BMJ 2001;322:928 ( 14 April )

Letters

Psychological debriefing

    Providing good clinical care means listening to women's concerns
    Research methodology was inadequate
    Qualitative research may be more appropriate
    Authors' reply

Providing good clinical care means listening to women's concerns

The first 150 words of the full text of this article appear below.

EDITOR---Small et al have shown the ineffectiveness of debriefing in reducing maternal depression after operative childbirth.1 Although we agree with the general findings of their study2 some methodological issues must be addressed, especially if their findings are interpreted to mean that women should not have the opportunity to talk about their delivery experiences in a therapeutic and supportive manner.

The authors assert that the expected prevalence of postnatal depression is 24%3; this is considerably higher than the 13% reported in other studies.4 They assessed postnatal depression using the Edinburgh postnatal depression scale at six months postpartum (when its validity is uncertain), thereby excluding women who had had postnatal depression earlier but then recovered.

Additionally, there is no indication in this study of the degree of stress associated with the delivery, and elective and emergency procedures were aggregated. In our clinical experience a forceps delivery is more traumatic . . . [Full text of this article]
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Relevant Article

Randomised controlled trial of midwife led debriefing to reduce maternal depression after operative childbirth
Rhonda Small, Judith Lumley, Lisa Donohue, Anne Potter, and Ulla Waldenström
BMJ 2000 321: 1043-1047. [Abstract] [Full Text] [PDF]

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