Skip to main content
Download PDF

The impact of expressive writing of deep feelings about labor experiences on postpartum depression: a randomized clinical controlled trial

BMC Psychology volume 13, Article number: 365 (2025) Cite this article

Abstract

Objective

This study aimed to evaluate the expression of deep feelings about labor experiences in a virtual group of peers on the rate of postpartum depression.

Methods

This randomized clinical trial was conducted on 154 women who had given birth at a public hospital in Birjand city, in the North East of Iran, between May and October 2019. The participants were randomly allocated into two groups using four permuted blocks (the emotion expression and the control group). The participants fulfilled the Edinburgh Postnatal Depression Scale and a demographic questionnaire 6–72 h after delivery. For two weeks and twice a day, the intervention group wrote about the deepest thoughts and feelings about their experiences during labor and delivery in their peers’ virtual social media group. The control group shared information about their daily life events or daily baby care experiences in another virtual social media group of their peers. The Edinburgh Postnatal Depression Scale was completed again by the participants at the end of the second week and three months after delivery. Data were analyzed using the Generalized Estimation Equations model. P < 0.05 was set as the level of statistical significance.

Results

The participants had a mean age of 27.7 years (SD = 5.2), with no significant differences observed between the two groups in terms of demographic and reproductive characteristics (p-values > 0.05). The results of the Generalized Estimation Equation model indicated that there was no statistically significant difference in depression scores between the two groups 6–72 h after childbirth (p = 0.404). Additionally, the analysis showed that the changes in depression scores over time did not significantly differ between the control and intervention groups following the intervention. This suggests that both groups experienced similar patterns of change in their depression scores (p = 0.112).

Conclusion

Overall, the results showed that the expression of deep feelings about labor experiences in a virtual social media group of peers does not affect the rate of postpartum depression. More clinical trials with larger sample sizes are needed to draw better conclusions.

Registry of clinical trial

Iranian Registry of Clinical Trial (IRCT). Registration number: IRCT20190610043859N1. Date of registration: 12/08/2019.

Peer Review reports

Introduction

Postpartum depression is one of the most common types of depression in women throughout the world and constitutes a significant mental health concern, especially for women in vulnerable populations [1]. This disorder affects 6.5–20% of postpartum individuals globally [2]. The prevalence of postpartum depression has been reported as 6.2–23.8 in Iran [3, 4].

Postpartum depression begins within four weeks after giving birth. It includes feelings of extreme loneliness, irritability, fear, and lack of self-esteem, and its peak is the first four weeks postpartum [5]. Various demographic, psychosocial, and hormonal factors contribute to the incidence of postpartum depression, including maternal age, social support, stressful life events during pregnancy or close to the time of delivery, young mothers’ feeling of inexperience, and a sudden drop in estrogen and progesterone concentrations after delivery [6]. Postpartum depression has adverse effects on the mother, the newborn, and the family. The immediate effects of this disorder include the mother’s inability to provide maternal care, a 5% risk of suicide, and a 4% risk of newborn homicide [7,8,9,10]. The subsequent long-term effects of maternal depression include the mother’s permanent depression and disruption in the mother-child relationship [9, 11].

Various approaches are used to treat psychological problems such as depression, including pharmacotherapy and psychotherapy. Non-pharmacological treatments include group therapy, family therapy, music therapy, massage therapy, and expressive writing (verbal or written expression) [12]. Writing down thoughts and feelings usually involves writing about a stressful or traumatic event for 20 min over three or four consecutive days [8]. Various studies have shown that writing about past emotional problems or experiences affects mental and physical health [13, 14]. Writing turns unspoken and unconscious emotions into consciously spoken statements. Everything unspoken and invisible is more frightening, and gaining awareness of these unspoken emotions reduces their tension and stress [15].

There are few studies on the positive impact of writing and expressing emotions on postpartum depression. These include a study by Belassio et al., who investigated the effects of expressive writing on postpartum depression and post-traumatic stress symptoms in postpartum women; their results showed that expressive writing had a positive impact on reducing depression and post-traumatic stress in the postpartum period [16].

