Randomised controlled trial of community debriefing following operative delivery

Abstract

Objective: The aim of this study was to determine if two debriefing sessions following an operative delivery could reduce a woman's fear of future childbirth.

Design: Prospective randomised controlled trial (RCT) with two arms comparing debriefing, aimed to reduce fear of future childbirth, with standard care after birth.

Setting: District General Hospital with 2500 deliveries per year.

Sample: Three hundred and nineteen mothers who delivered a first child by operative delivery (i.e. forceps, vacuum or emergency caesarean section). The study took place at Huddersfield Royal Infirmary, from January 2002 to July 2003.

Methods: Debriefing by community midwives specifically trained in postpartum debriefing at 10 days and 10 weeks.

Main outcome measure: Fear of childbirth was assessed using the Wijma Delivery Expectancy Scale (WDEQ). WDEQ scores were measured 10 days, 10 weeks and 20 weeks following delivery.

Results: Fear of childbirth as measured by the WDEQ was lower throughout the study for the debriefing group. However, it never reached statistical significance in the short term [10 days debriefing = 94.5, control = 97.5 (P= 0.295), 10 weeks debriefing = 92.0, control = 97.9 (P= 0.076), 20 weeks debriefing = 90.9, control = 97.4 (P= 0.057)].

Conclusion: This study shows in the short term there was no significant difference in the WDEQ fear of childbirth scores. The debriefing group were showing a tendency for lower scores. Long term follow up of these cases may be more relevant.