A holistic programme for mothers with postnatal depression: pilot study

Maternity care during a pandemic: Can a hybrid telehealth model comprising group interdisciplinary education support maternal psychological health?

Background

The transition to parenthood is one of the most challenging across the life course, with profound changes that can impact psychological health. In response to the coronavirus disease 2019 (COVID-19), came the rapid implementation of remote antenatal care, i.e., telehealth, with fewer in-person consultations. A change in service delivery in addition to the cancellation of antenatal education represented a potential threat to a woman’s experience – with likely adverse effects on mental health and wellbeing.

Aim

To explore a hybrid model of pregnancy care, i.e., telehealth and fewer in-person health assessments, coupled with concurrent small group interdisciplinary education delivered via video conferencing, extending into the postnatal period.

Methods

Using a quasi-experimental design with an interrupted time series and a control group, this population-based study recruited low-risk women booking for maternity care at one community health site affiliated with a large public hospital in Victoria, Australia.

Findings

Whilst there was no difference in stress and anxiety scores, a significant interactive effect of the hybrid model of care with time was seen in the DASS depression score (−1.17, 95% CI: −1.81, −0.53) and the EPDS (−0.83, 95% CI: −1.5, −0.15).

Discussion

The analyses provide important exploratory findings regarding the positive effects of a hybrid model of care with interdisciplinary education in supporting mental health of first-time mothers.

Conclusion

This study demonstrates that small group online education scheduled in conjunction with individual pregnancy health assessments can be executed within a busy antenatal clinic with promising results and modest but dedicated staff support.

Use of video feedback intervention in an inpatient perinatal psychiatric setting to improve maternal parenting

This study utilizes video feedback to improve maternal parenting behavior in clinically depressed mothers admitted to a perinatal inpatient psychiatric unit. Depressed mothers (n = 74) were randomized to "video" (n = 25), "verbal" (n = 26), or "standard care" (n = 23). "Video" mothers were taped playing with their infant; interaction was reviewed with a mental health specialist. "Verbal" mothers only discussed interaction with their infant. "Standard care" mothers received only routine inpatient care. Mothers were assessed for mental health status, perceptions of baby behavior, and parenting competence. There was significant improvement in mental health status of all participants, regardless of intervention. Neither intervention had an advantage, compared to standard care, in improving parenting confidence or perceptions of infant behavior. Video mothers were more likely to report no change in their parenting confidence the more feedback sessions completed. The number of intervention sessions for each participant was limited by the duration of their inpatient admission. Most participants were on simultaneous pharmacotherapy and psychotherapy, as well as receiving intensive mothercraft assistance; this may have influenced intervention effectiveness. Results suggest that this type of intervention may be beneficial, but in the current format does not add sufficiently to standard care to be detected by the measures used.