Nowadays, cyberspace provides a means of expressing feelings and emotions and offers a new arena for human life in which most of the needs and living activities of humans, groups, and communities can be admitted and performed [17]. Women, too, experience a separate form of presence in modern contemporary society by entering cyberspace [18]. Multimedia messaging applications and social networks are popular mobile services and facilities [19]. Women use the intimate atmosphere provided by these networks to unburden themselves to others and express their private and family issues; in a way, a sense of empathy, intimacy, and trust is established between them as they discuss, consult, and exchange views about their problems [19]. Examining all the mentioned aspects raised this question for the researchers as to how the unique power of social networks and the interactions hidden in them can be utilized to reduce postpartum depression. The advantages of this method include the easy access of women in the postpartum period to messaging applications, the very low costs of this method compared to referring to consultants or clinical psychologists, and the anticipated better reception of this method overwriting individually for oneself, which meant that designing research on this subject was necessary. The present study was conducted to determine the effect of women expressing their deep feelings about their labor experiences in a virtual peer group on postpartum depression.

Methods

Trial design

This randomized clinical trial protocol was registered at the Iranian Registry of Clinical Trials (registration number: IRCT20190610043859N1, Date: 12/08/2019). The manuscript has been drafted based on the CONSORT checklist [20].

Participants and setting

This study was conducted between May and October 2019 on 154 postpartum women at a public hospital in Birjand city, the North East of Iran.

The participants were women who were willing to collaborate in the project, had access to the internet and social media apps, had term vaginal delivery leading to the birth of a live baby, and were not diagnosed with mental disorders in recent weeks. The exclusion criteria were unwillingness to participate, neonatal death, maternal hospitalization in the postpartum period, stressful events, and having no activity in the social media app group for two consecutive days.

Sample size and randomization

The sample size was estimated as 77 per group using the output of SPSS software, and given the samples’ standard deviation of S1 = 9.7 and S2 = 9.01, the error limit of d = 1.5 and equal allocation of the samples to both groups, the final sample size reached 85 per group to take account of a potential 10% sample loss. Sampling was performed using the convenience method based on the inclusion criteria. The participants were then allocated to the intervention and control groups using permuted blocks of four. Six possible blocks are first listed (AABB, ABAB, BBAA, BABA, ABBA, and BAAB). Then, using a table of random numbers, a number is randomly chosen from one to six. By repeating this process, the allocation sequence is developed.

Study instruments

The instruments used in this study included a demographic and reproductive characteristic checklist and the Edinburgh Postnatal Depression Scale (EPDS).

Demographic and reproductive characteristic checklist

This checklist was focused on demographic and reproductive characteristics was administered, consisting of three sections:

(a) Demographic characteristics, which included nine items related to the participant’s age, husband’s age, education, education of husband, occupation, family income, and type of residence; (b) Previous pregnancy history, encompassing eight items regarding gravidity, parity, history of infertility, history of severe bleeding after delivery, history of postpartum depression, history of stillbirth, and history of miscarriage; (c) Current pregnancy details, featuring seven items related to desired pregnancy, satisfaction with the baby’s gender, gestational age, iron supplement consumption, mode of delivery, spontaneous onset of labor, and hospitalization during pregnancy.

Edinburgh Postnatal Depression Scale (EPDS)

EPDS was first developed by Cox et al. in 1978 [21] and contains ten items scored based on a 4-point Likert scale, with the responses sorted from low to high intensity for items 1, 2, and 4, and from high to low intensity for the rest of the items. Each item is given a score of zero to three, and the minimum score of this questionnaire is thus zero, with the maximum score being 30. A score of 12 or higher denotes postpartum depression. The Persian version of the Edinburgh Postnatal Depression Scale (EPDS) has demonstrated strong validity and reliability in detecting postpartum depression among Iranian women, with optimal cutoff scores of 12/13, yielding a sensitivity of 95.3% and specificity of 87.9%. The scale’s internal consistency was confirmed with a Cronbach’s alpha of 0.83, making it a valuable screening tool for early diagnosis in this population [22]. The reliability of this questionnaire has been reported in Iran with Cronbach’s alpha of 0.70, which indicates appropriate reliability in the Iranian population [23]. In the present study, the Cronbach’s alpha was also 0.70.

Interventions and outcomes

After introducing herself and explaining the study objectives and implementation method, the first author obtained written informed consent from the participants. Then, the participants filled out the demographic questionnaire and EPDS within 6–72 h after childbirth in the presence of the first author. In the intervention group, the participants were asked to express the deepest thoughts and feelings they had experienced during their hospitalization in the labor ward and during delivery (for instance, about hospitalization, family relationships, the other parturient, childbirth experiences, contact with the newborn, and breastfeeding) and what they currently felt about these events in a virtual social media app group created by the researchers for this purpose for two weeks, twice a day. In the control group, the participants were asked to share information about their daily life events or baby care experiences in another virtual social media app group for two weeks, twice daily. All participants in both groups were ensured of the confidentiality of their details and that it was important to write only about the events, behaviors, and incidents regardless of how others would think about them. They were also told not to worry about correct grammar and spelling. The participants could interact with each other. They just wrote their content without any feedback or reaction from the researchers.

