Optimal practice review: recommendation reminders detail
|Date issued:||July 2006|
Postnatal care refers to the care of women and their babies in the first 6–8 weeks after birth. Because each woman and baby has different needs, every postnatal contact is different.
Postnatal care is primarily about providing a supportive environment in which a woman, her baby and the wider family can begin their new life together. For most women and babies the postnatal period is uncomplicated. But postnatal care is also about being able to ensure that the mother and baby are recovering normally after the birth and being able to quickly identify and deal with any problems should they occur.
The majority of postnatal care takes place in the woman’s home and is likely to include routine clinical examination and observation of the woman and her baby, routine infant screening to detect potential disorders, support for infant feeding and ongoing provision of information and support.
Postnatal mental health problems can range from psychological problems to depression, anxiety, psychosis, and post-traumatic stress disorder (PTSD). For some women, PTSD can be a consequence of traumatic events that they experience during childbirth (as well as in pregnancy or immediately after birth). For other women, it is not always the sensational or dramatic events that trigger childbirth trauma but other factors such as loss of control, loss of dignity, the hostile or difficult attitudes of the people around them, feelings of not being heard or the absence of informed consent to medical procedures.
‘Debriefing’ is a structured or unstructured interview that is undertaken by an appropriately trained practitioner with the aim of preventing PTSD in an individual who has experienced a traumatic event. It has been investigated as a method of preventing postnatal psychological problems, particularly PTSD and depression.
The NICE Guideline Development Group (GDG) reviewed the evidence on debriefing to prevent emotional distress after giving birth. Three trials that met the inclusion criteria of debriefing were explored in detail. While one small study showed that the control group had higher levels of anxiety and depression, the other two larger trials found that the debriefing intervention had no effect on depression.
Although women in all three trials reported that the debriefing was helpful, current evidence suggests that it may not reduce psychological morbidity after giving birth. Therefore further research is needed and NICE recommends that formal debriefing of the birth experience is not carried out.
This page was last updated: 12 November 2009