SMIPS

Supporting Mothers In Pregnancy Study

Background
Pregnancy, childbearing and mothering demands a lot from women and can be a cause of stress. One important such source of information is the Depression After Childbirth Study (DACS) conducted by Sangath, where it was found that 23 % of mothers suffered from significant depressive symptoms at 6-8 weeks after childbirth. This study also showed that babies of these mothers were more likely to suffer under-nutrition, stunting and cognitive delays over the first 6 months of life.
Design
Using research evidence and our knowledge of Goan practices and beliefs, an intervention program was developed to support childbearing women, aimed at preventing postnatal depression in the mother and its negative consequences on her child. We then evaluated this intervention through a community based randomized controlled trial.
We screened more than 1000 pregnant women to identify 423 women who were at high-risk for depression. Women who gave consent to participate were then allocated randomly either to receive our intervention, or to be in a usual care group.
Anganwadi_wrks_trng

Anganwadi Workers Training

Women in the intervention group were offered support sessions which began during pregnancy, and continued till the 9th week after the birth of the baby. These sessions were conducted in the mother’s homes. The sessions consisted of information about pregnancy and child care, individual support and problem solving and assistance with early mother-infant interaction.
The practice of male-child preference was also challenged, since this was found to be one of the factors that increased a mother’s vulnerability to suffer depression. Outcome assessments were conducted at 3 and 6 months. We assessed the mother’s mental health, her child’s growth and development and, at 3 months, the mother-child interaction using video recordings.
Results and implication
Our research program is the first in Asia to study the benefits of providing extra support for women and their children in the later part of pregnancy and the crucial first months of the newborn child’s life. Preliminary results showed that although there was no significant differences in our main outcomes between mothers in the two arms of the trial, qualitative interviews with mothers in the intervention arm highlighted their satisfaction with, and the need for, the program.
We hope to extend our intervention to ensure it can be offered to high-risk mothers through the existing community networks. The second phase of the project comprised of dissemination and advocacy activities, aimed to train anganwadi workers in giving simple psychosocial interventions to all pregnant mothers and to create awareness about postnatal depression and child developmental outcomes.
We were able to train 137 anganwadi workers (out of 140 in Bardez and Tiswadi talukas who were involved with the research study). We have also produced a Konkani language manual on simple psychosocial interventions for mothers.