2002 International International Biennial Scientific Meeting

STRESS DEBRIEFING AFTER CHILDBIRTH: A RANDOMISED CONTROLLED TRIAL

Susan R Priest, Jenni Henderson, Sharon Evans, Ronald Hagan, Jenny Sharp, Anne St Jack, and Senia Malmgren

Department Obstetrics and Gynaecology, King Edward Memorial Hospital, Perth, Western Australia.

spriest@chilli.net.au

Objective: To determine whether a single, structured, midwife-led stress debriefing intervention reduces the incidence of depression during the 12 months after delivery of a full term infant.

Methods:

Design: Single blind randomised controlled trial.

Participants: 1745 women after healthy term delivery, screened for psychological disorders.

Intervention:. A single, structured, debriefing session using the Maternal Individual Debriefing Schedule

(MIDS) based on Critical Incident Stress Debriefing (CISD) principles. Control group received standard postnatal care.

Outcome Measures: Diagnosis of depression in 12 months postpartum using SADS psychological interview and DSM-IV criteria.EPDS used to screen for interviews at 2,6 and 12 months postpartum.

Results: 875 women allocated to debriefing (Intervention), 870 to control. Followup information available on 1730 (99.1%)- 482 SADS interviews.

No differences between groups on EPDS at 2,6,12 months or in formal diagnoses. Depression diagnosed in 156 (17.8%) of debriefed women and 158 (18.2%) controls, (OR (95%CI) 0.985 (0.872,1.112).

No differences in median (IQR) onset or duration of depression.

Conclusions: A structured debriefing intervention based on CISD principles did not reduce prevalence of PND during the first year after delivery.

Funded by NHandMRC