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Stress debriefing after childbirth: a randomised controlled trial.
Susan R Priest1, Jenni Henderson, Sharon F Evans
1Women and Infants Research Foundation, King Edward Memorial Hospital, Perth, WA, Australia.
The Medical Journal of Australia
|May 27, 2003
Summary
Critical incident stress debriefing after childbirth did not reduce postnatal psychological disorders in a randomized trial. This intervention showed no adverse effects but did not prevent depression or stress disorders in the postpartum year.
Area of Science:
- Obstetrics and Gynecology
- Psychiatry
- Public Health
Background:
- Postnatal psychological disorders, including depression and stress disorders, affect a significant number of women.
- Early intervention strategies are crucial for maternal mental health.
- Critical incident stress debriefing (CISD) is a psychological support technique used in crisis situations.
Purpose of the Study:
- To evaluate the effectiveness of midwife-led critical incident stress debriefing (CISD) in preventing postnatal psychological disorders.
- To assess the impact of CISD on the incidence of depression and stress disorders within the first year after childbirth.
Main Methods:
- A randomized single-blind controlled trial was conducted in two large maternity hospitals.
- 1745 women were allocated to either an intervention group receiving CISD within 72 hours of delivery or a control group.
- Psychological outcomes, including stress disorders and depression, were assessed using structured interviews and standardized scales up to 12 months postpartum.
Main Results:
- No significant differences were observed between the CISD intervention group and the control group in the incidence of stress disorders or major/minor depression.
- Scores on the Impact of Events Scale and Edinburgh Postnatal Depression Scale did not differ significantly between groups at 2, 6, or 12 months postpartum.
- There were no significant differences in the time to onset or duration of depression between the intervention and control groups.
Conclusions:
- A single session of midwife-led critical incident stress debriefing is not effective in preventing postnatal psychological disorders.
- The high prevalence of depression in the first year postpartum highlights the need for ongoing mental health support.
- While not effective, the CISD intervention demonstrated no adverse effects on maternal psychological well-being.