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Follow-up Data Were Available For One Thousand, Seven Hundred And Thirty ...

Follow-up data were available for one thousand, seven hundred and thirty (ninety-nine percent) women, four hundred and eighty-two of whom had the psychological interview. No significant differences were found in the proportions of women who met diagnostic criteria for PTSD, or major or minor depression in the year after giving birth. Two-thirds of the women rated the debriefing session as helpful.
Tam et al., (2003, p853) undertook an RCT of educational counseling at the obstetric unit of a teaching hospital in Hong Kong. Women who had at least one unexpected suboptimal outcome during their pregnancy and labour were selected (suboptimal outcomes included interventions such as instrumental or caesarean delivery). Five hundred and sixty women were randomised to receive current care or an educational counselling session with a trained research nurse whilst on the postnatal ward. The main study outcome measures included the HADS scale, the General Health Questionnaire, the World Health Organisation Quality of Life Scale and the Clinical Global Impression at six weeks and six months after the birth. the study found no differences in primary outcomes between the study groups were noted, although some differences on subgroup analysis were seen. Women delivered by elective caesarean section who received the intervention had significantly lower depression scores. It is important to note that very few details of the content of the educational intervention were given.
Ryding et al., (2004, p247) evaluated the benefit of two group counselling sessions following an emergency caesarean section in an RCT at a hospital in Sweden. The intervention was implemented by an obstetrician who had a psychotherapy qualification and a midwife. One hundred and sixty-two women were randomised to group counselling or the control group at one to two months postpartum. Data was presented on eighty-two women who received group counselling and sixty-five women in the control group. The intervention sessions comprised of a structured discussion of the medical procedures, feelings about the birth, baby, and motherhood. The remainder of the session progressed in accordance with the needs of the group. Outcomes were assessed at Six months using the Wijma Delivery Expectancy Scale (WDEQ), the IES and the EPDS. The levels of fear of birth were similar, as were symptoms of PTSD and depression. It is suggested that the lack of difference might be because the sample size was too small to detect statistically significant findings, and outcome measures might not have identified women with PTSD.
An RCT was undertaken at one maternity unit in the north of England, to ascertain the value of structured debriefing by community midwives. Three hundred and nineteen primiparous women who had an instrumental delivery or emergency caesarean section were randomised (Kershaw et al., 2005, p1504).

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