Emotional Freedom Techniques (EFT) and Postpartum Depression
Condition: Postpartum Depression
MeSH terms: Depression, Postpartum; Depression; Depressive Disorder
Study type: Interventional

Summary: 
      Hypothesis 1: Pregnant women in the EFT group will have a lower test score from Edinburgh
      Postpartum Depression Scale, and a follow-up score of three months and six months after the
      last application date, compared to the control group.

      Hypothesis 2: In the post-test of pregnant women in the EFT group, three months and six
      months after the last application date, the optimistic, self-confident and social support
      approach methods used to deal with stress will increase, and the helpless and submissive
      approach styles will decrease compared to the control group.

      Hypothesis 3: Pregnant women in the EFT group will have a lower test score from the
      State-Trait Anxiety Inventory, and a follow-up score of three months and six months after the
      last application date, compared to the control group.
    

Detailed description: 
      In addition to being a natural life event for women, pregnancy is also a period in which
      significant biological and psychosocial changes are experienced, and the risk of encountering
      many factors that may create anxiety and stress. While many women easily adapt to these
      changes occurring with pregnancy and childbirth, some women may develop various levels of
      mental illness. It is reported that the majority of depression, one of the mental illnesses,
      occurs in women aged 18-44, including fertility processes such as pregnancy, childbirth, and
      puerperium. A meta-analysis on the subject indicates that the rate of depression increases in
      pregnancy and postpartum period.

      Depression during pregnancy can cause serious effects for all family members. Pregnancy
      depression which is not managed well, damages the developing fetüs due to problems such as
      poorly managed pregnancy depression, substance abuse, insufficient prenatal care, and suicide
      attempt. It also causes an increased level of cortisol, which can lead to insulin resistance
      and, if not compensated, gestational diabetes may occur. In this process, elevated
      norepinephrine and cortisol reduce blood flow to the uterus, causing very serious obstetric
      and neonatal consequences both on pregnant and fetus, and pregnancy-related adverse events
      such as HT and preeclampsia are also increasing. Postpartum depression is the most negative
      result of untreated depression during pregnancy.

      In the initial treatment of pregnancy depression and postpartum depression, good psychosocial
      evaluation, activation of support systems and the combined use of integrated therapies are
      the most ideal options. Treatment options for postpartum depression are psychotherapy
      (interpersonal relationships therapy and cognitive - behavioral therapy), drug therapy and
      non-pharmacology applications. While it is recommended to apply psychotherapy and
      non-pharmacological approaches as the first choice in mild depression, the use of
      pharmacological treatments (antidepressants) stands out in moderate and severe depression.

      One of the psychotherapeutic techniques, whose numbers have increased rapidly in recent
      years, is "Emotional Freedom Techniques (EFT)". EFT; It combines cognitive therapy,
      acceptance and stability therapy, and acupuncture point stimulation, and is based on manual
      stimulation of acupuncture points specific to Shiatsu or other acupressure massage forms,
      rather than using acupuncture needles.Manual pressure on acupuncture sites has been found to
      be as effective as acupuncture needling technique.It is an initiative that can be applied by
      individuals and midwives easily after receiving the necessary education all over the world.

      EFT has a comprehensive research bibliography that includes successful treatment of various
      psychological conditions such as depression, anxiety, phobias, and post-traumatic stress
      disorder. The duration of treatment in these studies varies from one to ten sessions.
      Feinstein states that in EFT studies that include a follow-up assessment, participants
      maintain their profit and the rehabilitation period varies between 3 months and 2 years.

      Considering all these data, it is necessary to focus primarily on the prenatal period in
      order to develop preventive and therapeutic interventions. In the literature, scientific
      studies evaluating the effectiveness of EFT on depression are included, but only one study
      has been reached in which EFT is applied during pregnancy, and this study is related to
      stress and endurance. In addition, with this study, an important step will be taken to
      include an easy-to-apply, inexpensive therapeutic method such as pregnancy and postpartum
      depression treatments, and evidence will be sought to ensure that all professionals dealing
      with women's health, especially midwifery, use this technique.

      The aim of the study is to evaluate the effect of EFT on postpartum depression.
    

Intervention name(s): Emotional Freedom Techniques (EFT)
Intervention type(s): Behavioral
Intervention description(s): It combines cognitive therapy, acceptance and stability therapy, and acupuncture point stimulation, and is based on manual stimulation of acupuncture points specific to Shiatsu or other acupressure massage forms, rather than using acupuncture needles.
Allocation: Randomized
Intervention model: Parallel Assignment
Intervention model description: In order to determine the risk of depression, the Edinburgh Postpartum Depression Scale (EPDS) will be administered to the pregnant women. Pregnant women who receive 12 ≥ points from the EPDS will be included in the randomization process.
Subsequently, the tests will be applied to experimental and control groups. EFT will be applied to women in the experimental group. One or two weeks after the application, it will be discussed again and questioned how she feels, whether that problem still disturbs her. The number of EFT sessions can be increased or decreased depending on the condition of the woman (the average number of sessions reported in the studies ranges from 2-10). After all EFT sessions are completed, three months and six months after the last application, post-tests will be done. the control group will receive routine midwifery care. The post-tests will be done by the control group after three months and six months
Masking: None (Open Label)
Primary purpose: Prevention
Keywords: postpartum depression; pregnancy; stress