This is AWESOME news! (Although I could have told you this long ago – tis nice to have an official study to refer to now!)
TORONTO – Postpartum depression affects about 13 per cent of women in the first year after childbirth, but two new studies – one in Canada, one in the United Kingdom – have found that early identification and intervention can help new mothers who are at risk.
The result was fewer depressive symptoms in the months that followed childbirth, according to results published Friday in BMJ Online.
The Canadian study was led by Cindy-Lee Dennis, an associate professor at the University of Toronto, who had previously found that mothers receiving peer support over the telephone were significantly more likely to continue to breastfeed.
“Women just loved this telephone-based support, and I thought, well, what other conditions might this type of support be beneficial for? And so I then related this model to postpartum depression.”
The study involved 701 women in the first two weeks after giving birth who were identified as being at high risk for postnatal depression, scoring greater than nine using a measure known as the Edinburgh postnatal depression scale.
Volunteers to provide them with peer support over the telephone were recruited by putting up flyers in places like community centres and daycare centres and by putting ads in local newspapers in seven Ontario health regions.
To be a peer volunteer, women had to have experienced postpartum depression and recovered. They also took a four-hour training session, for which Dennis developed a training manual.
“What I had the peer volunteers do was let the mother lead the discussion and the conversation and I had the peer volunteers provide useful suggestions,” said Dennis, who holds a Canada research chair in perinatal community health.
The volunteers provided emotional support, validated the new mother’s experience, told the mother about strategies to make her feel better, or where she could seek help if needed.
“We found that mothers who received this telephone-based peer support were at half the risk of developing postpartum depression,” Dennis said.
Postnatal depression was defined as a score of greater than 12 on the Edinburgh postnatal depression scale. At 12 weeks, 14 per cent of women in the intervention group had postnatal depression, compared to 25 per cent in the control group that didn’t have a volunteer telephone partner.
In the other study, Jane Morrell, a health services researcher at the University of Huddersfield, trained “health visitors” – community nurses – to assess a mother’s mood and identify depressive symptoms at six to eight weeks postnatally using the Edinburgh scale. They were also taught specialized skills so they could offer “talking therapy.”
More than 4,000 new mothers took part in the trial, and those who had visits from the specially trained health visitors saw them for an hour a week for eight weeks.
“Irrespective of the kind of therapies or interventions that were offered to the women, the health visitors’ skills in the intervention group were associated with greater improvement in the intervention group than in the control group at six months postnatally,” Morrell said in an interview.
“This improvement was maintained at 12 months postnatally.”
Morrell said that in general, people don’t know enough about postnatal depression.
“Women and their partners need to be better educated about this, ideally during pregnancy,” she said.
“The moms need to be not afraid to ask for help when they’re suffering with symptoms postnatally. And there needs to be much more thorough training for health-care professionals.”
Dennis, meanwhile, said that several health regions that took part in the study plan to maintain their volunteers to continue the postnatal peer support work.
And Dennis is completing work on an economic evaluation of the trial so that health regions will know more about the costs of developing such a program and screening mothers for postpartum depression.