During the two weeks of the intervention, the researcher visited the virtual group and followed up on the participants’ activities. All the participants completed EPDS before the intervention, two weeks and three months postpartum.

Statistical analysis

The data were analyzed using SPSS-19 statistical software. We assessed the normality of quantitative variables with the Kolmogorov-Smirnov test and summarized them using mean and standard deviation (SD). Qualitative variables were represented as frequencies and percentages. Independent t-tests, Chi-square tests, Fisher’s exact tests, and the exact tests were applied for data analysis. Additionally, a Generalized Estimation Equation (GEE) model with a linear link function was employed to compare depression scores between the two groups over time, with statistical significance set at a threshold of less than 0.05.

Results

Although 216 women participated in the study, 154 entered the analysis. Sixty-two women were excluded due to exclusion criteria. (Fig. 1).

Fig. 1
figure 1

The CONSORT flowchart of the study

Full size image

Table 1 displays the demographic characteristics of the participants, including age, husband’s age, education, of husband’s education, job, type of living, and income. There were no statistically significant differences between the two groups regarding these variables (p > 0.05), as shown in Table 1.

Table 1 Characteristics of the participants
Full size table

When examining previous pregnancy history, there were no statistically significant differences between the two groups in terms of gravidity, parity, history of stillbirth, history of abortion, number of live births, and history of infertility (p > 0.05).Regarding current pregnancy details, most participants in both groups reported that their pregnancies were desired, with no significant difference (p = 0.447). Most women regularly consumed iron supplements, which showed no significant difference between the groups (p = 0.531). All participants in the intervention group delivered without instruments, while 5.3% in the control group did, which was no significant difference between the two groups (p = 0.057). The gestational age at delivery was between 39 and 40 weeks for both groups, with no significant differences (p = 0.082). Satisfaction with the child’s gender was high in both groups, and no significant difference was noted (p = 0.100). Finally, hospitalization rates during pregnancy were similar across both groups (p = 0.954), indicating no significant differences in complications requiring hospitalization (Table 1).

Table 2 compares the depression scores between the control and intervention groups at various measurement times. Before the intervention, measured 6 to 72 h after childbirth, the control group had a mean depression score of 19.18 with a standard deviation of 3.78, while the intervention group had a slightly higher mean score of 19.69 with a standard deviation of 3.28. According to the results of the GEE model, the “group effect” assesses whether there is a significant difference in depression scores between the two groups before the intervention. In this case, the group parameter had a coefficient (standard error, SE) of -0.474 (0.568) with a p-value of 0.404, indicating no statistically significant difference in depression scores between the two groups shortly after childbirth. This suggests that both groups experienced similar levels of depression at this early stage.

Table 2 Comparison of depression scores in later stages of labor between the two groups
Full size table

After the intervention, at the two-week postpartum mark, both groups had similar mean scores, with the control group at 19.18 (SD = 3.32) and the intervention group at 19.17 (SD = 2.94). By the three-month postpartum time point, the mean depression score for the control group increased to 20.76 (SD = 2.76), while the intervention group had a mean score of 20.32 (SD = 2.84). In the GEE model, the “time effect” evaluates whether depression scores change over time, regardless of group membership. The time parameter had a coefficient (SE) of 0.314 (0.186) with a p-value of 0.091. Although this result did not reach statistical significance, it suggests that, on average, participants in both groups experienced a slight increase in depression scores from the 6 to 72-hour postpartum period to the two-week and three-month postpartum time points. The “time*group interaction” in the GEE model specifically examines whether the change in depression scores over time differs between the control and intervention groups after the intervention. The interaction term had a coefficient (SE) of 0.423 (0.266) with a p-value of 0.112. This result indicates no statistically significant differences regarding changes in the depression score between the two groups after intervention. It suggests that both groups may have experienced similar patterns of change in depression scores, even though the intervention group had a slightly lower mean score than the control group at three months postpartum.

In summary, the GEE model results indicated no significant differences in depression scores between the control and intervention groups at any measured time points. While there was a trend suggesting that depression scores might increase over time, particularly from the two-week to the three-month postpartum period, this change was not statistically significant.

