
Sergio A. Silverio- MPsycholSci (Hons) L'pool, MSc Brun, PhD King's, CPsychol, RSci, AFBPsS, FRAI, FRSPH
- Lecturer at University of Liverpool
Sergio A. Silverio
- MPsycholSci (Hons) L'pool, MSc Brun, PhD King's, CPsychol, RSci, AFBPsS, FRAI, FRSPH
- Lecturer at University of Liverpool
Leading research on post-pandemic recovery of maternity, perinatal mental health, & perinatal bereavement care.
About
310
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Introduction
Sergio A. Silverio is a Chartered Psychologist, Social Scientist, & Qualitative Research Expert specialising in Lifecourse Analysis, with a primary research interest in women’s mental health.
He maintains four key portfolios of research:
(1) Women's Lifecourse Mental Health after Bereavement, Trauma, or Loss;
(2) Cross-Disciplinary Qualitative Research Innovations & Ethics;
(3) Maternal Health Systems, Policy, & Post-Pandemic Recovery;
(4) The Postpartum Specific Anxiety Scale.
Current institution
Additional affiliations
December 2022 - August 2024
August 2022 - present
Position
- Research Fellow in Social Science of Women's Health
Description
- Whilst the main focus of my research is women's mental health over the lifecourse - especially after experiencing loss, I currently lead the UK's largest portfolio of research dedicated to social science investigations into maternal and child health research in response to the SARS-CoV-2 pandemic. I am also the Qualitative Research Lead for the School of Life Course & Population Sciences and Qualitative Knowledge Hub Lead for King's Health Partners' Institute for Women & Children’s Health.
January 2022 - May 2024
Editor roles

Psychology of Women & Equalities Review
Position
- Editorial Board Member
Education
February 2021 - July 2024
September 2018 - August 2019
February 2014 - July 2014
Publications
Publications (310)
Qualitative researchers often engage in work addressing challenging, difficult, or sensitive topics and are consequently exposed to the participants' narratives which may be emotionally charged, distressing, or compromising. These narratives occasionally rest heavy on a researcher's conscience or may linger in the mind. Much literature has assessed...
Purpose: Early pregnancy complications are common and often result in pregnancy loss, which can be emotionally challenging for women. Research on the emotional experiences of those attending Early Pregnancy Assessment Units [EPAUs] is scarce. This analysis explored the emotions which women spontaneously reported when being interviewed about their e...
Background
The SARS-CoV-2 pandemic has brought racial and ethnic inequity into sharp focus, as Black, Asian, and Minority Ethnic people were reported to have greater clinical vulnerability. During the pandemic, priority was given to ongoing, reconfigured maternity and children's healthcare. This study aimed to understand the intersection between ra...
Purpose
This paper aims to call the public health and mental health communities to action by making women’s mental health a public health priority.
Design/methodology/approach
This conceptual paper introduces a “Female Psychology” approach to framing and interpreting mental health narratives and public health discourses. It also draws upon lifecou...
Background
The COVID-19 pandemic poses an unprecedented risk to the global population. Maternity care in the UK was subject to many iterations of guidance on how best to reconfigure services to keep women, their families and babies, and healthcare professionals safe. Parents who experience a pregnancy loss or perinatal death require particular care...
Introduction
Nearly three quarters of stillbirths and neonatal deaths occur in infants born prematurely. The mothers of these children may be at increased risk of developing mental health difficulties as a result of their premature labour and/or subsequent loss.
Methods
This systematic review was conducted to understand the psychological experienc...
Preterm birth is a significant public health concern. In England, 8.1% of all births in 2023 were classified as premature. The psychological impact of preterm birth on parents has become of increasing interest to researchers. However, the long-term psychological impact on preterm babies, the effect prematurity has on wider family units, and the eff...
Background The COVID-19 pandemic resulted in major maternity service reconfigurations, particularly an increase in virtual antenatal care (vANC). We aimed to explore the relationship between vANC trajectories over time and pregnancy outcomes. Methods Pregnancy and birth outcome data were obtained pre-pandemic, during the pandemic with, and without...
Between 2020 and 2022 in the United Kingdom (UK), there were 45 maternal deaths from venous thromboembolism (VTE), out of more than 2 million maternities. This occurred despite extensive risk assessment and prescribing of low molecular weight heparin (LMWH) thromboprophylaxis, alongside clinicians' overestimate of risk and commitment to the cause....
