Promising interventions to prevent postpartum depression
Numerous studies and meta-analyses have shown that women who receive a psychosocial or psychological intervention are significantly less likely to develop postpartum depression, compared with those receiving standard care.
A recent systematic review of 28 randomised controlled trials involving almost 17,000 women highlighted the effectiveness of psychosocial and psychological interventions to reduce the risk of postpartum depression.
Interventions that did not show strong evidence for prevention of postpartum depression included prenatal and postnatal classes, postpartum lay-based home visits, early postpartum follow-up, continuity of care models, in-hospital psychological debriefing, and cognitive behavioural therapy.
Promising interventions included:
- provision of intensive, individualized postpartum visits by public health nurses or midwives
- lay (peer) telephone support
- interpersonal psychotherapy
Interventions were particularly effective in preventing postpartum depression when they were initiated postnatally and targeted at-risk mothers. As an example of targeting, two of the identified promising interventions (flexible postpartum care provided by midwives and telephone-based support by laypersons) used screening to identify and target those with early depressive symptoms. Individual-based interventions were more effective than group-based; and most interventions were based on being in contact with the individual multiple times. Although the majority of studies focused on professionally-led interventions, there were similar benefits for lay-person led interventions.
The authors recommend that prevention interventions be simple and inexpensive to enable application to a large population. Specific research studies on preventive interventions related to the mother’s partner, ethnically and socio-economically diverse women, cognitive behavioural therapy, among others were suggested for the future.
See “Psychosocial and psychological interventions for preventing postpartum depression,” available on the Health Evidence site hosted by McMaster University.