Midwife-led psychosocial counseling with family support on postpartum depression and maternal functioning: a randomized controlled trial.

BACKGROUND: The postpartum period is a critical phase that can impact maternal mental health and functional adaptation. This study evaluated the effect of midwife-led psychosocial counseling with family support on postpartum depression and maternal functioning among primiparous women. METHOD: This randomized controlled trial enrolled 56 primiparous women aged 15-45 years who were recruited from healthcare centers in Tehran, Iran. Participants were selected through convenience sampling and randomly assigned to intervention and control groups using a four- block randomization protocol. The intervention group received three individualized 120-minute sessions of midwife-led psychosocial counseling, with a family member support person present; these sessions were administered at 3-5, 15-30, and 42 days postpartum. The control group received routine postpartum care. The Edinburgh Postnatal Depression Scale and the Barkin Index of Maternal Functioning were administered before, immediately after, and one month post-intervention. RESULTS: Repeated measures analysis revealed that depression scores declined over time in both groups; however, between-group differences were not statistically significant (P = 0.07, CI [-1.45-2.94]. Furthermore, repeated measures analysis indicated that maternal functioning improved significantly in the intervention group compared to the control group (p = 0.02, CI [0.58-7.03], η² = 0.075). DISCUSSION: Midwife-led psychosocial counseling with family participation significantly enhances maternal functioning in the early postpartum period. However, no statistically significant between-group effect was observed for postpartum depression, indicating that improvements in depressive symptoms may require longer follow-up or more intensive approaches. TRIAL REGISTRATION: The study was registered in the Iranian Clinical Trials Registry with NO (IRCT20231209060304N1) on 2024/2/20.