Discussion

The present study was conducted to investigate the effect of expressing deep feelings about labor experiences in a virtual group of peers on the rate of postpartum depression. Based on the results, the expression of one’s most deep feelings about childbirth experiences in the social media app group of peers did not affect the rate of depression two weeks and three months after delivery. Some previous studies have reported similar results. Ayers et al. evaluated expressive writing on postpartum health. Their results showed that writing had no significant effect on mood, anxiety, depression, or quality of life [24].

In a meta-analysis of randomized clinical trials, Qian et al. also examined the effect of expressive writing interventions on post-traumatic stress disorder, depression, anxiety, and pregnancy-related stress and examined 929 people in eight studies and found that expressive writing has been ineffective in reducing depression during pregnancy [25].

The results of some studies are inconsistent with the present one and suggest the effectiveness of expressive writing. For instance, Horsch et al. reported that expressive writing has reduced depression in women with preterm delivery [26]. This discrepancy could be due to methodological differences between the two studies. For example, in Horsch’s study, the intervention was performed over three consecutive days for 15 min each day, and the effect of the intervention was examined at three different time intervals, including three, four-, and six months post-intervention. The intervention method used in Horsch’s study consisted of writing individually in private on a piece of paper, while in the present study, expressive writing took place in a virtual group of peers, which is a very significant point [26]. Also, the findings reported by Ranjbar et al. showed that expressive emotional writing has a positive impact on the reduced severity of postpartum depression symptoms [27], which is not consistent with the present findings. Among the differences between Ranjbar’s study and the present study are the sample sizes, the tools used to measure depression, and the type of intervention administered as the sample size was 15 per group in their study, they used Beck’s Depression Inventory; and intervention took the form of writing individually on a piece of paper [27]. However, a previous systematic review study has reported the efficacy of expressive writing for depression was inconclusive [28]. In another systematic review study, the positive effects of expressive writing on postpartum depression reduction was reported [29].

Overall, it is essential to note that, in the present study, the control group also had the opportunity to express their daily experiences in writing, which appears to have led to a reduction in the score of depression in the control group. Another important point in this study is that, unlike other studies in which expressive writing about labor experiences has taken place in a private sphere on paper, in the present study, expressive writing took place virtually among peer groups. Women may feel uncomfortable expressing their private experiences in a group and may have been unable to express their deep experiences. For the intervention to be effective, it may need to be performed individually so that the women can easily express all their feelings and thoughts. Expressing emotions in a group can be very different from writing in private, and this issue seems to be the most important factor that has made the results of the present study non-significant. More studies with the same methodology as the present study will further determine the efficiency of expressive writing in a virtual group of peers. Further studies are therefore recommended to investigate the effect of an intervention consisting of expressive writing about deep labor experiences in virtual peer groups on postpartum depression.

It is important to acknowledge several limitations in our study that may affect the interpretation of our findings. One significant limitation is the relatively low prevalence of postpartum depression symptoms among the women in our sample. Since all postpartum women do not universally experience postpartum depression, the small sample size may not adequately capture the variability in symptoms. This limitation could hinder our ability to detect significant differences or effects, particularly in a population where the incidence of postpartum depression is low. Consequently, the statistical power of our analyses may be compromised, making it difficult to draw definitive conclusions about the effectiveness of the intervention.

Also, while the researchers tried to control the confounding variables, it was impossible to control for some variables. Individual differences among the participants, their impact on the responses to the research questions, and the impossibility of diagnosing depression through face-to-face interviews were among the limitations of the current study.

Conclusion

Overall, the results of this study showed that the expression of deep feelings about labor experiences in a virtual social media app group of peers did not affect postpartum depression. Since, according to the literature review, the present study was the first clinical trial to examine the expression of deep feelings about labor experiences in cyberspace and group form, more clinical trials appear necessary for enabling better judgment.

Data availability

The datasets used and/or analyzed during the current study are available from the corresponding author on reasonable request.

Abbreviations

IRCT:

Iranian Registry of Clinical Trials

CONSORT:

Consolidated Standards Of Randomized Trials

SPSS:

Statistical Package for Social Sciences

EPDS:

Edinburgh Postnatal Depression Scale

GEE:

Generalized Estimation Equation model

SD:

Standard Deviation

Std. Error:

Standard Error

References

  1. Liu X, Wang S, Wang G. Prevalence and risk factors of postpartum depression in women: A systematic review and Meta-analysis. J Clin Nurs. 2022;31(19–20):2665–77. https://doiorg.publicaciones.saludcastillayleon.es/10.1111/jocn.16121.

