What is the PASS used for?

The PASS, or Perinatal Anxiety Screening Scale, is used to screen for anxiety symptoms during pregnancy and the first postpartum year. Clinicians use it to identify people who may have clinically significant anxiety, gauge symptom severity across four domains, and decide whether a fuller assessment or follow-up is warranted.

How many questions are on the PASS?

The PASS has 31 self-report questions. Each is rated on a four-point scale from 0 (not at all) to 3 (almost always) based on the past month. Adding the items gives a total score from 0 to 93, where higher totals reflect more frequent or more severe anxiety symptoms.

How is the PASS scored and interpreted?

Scores are summed across all 31 items for a total of 0 to 93. Published bands read 0 to 20 as minimal, 21 to 41 as mild to moderate, and 42 to 93 as severe. A total of 26 or more was used in validation to flag clinically significant anxiety.

Is the PASS a diagnostic test?

No. The PASS is a screening tool, not a diagnosis. An elevated score signals that anxiety symptoms may be present and prompts follow-up, but it cannot confirm an anxiety disorder. A clinician should combine the result with a full assessment and clinical judgment before making any determination.

Can the PASS be used to track anxiety over time?

Yes. Because the PASS gives a numeric total, clinicians can repeat it during pregnancy and after birth to see whether symptoms rise or fall. Comparing scores across visits helps show change over time and supports decisions about ongoing monitoring or further assessment.

Perinatal Anxiety Screening Scale | Template & auto-scoring

The Perinatal Anxiety Screening Scale (PASS) is a 31-item self-report questionnaire that measures anxiety symptoms during pregnancy and the year after birth. Developed in 2014 by clinicians at King Edward Memorial Hospital in Western Australia, it rates worry, fears, and related symptoms across four domains to help identify perinatal anxiety that may need further assessment.

Why healthcare providers use the PASS

Perinatal focus. Unlike general anxiety tools, its items reflect worries specific to pregnancy and new parenthood.
Broad symptom coverage. It spans generalized worry, acute anxiety, social anxiety, and perfectionism in one short form.
Quantified severity. A single total score sorts symptoms into minimal, mild-moderate, or severe bands that guide clinical decision-making.
Quick to complete. Patients finish the 31 questions in a few minutes, which suits busy prenatal and postpartum visits.
Repeatable. The same score can be re-measured across pregnancy and postpartum to track change over time.

Which settings use the PASS?

Obstetrics and midwifery. Prenatal and postpartum visits use it to flag anxiety alongside routine depression screening.
Mental health clinics. Perinatal psychiatry and therapy practices use it to characterize anxiety and monitor response.
Primary care. Family medicine teams screen pregnant and postpartum patients during general visits.
Home visiting programs. Maternal and child health nurses use it during in-home checks.

What does the PASS measure?

The PASS measures how often anxiety symptoms occur over the past month across four domains. Because the scale is copyrighted by the Western Australia Department of Health, the questions are not reproduced here; the domains below describe the content it covers.

Acute anxiety and adjustment. Panic-like symptoms and difficulty adjusting to change.
General worry and specific fears. Persistent worry and focused fears about pregnancy, the baby, or health.
Perfectionism, control, and trauma. Need for control, high personal standards, and trauma-related responses.
Social anxiety. Discomfort and self-consciousness in social situations.

Scoring the PASS

Number of items. 31 self-report questions.
Per-item scale. Each item is rated 0 (not at all), 1 (sometimes), 2 (often), or 3 (almost always), based on the past month.
Total score range. 0 to 93, summed across all items.
Score direction. Higher scores indicate more frequent or more severe anxiety symptoms.

The PASS is a screening tool, not a diagnosis. A total score sorts symptom severity, but a patient's score may not fully correlate with their level of impairment, so results should guide clinical decision-making rather than replace a full assessment. The developers also note a cutoff of 26 from the pilot study for identifying clinically significant anxiety.

Score	Interpretation	Suggested next step
0 to 20	Minimal or no anxiety symptoms	Routine monitoring
21 to 41	Mild to moderate anxiety symptoms	Consider further assessment
42 to 93	Severe anxiety symptoms	Prompt further evaluation

Best practices for administration

Explain the time frame. Remind patients to answer based on the past month so ratings stay consistent.
Screen more than once. Administer during pregnancy and again postpartum, since anxiety can emerge at different points.
Pair with depression screening. Use it alongside a perinatal depression measure, as anxiety and depression often co-occur.
Review subscale patterns. Look at which domains drive the total, not just the overall number.
Follow up on high scores. Use elevated scores as a prompt for further assessment, not a standalone diagnosis.
Keep it private. Let patients complete it somewhere they feel comfortable answering honestly.

How Zentake helps with the PASS

Automatic scoring. Zentake tallies totals on submit, no hand-tallying.
Longitudinal tracking. Re-send it on a schedule and view change over time.
Before the visit. Patients at ob-gyn practices complete it from home on any device, so the clinician starts informed.
HIPAA compliant. Data is encrypted, with a signed BAA on every plan.

References

Somerville S, Dedman K, Hagan R, et al. The Perinatal Anxiety Screening Scale: development and preliminary validation. Archives of Women's Mental Health. 2014;17(5):443-454. This paper introduced the 31-item scale and the cutoff of 26 for clinically significant anxiety.

Somerville S, Byrne SL, Dedman K, et al. Detecting the severity of perinatal anxiety with the Perinatal Anxiety Screening Scale (PASS). Journal of Affective Disorders. 2015;186:18-25. This study defined the minimal, mild-moderate, and severe score bands.

Last updated: August 2026

Perinatal Anxiety Screening Scale