Rate, risk factors and assessment of a counselling intervention for antenatal depression by public health nurses in an Israeli ultra-orthodox community

Aim: To investigate the rate of and risk factors for perinatal depression in an Israeli ultra-orthodox Jewish community and assess the contribution of antenatal nursing intervention to reducing symptoms of postpartum depression. Background: Perinatal depression is recognized globally as a common complication of pregnancy and childbirth, with negative effects on the mother, infant and family. Among Jewish ultra-orthodox women both religion and childbearing play major roles. Design: Single-group pretest-posttest intervention study. Method: Depressive symptoms were assessed by the Edinburgh Postnatal Depression Scale. One-hundred-sixty women attending a mother-child healthcare clinic during December 2011–January 2013 completed the Edinburgh Postnatal Depression Scale prenatally and 148 (92·5%) repeated the survey 6 weeks postpartum. Nurses were trained to screen and offer non-directive supportive counselling intervention. Risk factors for antenatal depressive symptoms were analysed using multivariable logistic regression and analysis of changes in score was performed by 2-way analysis of variance. Results: Nineteen participants (11·9%) scored ≥10 on the Edinburgh Postnatal Depression Scale antenatally. Nurses provided intervention for 40 women. Postpartum, only one participant scored ≥10. The decrease in Edinburgh score was greater for those whose antenatal score was ≥10. Conclusion: Although the rate of antenatal depressive symptoms was similar to that in other studies, postpartum symptoms may have been underreported, possible due to culturally-related reticence. This underscores the importance of understanding the context in which the service is offered and the sensitivities of particular groups. The findings indicate that antenatal nursing intervention is a potentially protective measure for perinatal emotional well-being.