Can midwives reduce postpartum psychological morbidity? A randomized trial

Background: Women who are traumatized after childbirth find that listening, support, counseling, understanding, and explanation are the mast useful tr eatments. However little evidence is available from randomized trials of th e relative efficacy of these treatments as a positive postnatal interventio n. This study purpose was to examine if postnatal "debriefing" by midwives can reduce psychological morbidity after childbirth. Method: A randomized t rial was conducted in a regional teaching hospital in northwest England. On e hundred and twenty postnatal primigravidas were allocated by sealed envel opes to receive the debriefing intervention (n = 56) or not (n = 58). The m ain outcome measure was the Hospital Anxiety and Depression (HAD) scale adm inistered by postal questionnaire 3 weeks after delivery. The proportion of women in each group with anxiety and depression scores of more than 10 poi nts were compared, using odds ratios and 95% confidence intervals. Results: Women who received the intervention were less likely to have high anxiety and depression scores after delivery when compared with the control group. Conclusions: The support, counseling, understanding, and explanation given to women by midwives in the postnatal period provides benefits to psycholog ical well-being. Maternity units have a responsibility to develop a service that offers all women the option of attending a session to discuss their l abor.