Postnatal consultations with an obstetrician after critical perinatal events:a qualitative study of what women and their partners experience

Objective The objective of this study was to explore women’s and their partners’ experiences with attending postnatal consultations with an obstetrician after critical perinatal events.Design Qualitative interview study. We did semi-structured individual narrative interviews exploring the lived experiences. Interviews were analysed using a phenomenological approach and the thematic analysis was validated by a transdisciplinary group of anthropologists, obstetricians and a midwife.Setting Department of obstetrics at a large hospital in Denmark.Participants We did a qualitative study with 17 participants (10 women and 7 partners) who had experienced critical perinatal events.Results Five major themes were identified: (1) a need to gain understanding and make sense of the critical perinatal events, (2) a need for relational continuity, (3) the importance of discussing emotional effects as well as physical aspects of occurred events, (4) preparing for future pregnancies and (5) closure of the story.Most of the participants emphasised the importance of knowing the obstetrician undertaking the postnatal consultation. The majority of the participants described a need to discuss the emotional effects of the experience as well as the physical aspects of occurred events. The postnatal consultation served as an approach to obtain a positive closure of their birth story and to feel confident about potential future pregnancies.Conclusions This interview-based study suggests that postnatal consultation with an obstetrician might be an important tool for women and their partners in understanding the course of events during the critical birth experience and in processing it and preparing for future pregnancies. It appears to be important to assign an obstetrician whom they already know and to encourage them to discuss not only physical aspects of what happened but also the emotional effects of the experience

Evaluation of the Effect of Supervised Group Exercise on Self-Reported Sleep Quality in Pregnant Women with or at High Risk of Depression:A Secondary Analysis of a Randomized Controlled Trial

Poor sleep quality is common during pregnancy. Our objective was to evaluate the effect of supervised group physical exercise on self-reported sleep quality in pregnant women with or at high risk of depression, and secondly, to describe the association between sleep quality and psychological well-being during pregnancy and postpartum. This was a secondary analysis of a randomized controlled trial (n = 282) (NCT02833519) at Rigshospitalet, Denmark. Sleep quality was evaluated using the Pittsburgh Sleep Quality Index (PSQI), psychological well-being by the five-item WHO Well-Being Index (WHO-5). The intention-to-treat analysis showed no difference in mean global PSQI score neither at 29–34 weeks, 6.56 (95% CI: 6.05–7.07) in the intervention group and 7.00 (95% CI: 6.47–7.53) in the control group, p = 0.2, nor at eight weeks postpartum. Women with WHO-5 ≤ 50 reported higher mean global PSQI scores at baseline, 7.82 (95% CI: 7.26–8.38), than women with WHO-5 score > 50, mean 5.42 (95% CI: 5.02–5.82), p < 0.0001. A significant difference was also present post-intervention and eight weeks postpartum. No significant effect of group exercise regarding self-reported sleep quality was seen at 29–34 weeks of gestation or postpartum. Low psychological well-being was associated with poor sleep quality during pregnancy and postpartum

Psychological well-being and worries among pregnant women in the first trimester during the early phase of the COVID-19 pandemic in Denmark compared with a historical group:A hospital-based cross-sectional study

INTRODUCTION: A pandemic may negatively influence psychological well‐being in the individual. We aimed to assess the potential influence of the first national lockdown in Denmark (March to June 2020) due to the COVID‐19 pandemic on psychological well‐being and the content and degree of worries among pregnant women in early pregnancy. MATERIAL AND METHODS: In this hospital‐based cross‐sectional study based on self‐reported data we compared psychological well‐being and worries among women who were pregnant during the first phase of the pandemic (COVID‐19 group) (n = 685), with women who were pregnant the year before (Historical group) (n = 787). Psychological well‐being was measured by the five‐item World Health Organization Well‐being Index (WHO‐5), using a score ≤50 as indicator of reduced psychological well‐being. Differences in WHO‐5 mean scores and in the prevalence of women with score ≤50 were assessed using general linear and log‐binomial regression analyses. The Cambridge Worry Scale was used to measure the content and degree of major worries. To detect differences between groups, Pearson’s Chi‐square test was used. RESULTS: We found no differences in mean WHO‐5 score between groups (mean difference) 0.1 (95% CI −1.5 to 1.6) or in the prevalence of women with WHO‐5 score ≤50 (prevalence ratio 1.04, 95% CI 0.83–1.29) in adjusted analyses. A larger proportion of women in the COVID‐19 group reported major worries about Relationship with husband/partner compared with the Historical group (3% [n = 19] vs 1% [n = 6], p = 0.04), and 9.2% in the COVID‐19 group worried about the possible negative influence of the COVID‐19 restrictions. CONCLUSIONS: Our findings indicate that national restrictions due to the COVID‐19 pandemic did not influence the psychological well‐being or the content and degree of major worries among pregnant women. However, a larger proportion of women in the COVID‐19 group reported major worries concerning Relationship with husband/partner compared with the Historical group and 9.2% in the COVID‐19 group worried about the possible negative influence of the COVID‐19 restrictions

Short-term oestrogen as a strategy to prevent postpartum depression in high-risk women: Protocol for the double-blind, randomised, placebo-controlled MAMA clinical trial

Introduction Postpartum depression affects 10%-15% of women and has a recurrence rate of 40% in subsequent pregnancies. Women who develop postpartum depression are suspected to be more sensitive to the rapid and large fluctuations in sex steroid hormones, particularly estradiol, during pregnancy and postpartum. This trial aims to evaluate the preventive effect of 3 weeks transdermal estradiol treatment immediately postpartum on depressive episodes in women at high risk for developing postpartum depression. Methods and analysis The Maternal Mental Health Trial is a double-blind, randomised and placebo-controlled clinical trial. The trial involves three departments of obstetrics organised under Copenhagen University Hospital in Denmark. Women who are singleton pregnant with a history of perinatal depression are eligible to participate. Participants will be randomised to receive either transdermal estradiol patches (200 μg/day) or placebo patches for 3 weeks immediately postpartum. The primary outcome is clinical depression, according to the Diagnostic and Statistical Manual of Mental Disorders-V criteria of Major Depressive Disorder with onset at any time between 0 and 6 months postpartum. Secondary outcomes include, but are not limited to, symptoms of depression postpartum, exclusive breastfeeding, cortisol dynamics, maternal distress sensitivity and cognitive function. The primary statistical analysis will be performed based on the intention-to-treat principle. With the inclusion of 220 participants and a 20% expected dropout rate, we anticipate 80% power to detect a 50% reduction in postpartum depressive episodes while controlling the type 1 error at 5%. Ethics and dissemination The study protocol is approved by the Regional Committees on Health Research Ethics in the Capital Region of Denmark, the Danish Medicines Agency and the Centre for Data Protection Compliance in the Capital Region of Denmark. We will present results at scientific meetings and in peer-reviewed journals and in other formats to engage policymakers and the public. Trial registration number NCT04685148. </p