3.1 Emphasizing the Assessment and Understanding of Pregnant Women's Mental States
Our study found that most pregnant women face significant psychological stress and troubles during pregnancy and childbirth, with multiple sources of distress, including physical changes, child-rearing pressures, and societal role changes. This finding is consistent with the previous studies, which pointed out that the stressors of pregnant women are diverse, including physiological, psychological, and social aspects [16–18]. In China, the degree of attention nurses and other health care providers pay to the mental health issues of pregnant women needs to be further improved. They need to conduct regular mental health assessments and interventions to enhance the quality of life for this specific group. In terms of the barriers pregnant women face in seeking psychological help, our research results align with those of Park et al [19]. Societal stigma and misunderstandings about mental illness may be the primary factors hindering women from seeking psychological help[6, 8, 20, 21]. In China, we need to eliminate public prejudices and misunderstandings about psychological problems through education and popular science promotion, enabling more pregnant women to seek psychological help without obstacles. In addition, the accessibility of psychological help services in China needs to be improved[22]. This includes increasing the number of providers of psychological counseling services, improving service quality, and lowering the threshold for using services [23]. These efforts can provide necessary psychological support to pregnant women more effectively, helping them better cope with the stresses and challenges of pregnancy and childbirth[24].
3.2 Understanding and Meeting Pregnant Women's Expectations for Psychological Assistance
Our research shows that pregnant women's expectations for psychological help are diverse, mainly including being understood and accepted, obtaining effective psychological coping strategies, and resolving practical issues in life. This reminds us that, in the process of providing psychological help, it is necessary to fully understand and respect each woman's individual differences and needs. For example, psychotherapists can use effective listening and feedback skills to make each woman feel understood and accepted[25]. Moreover, psychotherapists need to offer practical and targeted psychological coping strategies to help women deal with psychological stress and troubles[26, 27]. In terms of the impact of psychological issues on daily life, our study found that pregnant women's psychological troubles often have a profound impact on their family relationships, job performance, and personal quality of life. In the reality of China, despite the gradually increasing emphasis on mental health, the actual provision of mental health services is still insufficient [28, 29]. Therefore, as health care providers, we need to incorporate mental health into a vital component of pregnant women's health care and conduct regular mental health assessments to timely identify and address psychological issues.
3.3 Promoting the Popularization of Psychological Counseling During the Pregnant Period
Our study reveals the strong demand for psychological counseling among pregnant women and the urgency of popularizing psychological services in China. The respondents hope that psychological counseling can provide practical strategies to help them manage stress during the pregnant period and improve their quality of life. This is consistent with the research results of Tol et al., who found that the provision of psychological counseling services helps to alleviate the stress of pregnant women and improve their quality of life[6]. Therefore, to meet the mental health needs of pregnant women, it is necessary to promote the popularization of psychological counseling during the pregnant period. This means that large-scale public education activities need to be carried out to raise the society's awareness of the psychological stress of pregnant women, and the training and education of mental health professionals need to be strengthened to improve their professional competence and service quality [30]. In China, although the government has made some progress in promoting the popularization of mental health services, there are still some challenges in the provision of psychological counseling services during the pregnant period[31, 32]. These challenges include a lack of service providers, limitations in service acceptability and accessibility, and social stigmatization of psychological problems [33]. Additionally, the findings of our study highlight our important responsibility: by enhancing the public's awareness of psychological services, we encourage pregnant women to proactively seek psychological help. This requires us to carry out more science popularization and educational work, allowing more people to recognize the importance of mental health and encourage them to seek help when needed.
3.4 Targeted Intervention Strategies to Alleviate Psychological Stress in Pregnant Women
This study reveals the multifaceted sources of psychological stress faced by pregnant women, which is consistent with many previous studies [1, 2, 34]. To address these stresses, we need to take targeted intervention measures that consider the specific circumstances in China. For stress due to physical changes, we can address it by promoting pre-pregnancy education. This education should not only include scientific knowledge about physical changes during pregnancy and childbirth but also cover psychological adaptation to these changes. In China, despite widespread recognition of the importance of pre-pregnancy education, there are still some issues in practice, such as limited educational content and lack of coverage [33]. Therefore, we need to promote innovation and popularization of pre-pregnancy education to help women better understand and accept the physical changes during pregnancy and childbirth. For parenting stress, we can provide more training on parenting knowledge and skills. This training can include understanding and dealing with infant behavior, establishing effective parent-child relationships, and balancing work and childcare. In China, due to the long-standing "one-child policy," many young parents may lack experience in parenting, so this support is particularly important[31]. For stress due to changes in social roles, we need to alleviate it by promoting societal understanding and acceptance of the role of mothers. Moreover, although Chinese women's social status has improved, the change in their roles within the family remains a significant challenge[28]. Traditional concepts still influence the perception of women's roles to a certain extent. Therefore, we need to promote societal understanding and acceptance of the mother's role through public education and media advocacy.