The Effect of Narrative Writing on Depression, Anxiety, and Stress of Pregnant Women

Introduction: Pregnancy is considered as a period of emotional crisis. Despite the high prevalence and complication for mother and child, attention to the mental status of pregnant mother is neglected by health care providers. This study was conducted with the aim of determining the effect of narrative writing on the depression, anxiety, and stress of pregnant women referring to the pregnancy care clinics of south health centers of Tehran University of Medical Sciences in Tehran, Iran. Methods: It was a quasi-experimental field trial. A total of 120 eligible pregnant women referring to the south health centers of Tehran University of Medical Sciences were recruited by convenience sampling. The health records of pregnant women were assessed at each center and the eligible subjects were identified.   Sampling was performed one week for the intervention group and the next week for the control group. Mothers in the experimental group were asked to write a narrative about their deep thoughts and feelings, twice a week for two months according to the given instructions; while the mothers in the control group received routine care. At first, both groups completed Beck Depression Inventory (BDI) and Depression, Anxiety and Stress Scale 21 (DASS21) before the intervention. Four and 8 weeks after the intervention both groups just completed DASS21. Data were analyzed by Mann -Whitney test, Chi -squared test, two-sample Kolmogorov-Smirnov test and repeated measures ANOVA using SPSS v.22. Significance level considered as p≤0.5. Results: Pre-intervention levels of anxiety, stress, and depression were similar in both groups. Four weeks after the intervention, only the variables of depression (P = 0.014) and anxiety (P = 0.004) were significantly reduced in the experimental group, but no statistically significant difference was found for the stress variable in this time interval. Finally, a significant decrease was observed in all three variables as the intervention continued for 8 weeks (P <0.001). Conclusion: According to the results, narrative writing could be used as a simple and low cost method for reducing anxiety, stress, and depression in pregnant women.