Abstract

This study evaluated the effect of telephone based peer support (mother to mother) in preventing postnatal depression among women identified as high risk within the first two weeks after delivery. Telephone based peer support to mothers may be a viable method to prevent postnatal depression in high-risk women. Women who received peer support were half as likely to develop postnatal depression 12 weeks after birth. Background: Postnatal depression, which affects approximately 13% of mothers, usually occurs within the first 12 weeks after giving birth. Psychosocial support may be a means of preventing postnatal depression and may address some feelings of "lack of support" or "feeling isolated". This study evaluated the effect of telephone based peer support (mother to mother) in preventing postnatal depression among women identified as high risk within the first two weeks after delivery.

Methods: Between November 2004 and September 2006, women at risk of postnatal depression from seven large health regions in Ontario, Canada were recruited to participate in this study. A total of 701 women participated in this study. Women in the standard care group received all normal services, which could have included (if available), the mother proactively seeking services from the public health nurse, physicians, and other community resources. Those women in the intervention group had access to all standard postpartum care in addition to being matched with a peer volunteer. The peer volunteer was requested to make a minimum of four contacts and interact with the new mother as necessary. This peer support lasted up to 12 weeks postpartum. Peer volunteers received four hours of training to develop skills required to provide effective telephone based support and to make referrals.

Findings: Women in the intervention group were less likely to have symptoms of postnatal depression at the 12 week assessment than those in the standard care group, specifically half the risk of developing postnatal depression than those in the control group. A 24 week follow-up indicated no differences between the two groups. This result was expected as mothers who exhibited signs of clinical depression were referred to the appropriate health care provider. Women in the standard care group, however, received more home visits from a public health nurse at the 24 week assessment than those receiving the peer support. On average, women in the intervention group received 8.8 contacts with their peer volunteer, with half of the contacts being telephone calls lasting an average of 14.1 minutes. Only 7% of contacts were initiated by mothers.

Conclusions: Telephone based peer support to mothers post delivery may be a viable method of preventing postnatal depression in high-risk women. Women who received peer support were half as likely to develop postnatal depression 12 weeks after birth. Most women were satisfied with the peer support program. In practical terms, the results of this study indicate that eight women would need to receive peer support to prevent one case of postnatal depression and that the volunteer coordinator would need to ensure that the peer volunteers fulfilled their obligations to provide a minimum number of contacts.

References

Dennis CL, Hodnett E, Kenton L, Weston J, Zupancic J, Stewart DE, Kiss A. "Effect of peer support on prevention of postnatal depression among high risk women: multisite randomised controlled trial". BMJ, 2009; 338: a3064.