HQ Team
March 13, 2024: Cognitive behavioural therapy could be an effective way to reduce the risks of developing postpartum mental health conditions, according to a study.
A National Institutes of Health-supported research team led by Dr Pamela J. Surkan at Johns Hopkins Bloomberg School of Public Health set out on an intervention to reduce anxiety during pregnancy thinking it might lessen mental health risks after childbirth.
They went under the presumption that this could improve outcomes for both mothers and children. The trial was conducted between April 2019 and January 2022 in the Punjab Province of Pakistan.
Researchers first sought input from pregnant women in Pakistan to learn more about their sources of anxiety, coping strategies, and resources.
Randomised controlled trial
The team developed an anxiety-focused intervention based on cognitive behaviour therapy. It is a type of psychotherapy that trains people to modify specific thoughts and behaviours.
They tested the intervention in a randomised controlled trial.
Pregnant women with symptoms of mild or greater anxiety but no depression were randomly assigned to receive either the intervention (380 women) or routine medical care (375).
Women in the intervention group received at least six sessions of one-on-one counselling given mostly during early to mid-pregnancy.
Identify behaviours
A final session occurred during the third trimester.
Sessions were designed to teach participants to identify anxious thoughts and behaviours. They then practised replacing them with helpful thoughts and behaviours.
Non-specialists, with the equivalent of a bachelor’s degree in psychology but no clinical experience, were trained to do the counselling.
Six weeks after childbirth, nine per cent of women in the therapy group had moderate-to-severe anxiety, compared to 27% of those in the control group.
In addition, 12% of women receiving therapy had a major depressive episode, compared to 41% in the control group.
Chronic low mood
Overall, the odds of women who received CBT having either depression or anxiety six weeks after childbirth were reduced by 81% compared to the control group.
Postpartum depression is the most prevalent mental health issue after childbirth. It affects 14-19% of new mothers. It is characterised by chronic low mood, thoughts of disappointment, worthlessness and consistent low energy levels in women within weeks of giving birth.
In many, self-harm thoughts result in suicide, accounting for about 20% of postpartum deaths. If there is no timely intervention and care, it can result in infanticide.
“In low resource settings, it can be challenging for women to access mental health care due to a global shortage of trained mental health specialists,” says Dr Joshua A. Gordon, director of NIH’s National Institute of Mental Health.
“This study shows that non-specialists could help to fill this gap, providing care to more women during this critical period.”
The results of the study were published in Nature Medicine.
