Psychological Interventions Targeting Maternal Role Development and Identity in Perinatal Mental Health: A Systematic Review with Qualitative Synthesis

Background: Maternal identity is the perception and recognition of a woman as a mother. Within this emerging identity, the maternal role takes on special importance as a manifestation of the set of responsibilities that a woman assumes in the care and upbringing of her baby. Respectful professional accompaniment during the period of maternal role acquisition is key to perinatal mental health and secure bonding with the baby. The main objective of this systematic review with narrative synthesis was to analyze the effects of psychological support programs aimed at maternal role acquisition during the transition to motherhood. Methods: Studies with experimental and quasi-experimental designs addressing maternal role acquisition in pregnant or postpartum women were included. A systematic search was conducted in PsycINFO, MEDLINE, PubMed and SCOPUS from inception to March 2025 following PRISMA recommendations. Due to the heterogeneity in study designs, interventions and outcome measures, a narrative synthesis was performed instead of a meta-analysis. Results: A total of 11 studies were extracted with a total sample of 1244 women, including five randomized controlled trials and six quasi-experimental studies. Psychological support programs focusing on maternal role acquisition generally showed improvements in maternal identity construction, self-efficacy and maternal competence, although not all findings reached statistical significance. In addition, several studies reported reductions in postnatal depressive symptoms, as well as improvements in subjective well-being and maternal role perception. Conclusions: results suggest that psychological support programs targeting maternal role acquisition may represent a promising approach for supporting perinatal mental health. However, the evidence should be interpreted with caution due to methodological limitations and heterogeneity across studies. In fact, most included studies were conducted in Eastern cultural contexts (Iran, China), limiting generalizability to Western populations without further adaptation and validation. Additionally, incomplete reporting of standardized effect sizes and precision measures across studies limits the quantitative interpretation of the findings. This review was not prospectively registered, and title/abstract screening was conducted by a single reviewer, increasing the risk of selection bias. Further research using rigorous and standardized designs is needed to clarify the effectiveness and generalizability of these interventions.