Objectives: To describe the development and the methodology for validation of a new scale for postpartum anxiety for mothers of preterm infants, and a ‘Velcro’ sub-scale of the Postpartum Specific Anxiety Scale for use with mothers who have had infants admitted to the Neonatal Intensive Care Unit. Methods: We undertook three forms of iterative psyc...
Problem: Perinatal bereavement can severely disrupt women’s anticipated role as mothers, affecting their psychological wellbeing and identity as parents.
Background: Existing research highlights many women report persistent and enduring grief for months or even years post-loss, highlighting the urgent need for interventions to help maintain a heal...
Health-related stigma is associated with adverse outcomes including depression, stress and reduced engagement in health behaviours which are particularly harmful in pregnancy and the postpartum. Women with gestational diabetes mellitus (GDM) report negative psychosocial experiences and may be at risk of stigma related to the condition. We aimed to...
Objectives: To evaluate whether term pre-eclampsia (PE) is reduced by screening for PE risk at 35 + 0-36 + 6 weeks' gestation and offering risk-based, planned early term birth. Study design: 'PREVENT-PE' is a multicentre, randomised trial (ISRCTN41632964). Inclusion: Singleton pregnancy, presentation for routine fetal ultrasound at 35 + 0-36 + 6 we...
CRD420251004239: Review question: What are the psychosocial experiences of women who have committed neonaticide, infanticide, or filicide?
Background
Irritable bowel syndrome (IBS) is a chronic and relapsing gastrointestinal condition that negatively impacts quality of life. Dietary triggers are common and dietary management is central to the IBS treatment pathway, and dietitians are the main education providers for patients.
Objective
The aim of this study was to explore dietitians’...
CRD420250653680: Review question: What are the psycho-social implications of body image and body dissatisfaction on the performance of female elite athletes?
Purpose: Whilst the antenatal period is well established as a period of increased vulnerability to mental health difficulties, restrictions resulting from COVID-19 lockdown in the UK are likely to have negatively affected psychosocial outcomes in these women.
Materials and Methods: This study aimed to describe prevalence rates of clinically relevan...
Sexual dissatisfaction is one of the main motivations for seeking female genital cosmetic surgery (FGCS), though the outcomes of such surgeries are controversial.
Evaluation of the sexual function, satisfaction, and assertiveness in FGCS groups.
From five clinical centers in Tehran, Iran, 200 women in the study group (women seeking or had undergone...
Background
The safety of vaginal breech birth is associated with the skill and experience of professionals in attendance, but minimal training opportunities exist. OptiBreech collaborative care is an evidence‐based care bundle, based on previous research. This care pathway is designed to improve access to care and the safety of vaginal breech birth...
Introduction
As health systems struggled to respond to the catastrophic effects of SARS-CoV-2, infection prevention and control measures significantly impacted on the delivery of non-COVID children's and family health services. The prioritisation of public health measures significantly impacted supportive relationships, revealed their importance fo...
Background
Recurrent early pregnancy loss [rEPL] is a traumatic experience, marked by feelings such as grief and depression, and often anxiety. Despite this, the psychological consequences of rEPL are often overlooked, particularly when considering future reproductive health or approaching subsequent pregnancies. The SARS-CoV-2 pandemic led to sign...
An increased burden during Covid, and the assumptions which could stand in the way of recovery and growth.
Maternity care is a core service provision of any healthcare system, delivering care for women and birthing people, and their wider family units. During the SARS-CoV-2 pandemic, much of maternity care service provision was reconfigured with the aim of continuing care provision which could not otherwise be re-scheduled or delayed, but in-line with i...
Introduction: Women identified at risk for preterm may be vulnerable to developing mental health difficulties due to the increased likelihood of poor pregnancy outcome and uncertainty surrounding their delivery. Formal assessment of mental wellbeing in specialist preterm birth clinics is not routinely offered but may offer the opportunity for early...
The perinatal period (from antepartum through to the end of the first postpartum year) is a critical and often joyous time for families. However, for some this period can be marked by bereavement, trauma, and/or loss, which can have profound emotional, psychological, and psycho-social impacts. Bereavement, trauma, and loss can take many forms, incl...
