Postpartum anxiety can involve persistent, difficult-to-control worries about a baby’s safety, caring for the baby or adjusting to the role of being a mother. A 2026 study suggests that a 12-item Brazilian Portuguese version of the Postpartum Specific Anxiety Scale may offer a useful way to screen for these concerns—but it should not be treated as a diagnosis.
The study assessed the PSAS-BR-RSF-C in 189 Brazilian mothers, who were between 18 and 44 years old and had babies aged 15 days to 12 months. The short form is based on an existing Brazilian Portuguese translation of the full scale. Each question is rated on a four-point scale, with higher totals indicating more anxiety.
What the short scale measures
The 12 questions cover four areas of postpartum worry:
- Bonding and confidence as a mother
- The baby’s safety
- Practical baby care
- Adjusting to motherhood
The scale was designed to capture postpartum-specific worries that may not be fully reflected in broader anxiety questionnaires such as the GAD-7. The full PSAS takes about 10 minutes to complete, while the short form includes three questions from each area.
Strong overall fit, but uneven subscores
Statistical testing supported the four-area structure. The model had a comparative fit index of 0.978, a Tucker–Lewis index of 0.970, an RMSEA of 0.060 and an SRMR of 0.077. By contrast, treating all 12 questions as one undivided score produced a poorer fit, including an RMSEA of 0.114.
Across all 12 questions, reliability was 0.85, close to the 0.87 reported for the English version. Reliability was strongest for the baby’s-safety area at 0.81 and was 0.74 for bonding and confidence as a mother.
The two remaining areas were less consistent when scored separately: practical baby care had reliability of 0.62, while adjusting to motherhood had reliability of 0.44. Both were below the usual 0.70 threshold used when judging separate scores. The researchers therefore advised caution with these subscores and suggested that future work test new or replacement questions.
In practical terms, the four area scores may be more useful as a rough guide to the topics causing concern than as precise measurements. The strongest individual question concerned worry that a baby might stop breathing during sleep. The weakest concerned how the relationship with a partner had changed since the birth.
What the scores can—and cannot—show
The average PSAS total score was 26.89, just above the 26-point cutoff described in earlier work as a sign of clinically significant anxiety. However, that cutoff was not checked against clinical interviews in this study. The average EPDS depression score was 12.03, above its usual cutoff of 10.
PSAS totals were moderately correlated with scores for depression on the EPDS, general anxiety on the GAD-7 and self-criticism. The correlations were 0.61, 0.52 and 0.52, respectively. These relationships show that the concerns measured by the PSAS can overlap with other forms of emotional distress; they do not establish that the scale can distinguish postpartum-specific anxiety from depression or general anxiety.
The study did not use clinical interviews, so it could not determine how accurately the short form identifies an anxiety disorder. It also measured participants at one time point and did not test whether scores remain stable or respond to improvement over time.
Why the sample matters
Participants were recruited through social media, and most came from southern and southeastern Brazil. The sample was mostly college-educated; 84.1% were married, about 70% were experiencing their first pregnancy, and 53.4% reported a past mental health diagnosis.
These characteristics, along with the relatively small, self-selected online sample, mean the findings may not represent Brazilian mothers generally. The study also took place in the context of the COVID-19 pandemic, which may further limit how broadly the results can be applied. The researchers did not test whether the scale performs similarly across cultures.
What this means for new mothers
A high PSAS score should be viewed as a prompt for closer conversation with a doctor, midwife or mental health professional—not as proof of an anxiety disorder. The tool may help identify worries that deserve attention, particularly when concerns feel persistent or difficult to control.
Postpartum anxiety symptoms are not unusual: a meta-analysis of 102 studies involving 221,974 women reported elevated self-reported anxiety symptoms in 15% of women between one and 24 weeks after birth, while 9.9% had a diagnosed anxiety disorder. Anyone concerned about their mental health after birth can discuss symptoms and screening results with a qualified professional.
AI tools were used to assist with the preparation of this article.
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