Beating the Blues before Birth (BBB) Program

Beating the Blues Before Birth

Free to access research trial

The Beating the Blues before Birth (BBB) program is an adaptation of the Getting Ahead of Postnatal Depression Group Program for pregnant women who are depressed. We are currently seeking expectant mums to take part in a research study. All participants receive a full assessment with a psychologist and are either managed by their GP or receive the BBB treatment free of charge. Participants are reimbursed for their time filling out questionnaires.

Beating the Blues before Birth (BBB) is an 8-session cognitive behavioural therapy program. It is designed for women experiencing depression during pregnancy and includes one couple session to provide partners with information, support and an opportunity to be involved in the therapeutic process.

BBB was developed by adapting PIRI’s evaluated treatment for Postnatal Depression and including relevant aspects from other PIRI programs including Towards Parenthood and research.

Beating the Blues Before Birth Treatment

Women receive 8 sessions of cognitive-behavioural therapy (CBT). The sessions aim to teach coping skills to help better manage mood. Seven sessions help women develop the following:

  • Understanding and managing mood
  • Pleasant Activities: How can I find the time?
  • Relaxation on the run
  • Assertiveness and self-esteem: Telling others what I think and how I feel
  • Unrealistic expectations of parenting: Influences from the past
  • Developing a more helpful thinking style
  • Challenging my internal critic

In addition, one couple session is held to provide information and support to partners.

We are currently running a clinical trial, click here to visit the trial landing page. To download the Beating the Blues before Birth trial brochure click here. For any enquiries please contact Yafit Hirshler on (03) 9496 4496 or email

Beating the Blues Before Birth

This paper aimed to evaluate the efficacy of a brief CBT treatment for maternal depression and anxiety in pregnancy. Both the feasibility study and RCT yielded promising results for adherence, acceptability and improvements in depression and anxiety. Strong reductions in anxiety were observed during pregnancy and improvements in depression were maintained at nine months. Infant outcomes showed effects favouring the intervention in domains including problem solving, self-regulation, and stress reactivity, which were independent of maternal postnatal mood.

Milgrom J, Holt C, Holt CJ, et al. (2015) Feasibility study and pilot randomised trial of an antenatal depression treatment with infant follow-up. Arch Womens Ment Health 18: 717-730.

Subsequent papers have focused on the epigenetic effects of antenatal depression and the effects on children’s brain development:

Bleker LS, Milgrom J, Gemmill AW, et al. (2019a) A 7-year follow-up of antenatal depression treatment with cognitive behavioral therapy: A case report of maternal and child outcomes: SAGE Open Med Case Rep. 2019 Apr 9;7:2050313X19841463. doi: 10.1177/2050313X19841463. eCollection 2019.

Bleker LS, Milgrom J, Parker D, et al. (2019b) Brain Magnetic Resonance Imaging Findings in Children after Antenatal Maternal Depression Treatment, a Longitudinal Study Built on a Pilot Randomized Controlled Trial. Int J Environ Res Public Health 16.

Bleker LS, Milgrom J, Sexton-Oates A, et al. (2019c) Exploring the effect of antenatal depression treatment on children’s epigenetic profiles: findings from a pilot randomized controlled trial. Clin Epigenetics 11: 019-0616.

Milgrom J, Holt CJ, Bleker LS, et al. (2019d) Maternal antenatal mood and child development: an exploratory study of treatment effects on child outcomes up to 5 years. J Dev Orig Health Dis 10: 221-231.

Bleker LS, Milgrom J, Sexton-Oates A, et al. (2020) Cognitive Behavioral Therapy for Antenatal Depression in a Pilot Randomized Controlled Trial and Effects on Neurobiological, Behavioral and Cognitive Outcomes in Offspring 3-7 Years Postpartum: A Perspective Article on Study Findings, Limitations and Future Aims. Front Psychiatry 11.