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Stress debriefing after childbirth: a randomised controlled trial
Author(s) -
Priest Susan R,
Henderson Jenni,
Evans Sharon F,
Hagan Ronald
Publication year - 2003
Publication title -
medical journal of australia
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.904
H-Index - 131
eISSN - 1326-5377
pISSN - 0025-729X
DOI - 10.5694/j.1326-5377.2003.tb05355.x
Subject(s) - medicine , debriefing , childbirth , interquartile range , depression (economics) , postpartum depression , randomized controlled trial , psychological intervention , incidence (geometry) , intervention (counseling) , physical therapy , psychiatry , pregnancy , genetics , physics , macroeconomics , optics , economics , medical education , biology
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.