Obstetric Coevolution

Working together to reduce postpartum depression  

1/5 women suffer postpartum depression and 7/10 feel low. It’s a pity that in one of the most important moments in life, some women have such a sad experience.

Is it a  biological fact? Is it inevitable?

Or on the contrary are there some (avoidable) obstetric practices that increase this bad experience?

In recent decades, many countries have reported a worrying increase in inductions. In Catalonia, almost 25% of low-risk labours are induced, however, Spanish recommendations are only 10%. Induction can have negative consequences, as it can lead to an increase in caesarean sections and episiotomy rates,  as well as it has a negative effect on early care of the baby.

Many mothers are encouraged to induce their labour without receiving much information from doctors, even if they ask for it (1). The same goes for other practices. Obstetric Coevolution (OBCOE) was born to listen to these mothers who feel unheard.

OBCOE is a citizen science project that aims to characterise whether obstetric practices during childbirth, including induction, have an impact on the mother’s mental health during the postpartum period, with a focus on postpartum depression. The project seeks the co-evolution of obstetric practices, working together with mothers and childbirth care professionals as citizen scientists. The main goal is to improve women’s experience of childbirth and to reduce the incidence of postpartum depression. 

OBCOE consisted of three phases: a qualitative phase, corresponding to face-to-face co-creation workshops in Barcelona, a quantitative phase, corresponding to an online survey,  and a dissemination phase. In the first phase, we had empathy workshops where mothers and professionals, separately, explain their experiences about childbirth and we identified five challenges to work on: fear, communication, medicalisation of childbirth, postpartum and mental health. In the ideation workshop, they worked together on proposals to face these challenges and also worked on the survey. 

The test workshop assessed if the proposals were feasible, as well as evaluated and improved the co-created survey. With the workshops done, the second and the third phase has begun, on one hand, we have been collecting responses to the co-created survey, and on the other hand, we are presenting the project at some conferences and we are going to holding workshops in medical schools to work on empathy with mothers. 

OBCOE project was funded by IMPETUS, which also gave us valuable tools to take the project forward and put us in contact with potential collaborators. IMPETUS has been our kickstarting point. The next steps are turning the proposals into reality and presenting the results to institutions to bring changes in health policies and hospital protocols.  

OBCOE project responds to current concerns that do not seem to be addressed with sufficient effectiveness and puts the welfare of women at the centre demanding respect for giving birth with the options chosen. Changes are needed, and these are greater than we thought, but fortunately, the project has been very well received by the participants,  who have been involved from the very beginning. Even so, there are still professionals who do not want to see the need… OBCOE has only just begun.

References:

 Espada-Trespalacios X, Ojeda F, Nebot Rodrigo N, Rodriguez-Biosca A, Rodriguez Coll P, Martin-Arribas A, Escuriet 

R. Induction of labour as compared with spontaneous labour in low-risk women: A multicenter study in Catalonia. Sex  Reprod Healthc. 2021 Sep;29:100648.

doi: 10.1016/j.srhc.2021.100648. Epub 2021 Jul 26. PMID: 34332215.

Obstetric Coevolution – Video