Problem and background
During the COVID-19 pandemic, there was substantial reconfiguration of maternity care services, affecting both users and healthcare providers (HCPs), in the United Kingdom (UK) and globally.
Aim
To further our understanding of the impact of maternity service reconfigurations in the UK, from the perspective of maternity HCPs....
Objectives : Preeclampsia (PE) occurs most commonly at term, and currently, there is no effective strategy to prevent it. The PE prevention by timed birth at term trial (PREVENT- PE) with embedded economic evaluation aims to provide cost-effectiveness evidence on whether screening for PE risk at 35+0–36+6 weeks’ gestation and offering women risk-ba...
Review question (CRD42024596532):
What are the qualitative evidences on the long-term experiences and repercussions of perinatal grief from the perspective of women who have lost their children?
Background: Postpartum anxiety is a prevalent emotional disorder affecting approximately 20% of women, often more common than postpartum depression. Despite its high prevalence, the Spanish healthcare system lacks screening programs specifically targeting this condition. Methods This study aimed to develop and validate a short version of the Postpa...
Genome sequencing (GS) has the potential to reduce the “diagnostic odyssey” that many parents of children with rare undiagnosed conditions experience. While much research has considered the impact of receiving a diagnostic result, research has rarely focused solely on the impact of receiving a “no primary finding” (NPF) result. This study aimed to...
Background
Postpartum Anxiety [PPA] is a prevalent problem in society, posing a significant burden to women, infant health, and the National Health Service [NHS]. Despite this, it is poorly detected by current maternal mental health practices. Due to the current lack of appropriate psychometric measures, insufficiency in training of healthcare prof...
Objectives: To evaluate whether term pre-eclampsia (PE) can be reduced by screening for PE risk at 35⁺⁰–36⁺⁶ weeks’ gestation and offering women risk-based, planned term birth.
Study design: ‘PREVENT-PE’ is a pragmatic, multicentre, randomised trial. Inclusion: singleton pregnancy, presentation for routine fetal ultrasound at 35⁺⁰-36⁺⁶ weeks’ gesta...
Maternal vaccination during pregnancy, in general and against COVID-19 infection, offers protection to both mother and baby, but uptake remains suboptimal. This study aimed to explore the perceptions regarding COVID-19 vaccination in pregnancy, particularly for marginalised populations and those living with social or medical complexity. A total of...
Background
Women who suffer an early pregnancy loss require specific clinical care, aftercare, and ongoing support. In the UK, the clinical management of early pregnancy complications, including loss is provided mainly through specialist Early Pregnancy Assessment Units. The COVID-19 pandemic fundamentally changed the way in which maternity and gyn...
Introduction
Healthcare services for pregnant and postpartum (‘perinatal’) women were reconfigured significantly at the advent and for the duration of the SARS-CoV-2 pandemic, and despite the United Kingdom announcing ‘Freedom Day’ on 19 July 2021 (whereafter all legal lockdown-related restrictions were lifted), restrictions to maternity (antenatal...
Background
Testing positive for COVID-19 was associated with higher rates of detrimental psycho-social and physical health outcomes. The COVID-19 pandemic caused unprecedented disruption to everyday life. This included major reconfiguration of maternal, child, and perinatal mental health and care services and provision. This study aimed to investig...
Maternity care is a core service provision of any healthcare system, delivering care for women and birthing people, and their wider family units. During the SARS-CoV-2 pandemic, much of maternity care service provision was reconfigured with the aim of continuing care provision which could not otherwise be re-scheduled or delayed, but in-line with i...
Irritable bowel syndrome (IBS) is a chronic and relapsing gastrointestinal condition which negatively impacts quality of life (1). Dietary triggers are common and dietary management is central to the IBS treatment pathway with dietitians being the main education providers for patients ⁽²⁾ . The aim of this study was to explore the perceptions of di...
Introduction
The burden of severe maternal morbidity is highest in sub-Saharan Africa, and its relative contribution to maternal (ill) health may increase as maternal mortality continues to fall. Women’s perspective of their long-term recovery following severe morbidity beyond the standard 42-day postpartum period remains largely unexplored.
Metho...
