Postpartum depression and companionship in the clinical birth environment: a randomized, controlled study.

Abstract

Postpartum depression is a common feature of childbearing and is the cause of considerable morbidity. We have explored the possibility that clinically oriented care during labor may contribute to its occurrence. Of 189 nulliparous women laboring in a familiar community hospital, 92 were allocated by randomized, sealed envelopes to receive additional companionship from one of three volunteer labor companions recruited from the community. The group receiving support attained higher self-esteem scores and lower postpartum depression and anxiety ratings 6 weeks after delivery. In the clinical labor environment companionship modifies factors that contribute to the development of postnatal depression. We emphasize the importance of paying attention to the psychosocial environment in which labor takes place, to facilitate adaptation to parenthood.