Review article Art-based interventions during pregnancy to support women’s wellbeing: An integrative review Tess Crane*, Melissa Buultjens, Patricia Fenner Department of Public Health, School of Psychology and Public Health, College of Science, Health and Engineering, La Trobe University, Melbourne, Australia A R T I C L E I N F O Article history: Received 28 May 2020 Received in revised form 26 August 2020 Accepted 28 August 2020 Available online xxx Keywords: Pregnancy Art therapy Art-based interventions Transition to motherhood A B S T R A C T Background: The transition to motherhood is a dynamic experience. Antenatal care and education are designed to support women during pregnancy, however childbearing women often report a further need for emotional and social support beyond preparation for birth. Broadening routine antenatal care to included art-based interventions may offer women an opportunity to explore important aspects of the transition to motherhood. Aim: The aim of this integrative review is to synthesise research regarding the use of art-based interventions with women during pregnancy. Method: A systematic integrative review of the current evidence-base was conducted. A multi-database keyword search was implemented, and a total of six articles met inclusion criteria. Results were analysed using an inductive thematic analysis framework. Findings: Six studies met the inclusion criteria. Three major themes were generated: art-based engagements supported women to express complex emotion, fostered a sense of connection and strengthened personal resourcefulness. Discussion: Creative expression provided an opportunity to explore important aspects of the motherhood experience including, complex emotion, identity and bonding with the unborn child. Being in a group enhanced the health effects of art-making and the social connection felt supportive when role and identity was evolving. Conclusions: Whilst research on the current topic is emergent, preliminary results suggest that facilitated art-based programs are valuable for pregnant women. Art-based experiences offer women a unique opportunity to explore the full dimensionality of the transition to motherhood which can contribute to improved health and wellbeing. These findings suggest that art-based programs may serve to complement existing antenatal care models. © 2020 Australian College of Midwives. Published by Elsevier Ltd. All rights reserved. Statement of significance Problem or issue The transition to motherhood is a dynamic process. Routine antenatal care has a focus on preparation for birth, however incorporating greater opportunities for women to explore their experience of becoming a mother is needed. What is already known Pregnant women desire support for psychosocial needs, including wellbeing. Art-based programs have been shown to be effective in supporting parental wellbeing; less is known about art-based programs in pregnancy. What this paper adds This review finds that art-based programs during pregnancy foster maternal wellbeing, resourcefulness and social connection. Making art with others enhances the health effects of creative expression and provides important emotional support in the transition to motherhood. 1. Introduction The transition to motherhood involves a dynamic renegotiation of identity [1]. During pregnancy women reformulate their sense of themselves, as relationships and identity change [2]. Women move from a previously known reality, to a new and unfamiliar world [3]. Pregnant women report a heightened awareness of judgement from others and can feel a pressure to conform to more * Corresponding author. E-mail addresses: T.Crane@latrobe.edu.au (T. Crane), M.Buultjens@latrobe.edu.au (M. Buultjens), P.Fenner@latrobe.edu.au (P. Fenner). http://dx.doi.org/10.1016/j.wombi.2020.08.009 1871-5192/© 2020 Australian College of Midwives. Published by Elsevier Ltd. All rights reserved. Women and Birth xxx (2019) xxx–xxx G Model WOMBI 1167 No. of Pages 10 Please cite this article in press as: T. Crane, et al., Art-based interventions during pregnancy to support women’s wellbeing: An integrative review, Women Birth (2020), https://doi.org/10.1016/j.wombi.2020.08.009 Contents lists available at ScienceDirect Women and Birth journal homepage: www.elsevier.com/locate/wombi