The role of anxiety is unknown in relation to postpartum bonding, unlike the well-known detrimental effect that postpartum depression has on the relationship between a mother and child. This study investigates how anxiety affects mother–infant bonding after childbirth, comparing the Italian version of the Postpartum Specific Anxiety Scale (PSAS-IT)...
Objective
To explore antenatal experiences of social and healthcare professional support during different phases of social distancing restriction implementation in the UK.
Design
Semi-structured interviews were conducted via telephone or video-conferencing software between 13 July 2020 – 2 September 2020. Interviews were transcribed and a recurren...
CRD42024522617
Review question
What are the effects of Jungian sandplay therapy on the psychological health of children and adolescents?
Objective
The English‐language Postpartum Specific Anxiety Scale (PSAS) is a valid, reliable measure for postpartum anxiety (PPA), but its 51‐item length is a limitation. Consequently, the PSAS Working Group developed the PSAS Research Short‐Form (PSAS‐RSF), a statistically robust 16‐item tool that effectively assesses PPA. This study aimed to asse...
Problem
The COVID-19 pandemic hindered access to routine healthcare globally, prompting concerns about possible increases in pregnancy loss and perinatal death.
Background
PUDDLES is an international collaboration exploring the impact of the COVID-19 pandemic on parents who experience pregnancy loss and perinatal death in seven countries, includin...
Background
Maternity care services in the United Kingdom have undergone drastic changes due to pandemic-related restrictions. Prior research has shown maternity care during the pandemic was negatively experienced by women and led to poor physical and mental health outcomes in pregnancy. A synthesis is required of published research on women’s exper...
Background: Returning to sport postpartum is becoming increasingly common for elite athletes. While policies to support women during this period are emerging, this remains an area of limited research. To date the lived postpartum experience of UK elite athletes as they returned to sport has not been explored.
Methods: This qualitative study collate...
Objective
Virtual reality (VR) has become increasingly popular in clinical and health settings where it has been used for a wide range of purposes. A recent scoping review explored VR applications to assist pregnant women and found that VR was a useful method to be used for a range of different purposes in both pregnancy and labour. However, no suc...
COVID-19 vaccination rates are lower in women of reproductive age (WRA), including pregnant/postpartum women, despite their poorer COVID-19-related outcomes. We evaluated the vaccination experiences of 3568 U.K. WRA, including 1983 women (55.6%) experiencing a pandemic pregnancy, recruited through the ZOE COVID Symptom Study app. Two staggered onli...
Background
Suicide is a leading cause of maternal death during pregnancy and the year after birth (the perinatal period). While maternal suicide is a relatively rare event with a prevalence of 3.84 per 100,000 live births in the UK [1], the impact of maternal suicide is profound and long-lasting. Many more women will attempt suicide during the peri...
Objective
Mothers of premature infants are more likely to develop anxiety during the first postpartum year than mothers of term infants. However, commonly used measures of anxiety were developed for general adult populations and may produce spurious, over-inflated scores when used in a postpartum context. Although perinatal-specific tools such as...
Objective
Depression is an increasingly common mental health disorder in the UK, managed predominantly in the community by GPs. Emerging evidence suggests lifestyle medicine is a key component in the management of depression. We aimed to explore GPs’ experiences, attitudes, and challenges to providing lifestyle advice to patients with depression....
Introduction
The first wave of the COVID-19 pandemic saw the reconfiguration of perinatal and maternity services, national lockdowns, and social distancing measures which affected the perinatal experiences of new and expectant parents. This study aimed to explore the occurrence of postpartum anxieties in people who gave birth during the pandemic....
Review question:
1) What are the psychological experiences of mothers who give birth to a preterm baby who subsequently dies?
Background
Breastfeeding offers many health benefits to mother and infant.
Problem
Breastfeeding difficulties are common and are linked with postnatal distress.
Aim
To explore the lived experiences of breastfeeding continuation despite facing difficulties.
Methods
Qualitative semi-structured interviews were conducted with eight women who had exp...
Problem
Early pregnancy losses [EPL] are common, varied, and require different courses of management and care.
Background
In the UK, women who suspect or suffer a pregnancy loss are usually provided specialist care in early pregnancy assessment units [EPAUs]. Their configuration has recently been evaluated, but recommendations for change in-line w...
