

This review included all articles regardless of time and geographical boundaries, addressing all quantitative and qualitative studies. Thus, it could be generalizable for the global population. However, the study excluded articles published in languages other than English, and data synthesis was not done, so the impact of heterogeneity, publication bias, and study variability were not assessed. Thus, this issue and some methodological issues, including study design shortcomings and sample size issues of the included studies, should be carefully considered while interpreting the findings.

According to this systematic review, depression, anxiety, and post-traumatic stress disorders were found to be the most common, but not the only, mental health disorders during the perinatal period. The review found that higher maternal resilience during perinatal periods reduces mental health disorders. It was also found that pregnant women were more resilient to mental health disorders than postpartum women. Regarding the mechanisms of resilience to mental health disorders during the perinatal period, tolerating uncertainty and a positive cognitive appraisal, women’s self-behaviour and family functioning, and protective psychosocial resources such as dispositional optimism, parental sense of mastery, self-esteem, gratitude, and forgiveness were found to be the most common mechanisms of resilience. Older age, residence area, educational level, employment status, having an adolescent partner, family income, distress, and increased physical activity were found to be detrimental factors of resilience.

Implication for practice

Noting that women’s resilience is an important tool to prevent perinatal mental health disorders, maternal healthcare providers need to counsel perinatal women on resilience-boosting mechanisms, such as applying self-behaviour and having social support or close family relationships. The current review took into consideration the need for healthcare providers to implement perinatal programs that aim to promote resilience by enhancing existing preventative measures and taking into account resilience mechanisms like active coping skills, self-care behaviors, social support, and cohesion. The integration of capacity building initiatives within current healthcare institutions could not only assist perinatal mothers, but also healthcare provider’s ability to provide quality services. Since high-level perinatal mental health conditions impair the biological and psychosocial development of the offspring, the mother and her unborn child would benefit more from positive reflection and protective psychosocial resources ( 85 – 89 ). We think it is also better to counsel the woman’s companion or partner to give strong support to the woman in each of the perinatal periods. Moreover, the concerned bodies need to incorporate counselling on resilience-boosting mechanisms into the antenatal and postpartum counselling packages.

Data availability statement

The original contributions presented in the study are included in the article/ Supplementary Material . Further inquiries can be directed to the corresponding authors.

Author contributions

MJ: Writing – original draft, Writing – review & editing. SA: Conceptualization, Data curation, Investigation, Methodology, Writing – review & editing. ZA: Conceptualization, Investigation, Methodology, Writing – original draft, Writing – review & editing. GT: Data curation, Investigation, Methodology, Supervision, Writing – review & editing. YW: Conceptualization, Data curation, Investigation, Project administration, Writing – review & editing. AD: Conceptualization, Data curation, Investigation, Software, Supervision, Writing – original draft. MH: Conceptualization, Investigation, Methodology, Project administration, Writing – review & editing. LW: Conceptualization, Investigation, Methodology, Writing – original draft. WG: Writing – original draft.

The author(s) declare that no financial support was received for the research, authorship, and/or publication of this article.

Acknowledgments

We (the authors) acknowledge all the authors of the original articles used in this review.

Conflict of interest

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Publisher’s note

All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article, or claim that may be made by its manufacturer, is not guaranteed or endorsed by the publisher.

Supplementary material

The Supplementary Material for this article can be found online at: https://www.frontiersin.org/articles/10.3389/fpsyt.2024.1373083/full#supplementary-material

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Keywords: mental health, associated factor, perinatal, women, resilience

Citation: Hajure M, Alemu SS, Abdu Z, Tesfaye GM, Workneh YA, Dule A, Adem Hussen M, Wedajo LF and Gezimu W (2024) Resilience and mental health among perinatal women: a systematic review. Front. Psychiatry 15:1373083. doi: 10.3389/fpsyt.2024.1373083

Received: 19 January 2024; Accepted: 28 June 2024; Published: 22 July 2024.

Reviewed by:

Copyright © 2024 Hajure, Alemu, Abdu, Tesfaye, Workneh, Dule, Adem Hussen, Wedajo and Gezimu. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY) . The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

*Correspondence: Mohammedamin Hajure, [email protected]

† ORCID : Mohammedamin Hajure Jarso, orcid.org/0000-0002-4596-9611 Wubishet Gezimu, orcid.org/0000-0002-5503-1360

Disclaimer: All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.

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Useful reading on literature searching and reviews (for Nursing)

Dissertations and writing, nursing.

Bottomley, J. & Pryjmachuk, S. (2017) Academic writing and referencing for your nursing degree , St Albans : Critical Publishing.

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Gimenez, J. (2019) Writing for nursing and midwifery students , Basingstoke ; New York, NY : Palgrave Macmillan

Glasper, E.A. & Rees, C. (eds), (2013) How to write your nursing dissertation , Chichester, West Sussex : Wiley-Blackwell.

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Williamson, G.R. & Whittaker, A. (2017) Succeeding in literature reviews and research project plans for nursing students , London : SAGE.

Garrard, J . (2022) Health Sciences Literature Review Made Easy : the matrix method. Burlington, MA : Jones & Bartlett Learning.

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Literature and systematic reviews

Aveyard, H. (2019) Doing a literature review in health and social care : a practical guide , London : Open University Press, McGraw-Hill Education.

Bettany-Saltikov, J. & McSherry, R. (2016) How to do a systematic literature review in nursing: a step-by-step gu ide , London : Open University Press.

Boland, A., et al. (2017) Doing a systematic review : a student's guide , Los Angeles : SAGE.

Holly, C., et al. (2022) Comprehensive systematic review for advanced nursing practice , New York : Springer Publishing Company.

Purssell, E. & McCrae, N. (2020) How to Perform a Systematic Literature Review A Guide for Healthcare Researchers, Practitione rs and Students , Cham: Springer International Publishing.