Effect of Midwife-led Counseling Based on Gamble’s Approach on Anxiety<span dir="RTL"> and Depression during Pregnancy

Background & aim: Pregnancy-related anxiety and depression are prevalent and increase the risk of negative maternal outcomes. Therefore, the current study aimed to examine the effect of midwife-led counseling according to Gamble’s approach on pregnancy-related anxiety and depression. Methods: This quasi-experimental study was carried out from April ۴, ۲۰۲۳, to September ۲۱, ۲۰۲۳, in Zahedan, Iran. Fifty-seven Iranian pregnant women at gestational ages of ۱۸-۲۴ weeks with a Hospital Anxiety and Depression Scale (HADS) score of ≥۸ were allocated to two intervention and control groups using convenience sampling. The intervention group (n=۲۸) received five counseling sessions according to Gamble’s approach, while the control group (n=۲۹) was subjected to the routine prenatal care. The HADS questionnaire was used to collect data before, immediately after, and two months after the intervention. Data were analyzed using Chi-square test, linear regression model, and repeated measures analysis of variance. Results: The two groups were not significantly different in terms of anxiety (P=۰.۹) and depression scores (P=۰.۲) before the intervention. However, after the intervention, the anxiety and depression scores significantly decreased in the intervention group in comparison with the control group (P<۰.۰۰۰۱). According to post-hoc analysis, in the intervention group, two months after the intervention, the levels of anxiety (P<۰.۰۰۷) and depression (P=۰.۰۰۱) were significantly lower compared to the pre-intervention stage. Conclusion: Midwife-led counseling based on Gamble’s approach may help to reduce symptoms of anxiety and depression during pregnancy. Further randomized controlled trials are needed to examine the effectiveness of this intervention in real-world healthcare settings.

Keywords:

Counseling , Anxiety , Depression , Midwifery , prenatal care , pregnancy