Prospective Evaluation of A Structured Nurse-Led Counseling And Follow-Up Program For Early Detection And Reduction of Postpartum Depression Among Postnatal Mothers

Abstract

Background: Postpartum depression is an important maternal mental health problem that can adversely affect maternal wellbeing, breastfeeding, mother–infant bonding, family relationships, and infant care. Early identification of depressive symptoms and timely psychosocial support are essential components of comprehensive postnatal care. Nurse-led screening, counseling, and follow-up may provide a practical strategy for improving maternal psychological wellbeing.

Aim: To evaluate the effectiveness of a structured nurse-led counseling and follow-up program for early detection and reduction of postpartum depression among postnatal mothers.

Material and Methods: This prospective interventional study included 110 postnatal mothers attending a tertiary care hospital. Demographic, obstetric, neonatal, and psychosocial characteristics were recorded using a structured proforma. Postpartum depressive symptoms were assessed using the Edinburgh Postnatal Depression Scale (EPDS). All participants received structured nurse-led counseling addressing postpartum emotional changes, stress management, sleep, nutrition, breastfeeding difficulties, family support, mother–infant bonding, and indications for professional mental health referral. EPDS and selected psychosocial parameters were reassessed during follow-up. Data were analyzed using IBM SPSS Statistics version 27.0, with p<0.05 considered statistically significant.

Results: The mean age of participants was 27.64 ± 4.62 years. At baseline, 32 mothers (29.09%) had EPDS scores ≥10. The mean EPDS score decreased significantly from 9.18 ± 5.06 at baseline to 5.74 ± 3.82 at follow-up, with a mean reduction of 3.44 ± 3.61 points (p<0.001). The proportion with EPDS ≥10 decreased from 29.09% to 11.82% (p<0.001). Significant reductions were also observed in sleep disturbance, anxiety symptoms, breastfeeding difficulties, and inadequate perceived family support. Anxiety symptoms, poor family support, sleep disturbance, breastfeeding difficulties, and unplanned pregnancy were independent predictors of elevated baseline EPDS scores.

Conclusion: Structured nurse-led counseling and follow-up were associated with significant reductions in postpartum depressive symptoms and improvement in important psychosocial outcomes. Integrating routine EPDS screening with structured nursing support may facilitate early detection and timely management of postpartum depression.