Effectiveness of Postpartum Education in the Reducing Symptoms of Postpartum Depression

Abstract

Objective To determine if an educational intervention provided during postpartum hospitalization is effective in decreasing the symptoms of postpartum depression (PPD) as measured by the Edinburgh Postnatal Depression Scale (EPDS) at 6‐weeks, 3‐months, and 6‐months postpartum. Design Quasi‐experimental. Setting A 12‐bed maternity unit of an acute care hospital in New England. Sample A sample of 240 women was recruited: the first 120 women served as the control group (usual care) and the next 120 women served as the educational intervention group. Respondents were predominantly White (89%) and multiparous (65%). The average age was 29.7 (range 19–40), and 34% were eligible for the Special Supplemental Nutrition Program for Women, Infants and Children. More than one third (36.7%) had a history of depression prior to pregnancy. Methods During postpartum hospitalization, participants completed written questionnaires including demographic, delivery, and infant feeding information as well as the Postpartum Depression Predictors Inventory (PDPI). Education about PPD was provided verbally and in writing at the bedside to respondents in the treatment group by a member of the research team based on the fact sheet from the U.S. Department of Health and Humans Services “Depression during and after Pregnancy.” Follow‐up by mail and telephone was completed at 6‐weeks, 3‐months, and 6‐months postpartum with a self‐report questionnaire, including the EPDS, updates regarding the health of mother and infant, and any employment or major life changes. Results The educational intervention did not have a significant effect on EPDS scores at any of the three data collection points. History of depression and anxiety was the most significant predictor of symptoms. Conclusion/Implications for Nursing Practice These results suggest that the postpartum period is important for identifying women at risk for depression, but that education during this time may not be effective. Further study is needed to determine a more appropriate time and method of intervening to ensure adequate care. Limited nursing time during the brief hospitalization may be better spent on implementing a mechanism for ensuring adequate follow‐up after discharge for women at risk. To determine if an educational intervention provided during postpartum hospitalization is effective in decreasing the symptoms of postpartum depression (PPD) as measured by the Edinburgh Postnatal Depression Scale (EPDS) at 6‐weeks, 3‐months, and 6‐months postpartum. Quasi‐experimental. A 12‐bed maternity unit of an acute care hospital in New England. A sample of 240 women was recruited: the first 120 women served as the control group (usual care) and the next 120 women served as the educational intervention group. Respondents were predominantly White (89%) and multiparous (65%). The average age was 29.7 (range 19–40), and 34% were eligible for the Special Supplemental Nutrition Program for Women, Infants and Children. More than one third (36.7%) had a history of depression prior to pregnancy. During postpartum hospitalization, participants completed written questionnaires including demographic, delivery, and infant feeding information as well as the Postpartum Depression Predictors Inventory (PDPI). Education about PPD was provided verbally and in writing at the bedside to respondents in the treatment group by a member of the research team based on the fact sheet from the U.S. Department of Health and Humans Services “Depression during and after Pregnancy.” Follow‐up by mail and telephone was completed at 6‐weeks, 3‐months, and 6‐months postpartum with a self‐report questionnaire, including the EPDS, updates regarding the health of mother and infant, and any employment or major life changes. The educational intervention did not have a significant effect on EPDS scores at any of the three data collection points. History of depression and anxiety was the most significant predictor of symptoms. These results suggest that the postpartum period is important for identifying women at risk for depression, but that education during this time may not be effective. Further study is needed to determine a more appropriate time and method of intervening to ensure adequate care. Limited nursing time during the brief hospitalization may be better spent on implementing a mechanism for ensuring adequate follow‐up after discharge for women at risk.