Emotional Distress Following Childbirth: An Intervention to Buffer Depressive and PTSD Symptoms

Abstract

Childbirth for some women is a negative experience associated with depressive and post-traumatic symptoms. The preventive actions focusing on helping mothers to cope with negative emotions experienced after childbirth are strongly recommended. It is also recommended both to intervene early and on all women to avoid the risk that these symptoms can worsen in the months after childbirth. The intervention described in the current study is focalized on the elaboration of post-partum negative thoughts and emotion through a writing task, with the purpose to help new mothers to reflect, understand, evaluate and, thus, reformulate the stressful situation with new beliefs and emotions. 176 women aged from 19 to 43 years (M = 31.55, SD = 4.58) were assessed for depression and PTSD in the prenatal phase (T1). In about 96 hours after childbirth they were randomly assigned to either “Making Sense condition” (MS: in which they wrote about the thoughts and emotions connected with delivery and childbirth) or “Control-Neutral condition” (NC: in which they wrote about the daily events in behavioural terms) and then reassessed for depression and PTSD (T2). A follow up was conducted 3 months later (T3) to verify depression and posttraumatic symptoms. The results showed that depressive symptoms decreased both at 96 hours and at 3 months as a result of making-sense task. Regarding the posttraumatic symptoms the positive effect emerged at three months and not at 96 hours after birth.

Preventing post‐traumatic stress disorder following childbirth and traumatic birth experiences: a systematic review

“…Of the 13 included articles, 12 were randomized controlled trials and one was a case control study (43; see Table for levels of evidence and details of each study).…”

“…The interventions were debriefing , encouraging skin‐to‐skin contact and immediate breastfeeding postpartum , encouraging mothers of a stillborn baby to see and hold the baby , expressive writing tasks and several different structured psychological interventions ().…”

“…Four studies examined an unselected (healthy) population and two studies included women with a traumatic or distressing birthing experience . The other studies focused on specific groups, such as women who had a stillbirth , who had a non‐spontaneous vaginal delivery (i.e.…”

Current Resources for Evidence‐Based Practice, September/October 2019

“…This intervention may also have the effect of aiding a woman's relationship with her newborn, although this was not measured by the study. Two studies used reflective writing to describe deep emotions associated with the birth to reform the memory of the event and decrease conflicting emotions or expectations . These studies recruited a general population of pregnant women prenatally.…”

“…Although there were racial and ethnic disparities in the results, they were much less than the national disparities. The qualitative analysis of this initiative, especially among women who had prior birth experiences, showed that women felt they were in control of their choices and were highly involved in their care . Therefore, midwives need to continue to pursue models of care that provide women with the support they need to have healthy pregnancies and births.…”