The Effectiveness of Dialectical Behavioral Therapy on the Success of Breast Feeding in Traumatic Childbirth: A Randomized Controlled Trial

Niloofar Rabiee; Ali Mohammad Nazari; Afsaneh Keramat; Ahmad Khosravi; Nahid  Bolbol-Haghighi

doi:10.18502/ijps.v17i2.8901

Niloofar Rabiee Student Research Committee, School of Nursing and Midwifery, Shahroud University of Medical Sciences, Shahroud, Iran.
Ali Mohammad Nazari Department of Nursing and Midwifery, Shahroud University of Medical Sciences, Shahroud, Iran.
Afsaneh Keramat Reproductive Studies and Women’s Health Research Center, Shahroud University of Medical Sciences, Shahroud, Iran.
Ahmad Khosravi Center for Health-Related Social and Behavioral Sciences Research, Shahroud University of Medical Sciences, Shahroud, Iran.
Nahid Bolbol-Haghighi Department of Nursing and Midwifery, Shahroud University of Medical Sciences, Shahroud, Iran

DOI: https://doi.org/10.18502/ijps.v17i2.8901

Keywords: Breast Feeding; Consultants; Childbirth; Dialectical Behavior Therapy; Traumatic

Abstract

Objective: Traumatic childbirth may expose mothers to physical and psychological postpartum disorders. The reduced rate of exclusive breast feeding is an essential consequence of this problem. The goal of this study was to see if dialectical behavioral therapy could help with the onset and duration of exclusive breast feeding after a traumatic delivery.

Method: This clinical trial study included, 210 primiparous women with traumatic vaginal births were admitted to Bahar hospital in Shahroud. A standard protocol was designed and administered. The group allocation imbalance happened by chance and was averted by utilizing block randomization with a size of four and sequentially numbering the intervention or control groups with a sealed concealed envelope Participants in the intervention group had one individual session and four group counseling sessions by the researcher, while the control group participants obtained a routine care. Breast feeding self-efficacy was measured using a related questionnaire before the intervention, six and 12 weeks postpartum. Exclusive breast feeding was determined using a related form at the end of each month until the fourth month.

Results: The outcome of repeated measure ANOVA Before the intervention, based on the greenhouse geisser test indicated no statistically significant difference in breast feeding self-efficacy (P = 0.07) or infant weight between the two groups. (P = 0.98). Nevertheless, a statistically significant difference between the mean score of breast feeding self-efficacy and infant's weight was discovered by a post hoc test utilizing the Bonferroni correction, (P = 0.001) between the two groups after the intervention. Therefore, in the intervention group, the level of exclusive breast feeding was higher than in the control group, and four months after birth, more infants in the intervention group were exclusively breastfed (58% vs 32%) (P < 0.001). The analysis of data using the GEE model showed that the odds of adherence to exclusive breast feeding in the intervention group were 3.4 (0.95 CI: 2.04-5.7).

Conclusion: Dialectical behavior therapy is a powerful tool for minimizing the negative features of traumatic childbirth and increase the success of breast feeding mothers. Therefore, it can be used as a supportive method for mothers.