Abstract
Introduction: Women with high-risk pregnancy are at increased risk of depression and anxiety during pregnancy, as well as a less favorable parent-infant interaction. This study aimed to investigate the effect of midwife-led psycho-education intervention on parental stress, competency, and postpartum depression in nulliparous women hospitalized with high-risk pregnancy.Methods: This randomized controlled trial was carried out on 66 nulliparous women admitted to the high-risk pregnancy ward of Kamali Hospital, Karaj, Iran. Using convenient sampling method, the mothers were randomly assigned to control and intervention groups. In addition to routine care, the intervention group received four sessions of midwife-led psycho-education intervention in two group sessions in pregnancy and two individual sessions immediately after delivery. The parental stress, parental competency, and postpartum depression questionnaires were used for data collection before, after, and one month after the intervention. Data were analyzed using SPSS software ver. 13.0. Repeated-measures ANOVA test was used for comparing the mean scores of parenting stress, parental competency, and depression between and within both study groups before, after, and one month after delivery.Results: While postpartum depression and parental stress decreased in intervention group, parental competency increased.Conclusion: Our findings indicated that midwife-led psycho-education was effective on parental stress, competency, and postpartum depression in high-risk pregnancy mothers. Accordingly, prenatal distress in high-risk pregnancies should be assessed routinely.
Highlights
Women with high-risk pregnancy are at increased risk of depression and anxiety during pregnancy, as well as a less favorable parent-infant interaction
The results of repeated-measures ANOVA showed that the variable of paternal stress had a significant change over time in the counselling group (P < 0.001) and there was a significant difference between the two groups (P < 0.001)
The variable of postpartum depression had a significant change over time in the intervention group (P < 0.001) and there was a significant difference between the two groups (P < 0.001)
Summary
Women with high-risk pregnancy are at increased risk of depression and anxiety during pregnancy, as well as a less favorable parent-infant interaction. This study aimed to investigate the effect of midwife-led psycho-education intervention on parental stress, competency, and postpartum depression in nulliparous women hospitalized with high-risk pregnancy. Physicians and healthcare staff can assess and screen mental disorders and offer health education and care in the field of pregnancy and mental health, and improve the quality of care and pregnancy outcome.[8,12] Midwifeled psycho-education is a type of intervention in the form of a brief counseling that does not require advanced psychotherapy and is provided by an obstetrician According to reports, it has been effective in reducing stress and high levels of fear of birth, postpartum stress, cesarean section, and situational anxiety. In the current randomized clinical trial, we educated the participants in two different time intervals (during pregnancy and during the postnatal period) to assess high-risk pregnancy, prenatal emotional distress, and later adaptation
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