Postnatal debriefing: women's need to talk after birth
There is a lack of evidence of the clinical benefit of postnatal debriefing, but qualitative studies show that women value talking to a midwife after birth. However, a very small proportion of women accepted a postnatal discussion meeting at the district general hospital where the author worked.
To determine why some women need to talk to a professional after giving birth.
A postal survey was sent to a sample of 447 women who gave birth during one calendar month at an NHS Trust in England. This instrument also included the impact of events scale (IES), which assessed women's feelings in relation to their recent experience of giving birth. A total of 170 women (38%) returned the completed form.
Some women need to talk about their birth experience after they have left the hospital. Women with symptoms of post-traumatic stress (PTS), measured by a high IES, were more likely to want to talk after giving birth and more likely to rate their experience of birth negatively, compared with those with a low IES. Approximately one-third of women who responded experienced high PTS symptoms.
Maternity providers should consider offering a postnatal listening service to meet women's needs in relation to understanding their experience of giving birth. This will also serve to identify women with PTS symptoms and offer further support.
A Cochrane review of debr iefing interventions for the prevention of psychological trauma in women following childbirth was published in 2015 (Bastos et al, 2015). Seven trials were included in the review, which took place in three countries. Debriefing was not narrowly defined, or dependent on being labelled ‘debriefing’, which allowed the inclusion of the maximum number of studies.
Bastos et al (2015) identified two main types of debriefing: postnatal debriefing and psychological debriefing. Postnatal debriefing was commonly a meeting with a midwife, at which women discuss their birth events with reference to the medical notes. Psychological debriefing was found to be more structured and usually involved a set of procedures aimed at preventing psychological morbidity. This Cochrane review, set in the maternity context, did not find clear evidence that debriefing either reduced or increased the risk of developing psychological trauma during the postpartum period, a finding that was due to the poor quality of the evidence and heterogeneity between the studies.
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