title: Blues and depression during early puerperium: home versus hospital deliveries.
abstract: OBJECTIVE
  To investigate whether women who give birth at home are less prone to mood disturbances during the early puerperium than those who give birth in hospital.
  
  
  METHODS
  A prospective study of 303 pregnant women who registered for antenatal care.
  
  
  METHODS
  The antenatal clinic at St Joseph's Hospital, Veldhoven, The Netherlands, and five antenatal consultation programmes of local midwives working in the surrounding region.
  
  
  METHODS
  Three hundred and eighty-two consecutive caucasian women registering for antenatal care were approached. Of these, 303 consented to participate and 293 completed the study.
  
  
  METHODS
  The predictor variable was the way in which the women gave birth: spontaneous vaginal parturition at home or in hospital as follows: spontaneously; vaginal parturition after stimulation with medication; vaginal parturition with forceps/vacuum extraction; or caesarean section. The outcome variables were blues and depression. The occurrence of blues was assessed at 4 weeks postpartum, using Pitt's criteria. The occurrence of depression was assessed at 4 weeks postpartum using the Research Diagnostic Criteria. The possible confounding effects of a set of obstetrical and psycho-social variables relating to the early puerperium were investigated using logistic regression analysis.
  
  
  RESULTS
  Of the 293 women who completed the study, 52% gave birth at home. Significantly more nullipara gave birth in hospital. Parturition occurred where it had been planned in 77% of women; referral occurred later on in pregnancy in 11% and during labour in 12%. Nullipara had to be referred significantly more often than multipara. In general, there was no difference in the incidence of blues and depression between women who gave birth at home and those who gave birth in hospital. Obstetric factors were not related to the occurrence of blues or depression in the early puerperium.
  
  
  CONCLUSIONS
  Women who gave birth in hospital are no more prone to postpartum mood disturbances, such as blues and depression, than women who give birth at home.
authors.affiliation: Department of Behavioural and Social Science, University of Tilburg, The Netherlands.
authors.forename: V J
authors.initials: VJ
authors.lastname: Pop
authors.forename: H A
authors.initials: HA
authors.lastname: Wijnen
authors.forename: M
authors.initials: M
authors.lastname: van Montfort
authors.forename: G G
authors.initials: GG
authors.lastname: Essed
authors.forename: C A
authors.initials: CA
authors.lastname: de Geus
authors.forename: M M
authors.initials: MM
authors.lastname: van Son
authors.forename: I H
authors.initials: IH
authors.lastname: Komproe
mesh_terms: D000341:Affective Disorders, Psychotic / Q000209:etiology*; D019052:Depression, Postpartum / Q000209:etiology*; D005260:Female; D006700:Home Childbirth / Q000523:psychology*; D006760:Hospitalization; D006801:Humans; D009426:Netherlands; D010298:Parity; D011247:Pregnancy; D011446:Prospective Studies