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Med J Aust. 2003 Jun 2;178(11):542-5.

Stress debriefing after childbirth: a randomised controlled trial.

Author information

1
Women and Infants Research Foundation, King Edward Memorial Hospital, Perth, WA, Australia.

Abstract

OBJECTIVE:

To test whether critical incident stress debriefing after childbirth reduces the incidence of postnatal psychological disorders.

DESIGN:

Randomised single-blind controlled trial stratified for parity and delivery mode.

SETTING:

Two large maternity hospitals in Perth.

PARTICIPANTS:

1745 women who delivered healthy term infants between April 1996 and December 1997 (875 allocated to intervention and 870 to control group).

INTERVENTION:

An individual, standardised debriefing session based on the principles of critical incident stress debriefing carried out within 72 hours of delivery.

MAIN OUTCOME MEASURES:

Diagnosis of stress disorders or depression in the 12 months postpartum, using structured psychological interview and criteria of the Diagnostic and statistical manual of mental disorders, 4th edition.

RESULTS:

Follow-up information was available for 1730 women (99.1%), 482 of whom underwent psychological interview. There were no significant differences between control and intervention groups in scores on Impact of Events or Edinburgh Postnatal Depression Scales at 2, 6 or 12 months postpartum, or in proportions of women who met diagnostic criteria for a stress disorder (intervention, 0.6% v control, 0.8%; P = 0.58) or major or minor depression (intervention, 17.8% v control, 18.2%; relative risk [95% CI], 0.99 [0.87-1.11]) during the postpartum year. Nor were there differences in median time to onset of depression (intervention, 6 [interquartile range, 4-9] weeks v control, 4 [3-8] weeks; P = 0.84), or duration of depression (intervention, 24 [12-46] weeks v control, 22 [10-52] weeks; P = 0.98).

CONCLUSIONS:

There is a high prevalence of depression in women during the first year after childbirth. A session of midwife-led, critical incident stress debriefing was not effective in preventing postnatal psychological disorders, but had no adverse effects.

PMID:
12765500
[Indexed for MEDLINE]

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