title: Effectiveness of a counseling intervention after a traumatic childbirth: a randomized controlled trial.
abstract: Adverse childbirth experiences can evoke fear and overwhelming anxiety for some women and precipitate posttraumatic stress disorder. The objective of this study was to assess a midwife-led brief counseling intervention for postpartum women at risk of developing psychological trauma symptoms.
  
  
  METHODS
  Of 348 women screened for trauma symptoms, 103 met inclusion criteria and were randomized into an intervention (n = 50) or a control (n = 53) group. The intervention group received face-to-face counseling within 72 hours of birth and again via telephone at 4 to 6 weeks postpartum. Main outcome measures were posttraumatic stress symptoms, depression, self-blame, and confidence about a future pregnancy.
  
  
  RESULTS
  At 3-month follow-up, intervention group women reported decreased trauma symptoms, low relative risk of depression, low relative risk of stress, and low feelings of self-blame. Confidence about a future pregnancy was higher for these women than for control group women. Three intervention group women compared with 9 control group women met the diagnostic criteria for posttraumatic stress disorder at 3 months postpartum, but this result was not statistically significant.
  
  
  CONCLUSIONS
  A high prevalence of postpartum depression and trauma symptoms occurred after childbirth. Although most women improved over time, the intervention markedly affected participants' trajectory toward recovery compared with women who did not receive counseling.
  
  
  CONCLUSIONS
  A brief, midwife-led counseling intervention for women who report a distressing birth experience was effective in reducing symptoms of trauma, depression, stress, and feelings of self-blame. The intervention is within the scope of midwifery practice, caused no harm to participants, was perceived as helpful, and enhanced women's confidence about a future pregnancy.
authors.affiliation: Research Centre for Clinical Practice Innovation, Griffith University, Meadowbrook, Queensland, Australia.
authors.forename: Jenny
authors.initials: J
authors.lastname: Gamble
authors.forename: Debra
authors.initials: D
authors.lastname: Creedy
authors.forename: Wendy
authors.initials: W
authors.lastname: Moyle
authors.forename: Joan
authors.initials: J
authors.lastname: Webster
authors.forename: Margaret
authors.initials: M
authors.lastname: McAllister
authors.forename: Paul
authors.initials: P
authors.lastname: Dickson
mesh_terms: D000328:Adult; D003376:Counseling; D019052:Depression, Postpartum / Q000523:psychology* / Q000628:therapy*; D004311:Double-Blind Method; D004420:Dystocia / Q000523:psychology*; D005260:Female; D006801:Humans; D008427:Maternal Health Services; D008880:Midwifery; D011247:Pregnancy; D015995:Prevalence; D011793:Queensland; D011795:Surveys and Questionnaires; D016896:Treatment Outcome