title: Midwife-led debriefing after operative birth: four to six year follow-up of a randomised trial [ISRCTN24648614].
abstract: BACKGROUND
  There is little evidence that single-session debriefing is effective in reducing adverse mental health outcomes after trauma. Few trials have included long-term follow-up, but two also suggest possible negative effects of debriefing. We aimed to assess longer-term maternal health outcomes in a trial of midwife-led debriefing following an operative birth, given that findings at six months could not rule out a possible adverse effect of debriefing.
  
  
  METHODS
  Four to six years after participating in a midwife-led trial of debriefing following an operative birth, 1039/1041 women were mailed a questionnaire containing the Edinburgh Postnatal Depression Scale (EPDS) and the SF-36 health status measure.
  
  
  RESULTS
  Responses were obtained from 534 women (51.4%). Responders from the two trial groups remained comparable 4-6 years postpartum. No significant differences on maternal health outcomes were found between the trial groups.
  
  
  CONCLUSIONS
  In the longer term, maternal health status was neither positively nor adversely affected by the experience of debriefing, despite a hint of adverse effects at six months postpartum. Short debriefing interventions have not proven effective in improving mental health outcomes for women following childbirth.
authors.affiliation: Mother & Child Health Research, La Trobe University, 251 Faraday Street, Carlton Victoria 3053, Australia. r.small@latrobe.edu.au
authors.forename: Rhonda
authors.initials: R
authors.lastname: Small
authors.forename: Judith
authors.initials: J
authors.lastname: Lumley
authors.forename: Liesje
authors.initials: L
authors.lastname: Toomey
mesh_terms: D000328:Adult; D002585:Cesarean Section / Q000523:psychology*; D003376:Counseling; D019052:Depression, Postpartum / Q000523:psychology; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008429:Maternal Welfare / Q000523:psychology; D008603:Mental Health; D008880:Midwifery; D036801:Parturition / Q000523:psychology*; D011181:Postnatal Care; D011182:Postoperative Care; D011247:Pregnancy; D016032:Randomized Controlled Trials as Topic