Prenatal anxiety has been associated with poor health outcomes of mothers and children, but much of the evidence is based on high-income nations using measures that have been developed for use in these populations. In this project, we first systematically review research on prenatal anxiety in order to get a clear overview of measures of pregnancy-related anxiety. We have then conducted focus group discussions to investigate the domains of pregnancy-related anxiety in Ghanaian women in the Northern Region. This informed the adaptation and validation of a measure of prenatal anxiety that is culturally relevant and adapted to the context in Ghana. The adapted measure was pilot tested in a survey study of 586 pregnant women in Mion, Savelugu, and Tamale Metropolitan districts.