Evaluation of expressive writing for postpartum health: a randomised controlled trial

Abstract

Pregnancy, birth and adjusting to a new baby is a potentially stressful time that can negatively affect the health of women. There is some evidence that expressive writing can have positive effects on psychological and physical health, particularly during stressful periods. The current study aimed to evaluate whether expressive writing would improve women’s postpartum health. A randomized controlled trial was conducted with three conditions: expressive writing (n = 188), a control writing task (n = 213), or normal care (n = 163). Measures of psychological health, physical health and quality of life were measured at baseline (6–12 weeks postpartum), 1 and 6 months later. Ratings of stress were taken before and after the expressive writing task. Intent-to-treat analyses showed no significant differences between women in the expressive writing, control writing and normal care groups on measures of physical health, anxiety, depression, mood or quality of life at 1 and 6 months. Uptake and adherence to the writing tasks was low. However, women in the expressive writing group rated their stress as significantly reduced after completing the task. Cost analysis suggest women who did expressive writing had the lowest costs in terms of healthcare service use and lowest cost per unit of improvement in quality of life. Results suggest expressive writing is not effective as a universal intervention for all women 6–12 weeks postpartum. Future research should examine expressive writing as a targeted intervention for women in high-risk groups, such as those with mild or moderate depression, and further examine cost-effectiveness.Clinical trial registration number ISRCTN58399513 www.isrctn.comElectronic supplementary materialThe online version of this article (10.1007/s10865-018-9970-3) contains supplementary material, which is available to authorized users.

What are women stressed about after birth?

“…Of these, 319 women were allocated to the expressive writing condition and 148 completed the expressive writing task 6‐12 weeks after birth. Additional details on sampling, recruitment, and attrition for HABiT are reported elsewhere …”

“…This event could have been related to pregnancy, birth, the baby, or to something else going on in their lives. This was conducted as part of the Health after Birth Trial (HABiT), a randomized controlled trial (RCT) of the effectiveness of expressive writing for postpartum health . Analyzing the events women wrote about provides the opportunity to identify key stressors women experience in the early postpartum period in contemporary Western society.…”

Personalised approaches to intervention for perinatal mental health difficulties

“…This may explain why some studies suggest an intervention that is not universally effective may be effective for some women, e.g. the HABiT study of expressive writing (Ayers et al, 2018).…”

Análise Da Produção Científica Acerca Do Conhecimento Das Mulheres Sobre a Contracepção No Puerpério

“…Além do conhecimento da fisiologia do período pós-parto, as mudanças são intensas no aspecto psicológico, social, profissional, familiar e conjugal da mulher, observando a necessidade de uma rede de apoio (1) . Ao considerar tais mudanças, observa-se que este período pode levar a agravos e consequentemente a morbidades significativas para a saúde pública, tornando um dos focos de políticas públicas voltada para a mulher em toda sua integridade (4) . Para a garantia de uma assistência qualificada, integral, humanizada, com acesso aos direitos e aos meios de serviços e estimulação a redução de morbimortalidade feminina no Brasil, foi criado em 2004 o Programa Nacional de Atenção Integral a Saúde da Mulher (PNAISM), fundamentada nos princípios do Sistema Único de Saúde (SUS) (5) .…”