The effect of debriefing intervention on posttraumatic stress symptoms after childbirth and postpartum depression: a randomized clinical trial

Introduction: Consultation with the debriefing approach means structured conversation with someone who has recently been exposed with a stressful or traumatic event and focuses on preventing severe psychological complications following traumatic or stressful incidents. Women who experience severe distress during the process of childbirth might develop postpartum post-traumatic stress disorder (PTSD). One of the most important complications of traumatic childbirth associated with PTSD following childbirth is postpartum depression. The purpose of the present study was to determine the effect of debriefing intervention on postpartum post-traumatic stress symptoms and depression.Methods: This randomized controlled clinical trial was conducted on ۷۰ postpartum women who experienced traumatic childbirth based on the DSM-۵ [A] criteria in teaching hospitals affiliated to Tabriz University of Medical Sciences, Iran. Using block randomization, the participants were assigned into a counselling and a control group (n=۳۵ per group). The intervention group attended a group counselling session with debriefing approach within ۲۴-۴۸ hours after childbirth, before discharge from hospital. The control group received only routine postpartum care. Post Traumatic Stress Check List (PCL-۵) and Edinburgh Postnatal Depression Scale (EPDS) were completed by the participants before intervention and ۱۰-۱۵ days and ۴-۶ weeks after childbirth. Repeated Measure ANOVA was used to analyse the data.Results: The two groups were matching in terms of their demographic and obstetric-neonatal characteristics, and baseline depression score. The mean score of post-traumatic stress symptoms showed significant decrease in the intervention group compared to the control group (adjusted mean difference =-۵.۵۲; ۹۵% CI: -۱۰.۲۳ to -.۸; P=.۰۲). However, debriefing intervention had no significant effect on mean score of depression between groups (adjusted mean difference = -۱.۴۲; ۹۵% CI: -۳.۶۵ to ۰.۸; P = ۰.۲).Conclusion: Debreifing intervention decreased post-traumatic stress symptoms in mothers with traumatic childbirth. It is suggested to use this counseling approach in postpartum wards to prevent severe psychological complications following traumatic childbirth.

Keywords:

Debriefing , Traumatic childbirth , Post-traumatic stress symptoms , Postpartum depression