Disrespect and abuse during childbirth and postpartum depression: a scoping review

This study aims to map, within the scientific literature, the relationship between disrespect and abuse during childbirth and the occurrence of postpartum depression. This is a scoping review designed in accordance with the recommendations of the Joanna Briggs Institute. The search was performed in Embase, LILACS, MEDLINE, PsycINFO, Web of Science, and in the CAPES Portal of Theses and Dissertations. We included studies that investigated the relationship between disrespect and abuse during childbirth with postpartum depression, considering cases diagnosed by physicians and by self-reports via validated scales, without restrictions regarding the year of publication and language. A total of 3,399 publications were identified and, after removing the duplicates and reading the title, abstracts, and the full-texts, seven articles were selected to integrate this review. Studies were published from 2017 onward, in four countries. Women who had experienced disrespect and abuse during childbirth were more likely to experience symptoms of postpartum depression. A standard terminology is necessary for disrespectful and abusive care during childbirth, as well as the elaboration of a measurement instrument that is universally accepted.

[Variables associated with the risk of postpartum depression. Edinburgh Postnatal Depression Scale]

OBJECTIVE

To find some of the variables associated with values on the Edinburgh Postnatal Depression Scale (EPDS) which suggest postnatal depression in women living in the province of Soria.

DESIGN

Population-based case study with controls.

SETTING

Soria Health Region.

PARTICIPANTS

Women living in Soria giving birth in the INSALUD General Hospital between January and October 2000.

MAIN MEASUREMENTS

Questionnaire sent by mail, containing socio-economic variables, pathology background, gynaecological and obstetric details, the EPDS and the APGAR Family score. Those questionnaires filled in between the third and eighth week after birth were considered valid.

RESULTS

340 questionnaires out of 556 sent out were received back (61.2% reply rate). 34 were excluded for lack of data or evident mistakes. 15.7% (95%, CI, 11.6-19.8) of the women scored 13 or more on the EPDS and were at risk of suffering postnatal depression. The independent variables associated with postnatal depression were: age of mother, poor or very poor economic situation, personal history of disturbed states of mind, being anaesthetised during birth and family dysfunction.

CONCLUSIONS

The risk of postnatal depression was mainly related to socio-economic and family variables. Identification of these variables along with application of the EPDS after giving birth raises the alarm for a possible postnatal depression, and enables the study and follow-up in benefit of the mother and of the subsequent evolution of the new-born to be initiated.