Introduction
It is well established that a premature birth increases the likelihood of developing anxiety during the postpartum period, and that the environment of the neonatal intensive care unit (NICU) might be a contributing factor. Mothers of earlier premature infants may experience these anxieties to a higher degree compared to mothers of late...
Introduction: The COVID-19 pandemic posed a significant lifecourse rupture, not least to those who had specific physical vulnerabilities to the virus, but also to those who were suffering with mental ill health. Women and birthing people who were pregnant, experienced a perinatal bereavement, or were in the first post-partum year (i.e., perinatal)...
Conferences have been discussed as spaces for academic work to extend beyond the confines of one’s institution, fostering environments of collaborative working, learning, and social bond-making. The British Psychological Society’s Psychology of Women and Equalities Section hosts an annual conference, attended by feminist scholars from around the wo...
Background
Persistent, high rates of maternal mortality amongst ethnic minorities is one of the UK’s starkest examples of racial disparity. With greater risks of adverse outcomes during maternity care, ethnic minority women are subjected to embedded, structural and systemic discrimination throughout the healthcare service.
Methods
Fourteen semi-st...
Postpartum anxiety has negative consequences for both mother and infant, so effective identification and measurement is vital to enable intervention. Despite NICE recommendations to prioritise the measurement of postpartum anxiety in mothers, current clinical measurement in England remains both fragmented and flawed. The Postpartum Specific Anxiety...
Introduction: We aimed to explore the lived experiences of caesarean birth complicated by impaction of the foetal head, for mothers and midwives. Methods: A pragmatic, qualitative, focus group study of mixed-participants was conducted, face-to-face. They were postpartum women (n = 4), midwives (n = 4), and a postpartum midwife (n = 1) who had exper...
Résumé
La COVID-19 a entraîné des changements dans les services de santé périnataux. Une étude transversale mixte réalisée auprès de 58 femmes québécoises ayant vécu le décès de leur enfant en période périnatale durant la pandémie permet d’identifier les enjeux de ce parcours parental complexifié et de proposer une offre de soins et services sécuri...
Introduction
While often positive, the lifecourse transition to motherhood is susceptible to the risk for developing mood disorders. Postpartum anxiety has often been overshadowed by other perinatal-specific mental health disorders, such as postpartum depression, and therefore has not been at the forefront or center of as much empirical study. This...
Background
The increasing prevalence of postpartum anxiety as a common psychological problem affects a large part of women's lives. Despite the existence of tools in this field, but due to the lack of specificity in reflecting postpartum anxiety, it is necessary to have a specific tool to screen it. Since the psychometric evaluation of the Postpar...
Background
The global prevalence of gestational diabetes mellitus (GDM) is increasing, and it can significantly impact women’s psychosocial outcomes in the perinatal period. The aim of this study was to explore the psychosocial impacts including experiences of support for women with GDM in the antenatal and postnatal period.
Methods
Semi-structure...
Background Due to its high pervasiveness and adversarial consequences, postpartum anxiety has been one of the most worrying public health concerns in the last decade. According to previous research, the occurrence of mental disorders among women in the postpartum period upsurges significantly in the course of universal disasters. The Postpartum Spe...
Background
Disadvantaged populations (such as women from minority ethnic groups and those with social complexity) are at an increased risk of poor outcomes and experiences. Inequalities in health outcomes include preterm birth, maternal and perinatal morbidity and mortality, and poor-quality care. The impact of interventions is unclear for this pop...
Initial COVID-19-related social distancing restrictions, imposed in the UK in March 2020, and the subsequent lifting of restrictions in May 2020 caused antenatal disruption and stress which exceeded expected vulnerabilities associated with this lifecourse transition. The current study aimed to explore the antenatal psychological experiences of wome...
Background
Pregnant and postpartum women were identified as having particular vulnerability to severe symptomatology of SARS-CoV-2 infection, so maternity services significantly reconfigured their care provision. We examined the experiences and perceptions of maternity care staff who provided care during the pandemic in South London, United Kingdom...
How does health literacy influence adherence to dietary recommendations, guidance, and advice in women at risk of gestational diabetes mellitus or those with a diagnosis?
Objective:
The transition to motherhood is a period of risk for the development of mood disorders. Postpartum anxiety has not been as thoroughly studied as other emotional disorders despite its impact on mothers and their babies. The absence of standardized programmes for early detection and specific tools for its diagnosis means postpartum anxiet...
