Impact of midwife-led counseling for women who have experienced traumatic childbirth: A clinical trial.

BACKGROUND

Given high traumatic births, post-traumatic stress, anxiety, and depression, more research is needed for counseling frameworks for healthcare professionals. This study aims to assess midwife-led counseling impact on women who have experienced traumatic childbirth.

METHOD: This study employed a controlled clinical trial conducted at Imam Ali Hospital from June 2023 to January 2024. Ninety-six eligible women who had experienced traumatic childbirth were stratified into two groups, namely the postpartum midwifery counseling group (n=48) and the control group (n=48), utilizing random block allocation. The counseling group received standard postpartum care supplemented with face-to-face counseling based on the Gamble model within 72 h after childbirth, followed by two telephone counseling sessions in the fourth and eighth weeks post-delivery. Conversely, the control group received solely routine postpartum care. Women's anxiety during the postpartum period was assessed as a secondary outcome. Statistical analysis was conducted using IBM SPSS Statistics version 20, with a significance level set at less than 0.05.

RESULTS

Significant differences were observed between the counseling and control groups regarding changes in Acute Stress Disorder (ASD) scores from baseline to 12 weeks post-intervention (-18.32; 95 % CI, -12.52 to -24.13; P< 0.001). Additionally, notable disparities were noted between the groups in terms of changes in Post-Traumatic Stress Disorder (PTSD) scores based on the Impact of Event Scale - Revised (IES-R) (-14.49; 95 % CI, -11.63 to -17.34; P< 0.001) and the CheckList - Civilian (PCL) (-11.10; 95 % CI, -8.42 to -13.60; P< 0.001) from baseline to post-intervention. Furthermore, a significant difference was observed in changes in anxiety scores from baseline to post-intervention (-19.49; 95 % CI, -15.28 to -3.69; P< 0.001). The relative risk (RR) of developing PTSD based on both scales was over 60 % lower in the counseling group compared to the control group.

CONCLUSION

In conclusion, this study shows midwife-led counseling effectively reduces psychological distress after traumatic childbirth. It improves ASD, PTSD symptoms, and anxiety. Integrating such counseling into postpartum care can mitigate PTSD risk. Lower relative risk underscores its potential in promoting maternal mental health. Future research should explore long-term effects.