Prevention of postnatal distress or depression: an evaluation of an intervention at preparation for parenthood classes

Matthey, Stephen, Kavanagh, David J., Howie, Pauline, Barnett, Bryanne and Charles, Margaret (2004) Prevention of postnatal distress or depression: an evaluation of an intervention at preparation for parenthood classes. Journal of Affective Disorders, 79 1-3: 113-126. doi:10.1016/S0165-0327(02)00362-2


Author Matthey, Stephen
Kavanagh, David J.
Howie, Pauline
Barnett, Bryanne
Charles, Margaret
Title Prevention of postnatal distress or depression: an evaluation of an intervention at preparation for parenthood classes
Journal name Journal of Affective Disorders   Check publisher's open access policy
ISSN 0165-0327
Publication date 2004-04
Sub-type Article (original research)
DOI 10.1016/S0165-0327(02)00362-2
Volume 79
Issue 1-3
Start page 113
End page 126
Total pages 14
Editor C. Katona
H.S. Akiskal
Place of publication Amsterdam, The Netherlands
Publisher Elsevier BV
Collection year 2004
Language eng
Subject C1
321021 Psychiatry
730211 Mental health
Formatted abstract
Objective:
To determine the effectiveness of a psychosocial intervention, provided to expectant couples in routine antenatal classes, on the postpartum psychosocial adjustment of women and men.

Design:
A 3*3 between subjects randomised control design was utilised. The two factors were condition and self-esteem. Preparation for Parenthood programs were randomly allocated to one of three conditions: usual service ('control'), experimental ('empathy'), or non-specific control ('baby-play'). The latter condition controlled for the non-specific effects of the intervention, these being: the provision of an extra class; asking couples to consider the early postpartum weeks; and receiving booster information after the antenatal class, and again shortly after the birth. Women and men were categorised into three levels of self-esteem, as measured antenatally: low, medium and high.

Methods:

268 participants were recruited antenatally. Interview data and self-report information was collected from 202 of these women at 6 weeks postpartum, and 180 women at 6 months postpartum. The intervention consisted of a session focusing on psychosocial issues related to becoming first-time parents. Participants discussed possible postpartum concerns in separate gender groups for part of the session, and then discussed these issues with their partners. Hypothetical scenarios depicting stressful situations in the early postpartum weeks for women and men were discussed, with solutions that parents have found useful given to the participants. In the non-specific control condition, the session focused on the importance of play with a baby, with videotapes and discussion around how parents can play with infants.

Results:

At 6 weeks postpartum there was a significant interaction effect between condition and self-esteem on maternal adjustment. Women with low self-esteem, who had received the intervention, were significantly better adjusted on measures of mood and sense of competence than low-self-esteem women in either of the two control conditions. There were no main or interaction effects by 6 months postpartum. The beneficial effect at 6 weeks was related to partners of these women being more aware of how the mother was feeling, and with women reporting greater satisfaction with the sharing of home and baby tasks. There were no significant main or interaction effects for men at either time point, other than men with low self-esteem reporting poorer adjustment.

Conclusion:
This brief and inexpensive intervention was effective in reducing postpartum distress in some first-time mothers at 6 weeks postpartum. The effectiveness of this intervention was related to an increased level of awareness in the men as to how their partners were experiencing the early postpartum weeks. That the effect was only evident for women who, antenatally, reported being low in self-esteem, is an important advance in our knowledge of the effectiveness of such prevention programs. No previous studies have investigated the differential effectiveness of such programs depending upon the woman's level of self-esteem, and this finding indicates that future work should measure this variable. These findings should be understood in the context that the population sampled were those attending preparation for parenthood classes, and thus different interventions will be needed for couples who do not attend such classes. This brief psychosocial intervention can be readily applied to antenatal classes routinely conducted in hospitals or the community. (C) 2002 Elsevier B.V. All rights reserved.
Keyword Psychiatry
Postnatal Depression
Antenatal Classes
Preparation
Fathers
Postpartum Depression
Controlled-trial
Self-esteem
Mental-health
Scale
Transition
Validation
Symptomatology
Symptoms
Support
Clinical Neurology
Q-Index Code C1

Document type: Journal Article
Sub-type: Article (original research)
Collections: Excellence in Research Australia (ERA) - Collection
2005 Higher Education Research Data Collection
School of Medicine Publications
 
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Created: Wed, 15 Aug 2007, 04:34:12 EST