Introduction: Infant and maternal breastfeeding benefits are well documented, globally. Despite efforts to increase global breastfeeding rates, the majority of high-income settings fall short of recommended targets. Breastfeeding rates in the UK are especially poor, and physiological difficulties (e.g., inverted nipples), fail to account for the ob...
Engaging women affected by Obstetric Fistula as advocates has been proposed as an effective strategy to raise awareness of the condition. Limited literature exists on the experience of those who become advocates. A model of community education, in Sierra Leone, trained women affected by Obstetric Fistula to become volunteer Fistula Advocates. This...
Introduction
A recent analysis of Gambian infants showed that plasma iron concentrations decline rapidly from birth to levels below the 95% reference range within 5 months of age. To address this issue, a clinical trial was initiated to assess the efficacy of early iron supplementation in breastfed infants under 6 months of age (‘Iron Babies’; NCT...
Problem: There has been little focus on women's views of care and recovery following pregnancy complicated by hypertensive disorders of pregnancy [HDP] despite long-term implications for maternal health.
Background: Increasingly in clinical research, areas of interest include the extent to which women are involved in postnatal care planning, perc...
Background
Women from Black, Asian and mixed ethnicity backgrounds in the UK experience higher rates of maternal and neonatal mortality and morbidity, and report poorer experiences of maternity care. Research is required to understand how to reduce these disparities, however, it is acknowledged these groups of women are under-represented in clinica...
Women of reproductive age are a group of particular concern with regards to vaccine uptake, related to their unique considerations of menstruation, fertility, and pregnancy. To obtain vaccine uptake data specific to this group, we obtained vaccine surveillance data from the Office for National Statistics, linked with COVID-19 vaccination status fro...
1) What is the relationship between gestational age and postpartum anxiety?
2) What are the experiences of mothers of premature infants with postpartum anxiety?
PROSPERO Registration Number: CRD42023369647
1) What is the relationship between prenatal anxiety and gestational age?
2) What are the experiences of prenatal anxiety in mothers who have previously experienced a preterm birth?
3) What are the experiences of prenatal anxiety in mothers who have previously experienced a mid-trimester loss (from 14 weeks' gestation)?
4) What are the experiences...
Objective
This qualitative study examines the linguistic features associated with postpartum depression.
Methods
In this longitudinal online study, 53 mothers completed self-report questionnaires assessing symptoms of postpartum depression and an expressive writing exercise about their pregnancy and birth. Mothers were randomly divided into two gr...
Problem
Maternity care underwent substantial reconfiguration in the United Kingdom during the COVID-19 pandemic.
Background
COVID-19 posed an unprecedented public health crisis, risking population health and causing a significant health system shock.
Aim
To explore the psycho-social experiences of women who received maternity care and gave birth...
Background
Twenty percent of women in the UK develop perinatal mental health (PMH) problems, which have widespread effects on maternal and child health. Community pharmacists are ideally placed to identify PMH problems and refer to other trained healthcare professionals.
Objective
This study explored community pharmacists’ attitudes, current couns...
Objectives:
This study aimed to explore community pharmacists' practices and attitudes towards the provision of healthcare advice regarding preconception and pregnancy.
Methods:
A qualitative focus group study was conducted virtually with community pharmacists around urban areas of London in October 2021. A topic guide was utilised to cover phar...
Background: Primary psychopathy (i.e., unemotional and callous predisposition) is associated with career, educational, and general life success, whereas secondary psychopathy (i.e., impulsivity and risk-taking) relates to criminality, hedonistic lifestyles, and detrimental behaviours. Although psychopathy sub-types have differential relationships t...
Which factors influence the candidacy to seek care during pregnancy of pregnant women and birthing people from underserved groups in high income settings?
PROSPERO Registration Number: CRD42023389306
Questions
Questions (5)
Calling for contributions to British Mensa's: Androgyny - a new journal-zine for all things gender! Topics: Androgyny, gender equality, gender and sexuality and more.
Contributions can include: letters; research articles, debates, literature reviews; recent and relevant news and events; creative writing pieces, monographs, personal reflections, art, poetry, book reviews.
I have just taken over as Editor and would like to publish 4 times a year - all contributions will be welcomed and I shall work with you to i=edit as appropriate. If interested please get in touch