The efficacy of ‘debriefing’ after childbirth: Is there a case for targeted intervention?

Abstract

Objective: To review the efficacy of debriefing interventions for reducing posttraumatic stress (PTS) and/ or depressive symptoms in postnatal women. Background: Techniques referred to as debriefing have been adapted for use within maternity care settings to prevent the development of PTS symptoms or depression. There is a requirement to disaggregate methods and approaches used by existing studies, rather than review the research as a whole, to identify elements that may contribute to an efficacious intervention and to clarify what is currently a confused position. Methods: Papers assessing the utility of providing a brief psychological intervention involving discussion of a birth with the mother and a professional, to reduce symptoms of PTS or depression, were reviewed. Discussions could be structured or unstructured, and involve any aspect of discussing the birth, responses and coping strategies. Results: Nine papers (eight studies) were reviewed. While the majority of studies reported findings indicating that debriefing was ineffective for reducing PTS or depressive symptoms, there was evidence indicating that targeted interventions (for women who experienced a traumatic birth) were efficacious. Conclusion: There may be potential utility in providing a debriefing intervention for women who perceive their childbirth experience to have been traumatic. A diversity of approaches termed 'debriefing' highlight a requirement to consider alternative terminology; the term 'childbirth review' is suggested as a useful alternative. Further research evaluating the efficacy of debriefing using a targeted approach for trauma perception is recommended.

“It Can’t Be Like Last Time” – Choices Made in Early Pregnancy by Women Who Have Previously Experienced a Traumatic Birth

“…Recent work by Sheen and Slade unpicks some of these issues, arguing a case for targeted debriefings, and specifying what these should involve. Their work is however primarily concerned with whether debriefing “reduce[s] symptoms of PTS or depression,” and/or whether it is “efficacious … for women who experienced a traumatic birth” (Sheen and Slade, 2015). For the women in this study, engaging in a birth reflections meeting was not primarily intended to result in psychological or emotional improvement, but was used by the women as a tool to help them prepare for their forthcoming birth.…”

Be Quiet and Man Up: A Qualitative Questionnaire Study into Fathers Who Witnessed Their Partner’s Birth Trauma

“…However, it is important to note that debriefs are not necessarily effective in themselves at addressing the effects of a traumatic birth. Sheen and Slade (2015) found that postnatal debriefs were ineffective in reducing post-traumatic stress or depressive symptoms and should not replace targeted interventions. Despite this, the participants in the current study suggested that receiving some information about what had happened would assist with their own understanding of the process.…”

Be quiet and man up: a qualitative questionnaire study into fathers who witnessed their Partner’s birth trauma

“…However, it is important to note that debriefs are not necessarily effective in themselves at addressing the effects of a traumatic birth. Sheen and Slade [30] found that postnatal debriefs were ineffective in reducing post-traumatic stress or depressive symptoms and should not replace targeted interventions. Despite this, the participants in the current study suggested that receiving some information about what had happened would assist with their own understanding of the process.…”