Effect of online health training/counseling and progressive muscle relaxation exercise on postpartum depression and maternal attachment: A randomized controlled trial

Objective: To evaluate the effect of online health training/counseling and a progressive muscle relaxation exercise (PMRE) program on postpartum depression and maternal attachment. Methods: The present study was a randomized, controlled, experimental trial. Participants were asked to complete the Prenatal Attachment Inventory (PAI) and the Edinburgh Postpartum Depression Scale (EPDS) at 35 weeks of pregnancy. Group assignment was done by stratified block randomization according to EPDS score (0-9, 10-30) and parity. Women in the experimental group received training in progressive muscle relaxation, postpartum depression, and maternal attachment via online video calls twice a week starting at 36-37 weeks of pregnancy. They were asked to complete the PMRE program from 36 weeks of pregnancy until 6 months postpartum, and online counseling was provided throughout this period. Participants completed the Maternal Postpartum Attachment Scale (MPAS) and the EPDS at 6 weeks postpartum. Results: Mean PAI score was 64.24 +/- 9.61 in the experimental group before the intervention and 62.14 +/- 10.13 in the control group. The mean EPDS score of the experimental group was 9.12 +/- 5.05 and the mean score of the control group was 9.77 +/- 6.30 (P > 0.05). The mean MPAS score after the intervention was 13.92 +/- 5.54 in the experimental group and 17.51 +/- 6.12 in the control group. The mean EPDS score of the experimental group was 3.40 +/- 3.00 and the mean score of the control group was 11.40 +/- 5.91 (P < 0.05). Conclusion: Online health training/counseling and PMRE reduce the risk of postpartum depression and increase maternal attachment.