JMIR Publications

ABSTRACT

Background:

The frenzy of post-birth events often takes a toll on mothers’ mental wellbeing, leaving them susceptible to postpartum psychological disorders such as postnatal depression. Social support has been found to be effective in restoring the emotional wellbeing of new mothers. Therefore, mothers need to be supported during the crucial postpartum period to buffer the negative after-effects of childbirth and to promote healthier maternal wellbeing.

Objective:

To evaluate the effectiveness of a technology-based peer-support intervention program (PIP) on maternal outcomes during the early postpartum period.

Methods:

A randomized, parallel-armed controlled trial was conducted. The study recruited 138 mothers (69 intervention group, 69 control group) at risk of postnatal depression from a tertiary hospital in Singapore. To support these mothers, 20 peer volunteers were recruited by word of mouth and trained by a psychiatrist in social support skills before the intervention commenced. The four-week long intervention included a weekly follow-up with a peer volunteer through phone calls or text messages. The intervention group received peer support in addition to the standard care offered by the hospital. The control group only received postnatal standard care. Maternal outcomes (postnatal depression, postnatal anxiety, loneliness, and perceived social support) were measured with reliable and valid instruments. Data were collected immediately postpartum, at four weeks postpartum, and at 12 weeks postpartum. Linear mixed models were used to compare the groups for postpartum changes in the outcome variables.

Results:

There is statistically significant difference in the Edinburgh Postnatal Depression Scale mean scores between the intervention and control groups from the baseline to 12 weeks postpartum after adjusting for covariates (d=0.15; 95% CI=-1.33, 1.64; P=.02). Although the mean differences for other maternal outcomes [i.e. postnatal anxiety (d=-2.47; 95% CI=-11.17, 6.24; P=0.09), loneliness (d=-0.70; 95% CI=-5.54, 4.44; P=0.14), and perceived social support (d=-1.63; 95% CI=-4.15, 0.89; P=0.20)] were not statistically significant between groups over time, the intervention group had observably better scores than the control group at four and 12 weeks postpartum.

Conclusions:

The technology-based PIP was found to be effective in reducing the risk of postnatal depression among new mothers and showed a generally positive trend in reducing postnatal anxiety and loneliness and increasing perceived social support. This study highlights the importance of training paraprofessionals to provide needed support for new mothers postpartum. A further long-term evaluation of the PIP on maternal and family outcomes as well as its cost-effectiveness is needed to inform clinical practices. Clinical Trial: ISRCTN14864807