The Effect of Supportive Counseling on Post-Traumatic Stress Disorder after Childbirth and Neonatal Neuromuscular Development

Abstract

Abstract

Introduction: Many women who experience traumatic childbirth report that they do not have the opportunity to talk about their worries and stresses; Adequate psychological support is essential to reduce the long-term and severe consequences. The aim of this study was to determine the effect of supportive counseling on post-traumatic stress disorder after delivery and neonatal neuromuscular development. Methods: This quasi-experimental study was performed on 166 women with obstetric trauma hospitalized in Arak public hospitals. Participants were randomly assigned to the intervention and control groups according to the type of delivery (vaginal or emergency cesarean section). After completing the Demographic Characteristics and Postpartum Bonding Questionnaire, for the intervention group (83 people), individual supportive psychotherapy in two face-to-face sessions, before discharge from the hospital and 10-15 days after delivery and a telephone consultation was provided 4-6 weeks after delivery. The control group received only routine postpartum care. Post-traumatic stress disorder questionnaires (PCL-5: PTSD Checklist for DSM-5), postpartum bonding questionnaire and Edinburgh postpartum depression scale was filles at two months, and PCL-5 and Ages and Stages Questionnaire was completed by the researcher at four months. The checklist of anthropometric variables based on delivery record and measurements were completed at two and four months of age. Data were analyzed using SPSS25 software and Chi-square, t-test, ANCOVA after adjusting the baseline score and RMANOVA were used. Results: At two months, the frequency of PTSD in the intervention group was 6.3% and in the control group was 7.2% (p = 0.27) and the severity of symptoms of posttraumatic stress disorder in the intervention group was significantly lower than the control group. (Mean difference -6.37, confidence interval 95%: (-9.18--3.55); p = 0.04). At four months, the frequency of PTSD in the intervention group was 9.36% and in the control group was 8.43 (P = 1,000) and the severity of symptoms of posttraumatic stress disorder in the intervention group was lower than the control group (mean difference -13.4, confidence interval). 95%: (-16.15 - - 10.66); P<0/001). Regarding the effect of supportive counseling on neonatal neuromuscular development, four months after delivery in five areas of communication, gross motor, fine motor, personal-social and problem solving, a significant improvement was observed in the intervention group compared to the control group (P<0/001).

Conclusion: Providing supportive counseling after traumatic childbirth is effective in reducing the severity of PTSD symptoms and improving neonatal neuromuscular development. So, it is recommended that supportive counseling be included in the care program of mothers with traumatic childbirth.