Factors Influencing the Effectiveness of Midwife Led Debriefing on Prevention of Postpartum Depression in Western, Kenya

Abstract

Childbirth is a stressful event in women’s lives and could influence emotions which may lead to mental ill health like depression in the postnatal period if not resolved. Depression is a common mental disorder with serious consequences especially during the postpartum period. The prevalence of postpartum depression varies globally, and can be as low as 0.5% or as high as 60.8% in the first year after childbirth. Due to its detrimental impacts, postpartum depression is a serious public health problem. Debriefing is a type of interpersonal therapy, utilized to treat and prevent serious depressive disorders in both pregnant women and the general adult population. Although debriefing has been shown to be useful in both preventing and treating postpartum depression, its effectiveness has not been fully evaluated. The purpose of the study was to assess factors influencing the effectiveness of midwife-led debriefing on prevention of Postpartum Depression in Western region, of Kenya. The study used a quasi-experimental design with pre and post-test assessments. Systematic random sampling was used to identify and allocate participants. The target population was women of childbearing age and study participants were women who gave birth during the study period, of which a sample of 212 participated. Data were collected using standard questionnaire including Edinburg postpartum depression scale (EPDS) score and an interview schedule. Data was analyzed using Statistical Package for Social Sciences (SPSS) version 26. Chi-square was used to test association between variables. Logistic regression model was used to assess the influence of time-based outcome, based on social cultural and demographic characteristics of women on prevention of postpartum depression. Study results indicated that parity, Age, living together with spouse and social support (p=0.004; p=0.003; p=0.002) were significant factors. Additionally, it showed that social support significantly reduced the symptoms of postpartum depression. In conclusion, at the 5% significance level, the key factor was social support (p=0.001) <0.05 which showed that participants postpartum depression symptoms decreased greatly. Midwife led debriefing is recommended as a routine care during perinatal period. Further studies to be done to explore how social support influences midwife led debriefing on prevention of Postpartum depression.