An Intervention for Mothers Experiencing Postnatal Emotional Distress

A study funded by Australian Rotary Health (ARH) that examines an intervention for mothers experiencing postnatal emotional distress, shows potential in encouraging more women to seek help.

40 Maternal and Child Health Nurses (MCHNs) from three Victorian towns were recruited to the trial, and were randomly divided into either the intervention group, which delivered a motivational interviewing (MI) intervention to women during postnatal consultations, or the control group, which delivered routine care to patients during postnatal consultations.

Professor Jeanette Milgrom, who led the study, said the brief intervention was developed for Maternal and Child Health Nurses, as they are often the first health professionals to whom women disclose their feelings when they are not coping after childbirth.

“Motivational interviewing is a way of working with women to find their own reasons to engage in treatment rather than giving of advice,” Jeanette said.

“To our knowledge this is the first study to apply motivational interviewing to improve uptake of treatment, specifically for women experiencing postnatal emotional distress.”

Women who took part in the study received either the intervention or control by the MCHNs at 4 weeks, 8 weeks and 4 months post-birth, and completed follow-up questionnaires at 7 weeks, 15 weeks, and 12-months after birth. MCHNs also filled out two 10-point Likert Scales, rating the usefulness of the intervention and their confidence in delivering the intervention.

Results found in the MI condition, 60.3% of women considered ‘emotionally distressed’ sought help from their GP, a psychologist/counsellor, and/or their MCHN, compared with only 35.4% of women in the routine care condition.

Women receiving the MI intervention also had lower depression, anxiety, and stress scores at 12 months post-birth than women in the routine care condition, however Linear Mixed Models analyses showed that these differences were not statistically significant (p > .05).

“Given the concerningly low levels of treatment uptake by women showing postnatal emotional distress, it is fantastic that we have been able to provide maternal and child health nurses with an effective way to support women to increase treatment uptake,” Jeanette said.

“Maternal and child health nurses in the study really valued the motivational interviewing training and felt that it improved their clinical practice.”

Some other interesting findings included the reasons behind why women are not seeking help:

  • “I thought I would be able to manage on my own” (11.1%)
  • “I felt I should be able to manage on my own” (11.1%)
  • “I did not think I needed help” (6.7%)
  • “I did not want people to know I wasn’t coping” (6.1%)

It was concluded that MI intervention delivered by MCHNs within the context of a routine postnatal screening and emotional health assessment can increase help-seeking and may be a valuable tool to use in the future.

Professor Jeannette Milgrom received funding for an ARH Mental Health Grant between 2011 and 2013. The study was conducted at the Parent-Infant Research Institute, Austin Health, Victoria.

This study was published in 2017 in the journal ‘Archives of Women’s Mental Health’. Click here for the full article: https://link.springer.com/epdf/10.1007/s00737-017-0767-0?author_access_token=YThEpH-G5G56A7sGHf-FL_e4RwlQNchNByi7wbcMAY4NpW5-yA-lDW7t8xFRc2ghsorwtlYzQ8E0udTPLCZr6MDyoLR8B33zEmgzJKg-2KLjiFVxx9CGbgAD6wHQ7P0RAtS7a51qJmee99RvvwJlDg%3D%3D