    Article  PubMed  Google Scholar 

  2. Sharma R, Bansal P, Saini L, Sharma N, Dhingra R. Zuranolone, a neuroactive drug, used in the treatment of postpartum depression by modulation of GABAA receptors. Pharmacol Biochem Behav. 2024;238:173734.

    Article  PubMed  Google Scholar 

  3. Karbalaei S, Lamyian M, Eslami M, Sahebi L, Ansari S. Prevalence and factors affecting symptoms of postpartum depression 6 months before and 6 months after the COVID-19 pandemic: A comparative study. Payesh. 2024;23(1):69–79.

    Article  Google Scholar 

  4. Ghanbari-Homaie S, Naseri E, Mirghafourvand M, Vahidi F. Prevalence of postpartum depression and its relationship with birth experience among adolescent mothers: a cross-sectional study. Payesh. 2024;23(2):199–208.

    Article  Google Scholar 

  5. Wells T. Postpartum depression: screening and collaborative management. Prim Care. 2023;50(1):127–42. https://doiorg.publicaciones.saludcastillayleon.es/10.1016/j.pop.2022.10.011.

    Article  PubMed  Google Scholar 

  6. AktaŞ D, TerzİOĞLu F. Occurrence of depression during the postpartum period and risk factors that affect the development of the depression. Turk J Med Sci. 2013;43:843–50.

    Article  Google Scholar 

  7. Bottino MN, Nadanovsky P, Moraes CL, Reichenheim ME, Lobato G. Reappraising the relationship between maternal age and postpartum depression according to the evolutionary theory: empirical evidence from a survey in primary health services. J Affect Disord. 2012;142(1–3):219–24.

    Article  PubMed  Google Scholar 

  8. Glynn LM, Davis EP, Sandman CA. New insights into the role of perinatal HPA-axis dysregulation in postpartum depression. Neuropeptides. 2013;47(6):363–70.

    Article  PubMed  Google Scholar 

  9. Hall AJ, Logan JE, Toblin RL, Kaplan JA, Kraner JC, Bixler D, et al. Patterns of abuse among unintentional pharmaceutical overdose fatalities. JAMA. 2008;300(22):2613–20.

    Article  PubMed  Google Scholar 

  10. Veisani Y, Delpisheh A, Sayehmiri K, Rezaeian S. Trends of postpartum depression in Iran: a systematic review and meta-analysis. Depress Res Treat. 2013;2013:291029.

    PubMed  PubMed Central  Google Scholar 

  11. Topham GL, Page MC, Hubbs-Tait L, Rutledge JM, Kennedy TS, Shriver L, et al. Maternal depression and socio-economic status moderate the parenting style/child obesity association. Public Health Nutr. 2010;13(8):1237–44.

    Article  PubMed  Google Scholar 

  12. Kupeli N, Chatzitheodorou G, Troop NA, McInnerney D, Stone P, Candy B. Expressive writing as a therapeutic intervention for people with advanced disease: a systematic review. BMC Palliat Care. 2019;18(1):65.

    Article  PubMed  PubMed Central  Google Scholar 

  13. Lai J, Song H, Wang Y, Ren Y, Li S, Xiao F, Liao S, Xie T, Zhuang W. Efficacy of expressive writing versus positive writing in different populations: systematic review and meta-analysis. Nurs Open. 2023;10(9):5961–74. https://doiorg.publicaciones.saludcastillayleon.es/10.1002/nop2.1897.

    Article  PubMed  PubMed Central  Google Scholar 

  14. Lim X, Ang MQ, Foo A, Chng KKY, Koh SSL. Effectiveness of expressive writing therapy for postpartum women with psychological distress: Meta-analysis and narrative review. Int J Gynaecol Obstet 2024 Dec 9. https://doiorg.publicaciones.saludcastillayleon.es/10.1002/ijgo.16019

  15. Farokhzad P, Jannesaran M, Norouzi A, Arabloo J. Effect of emotional catharsis by writing on depression in female cancer patients. Razi J Med Sci. 2017;24(156):64–71.

    Google Scholar 

  16. Blasio PD, Camisasca E, Caravita SC, Ionio C, Milani L, Valtolina GG. The effects of expressive writing on postpartum depression and Post-traumatic stress symptoms. Psychol Rep. 2015;117(3):856–82.

    Article  PubMed  Google Scholar 

  17. Hafeznia M. Geopolitical conceptualization of the internet and cyber space. J Geopolitical. 2011;7(1):32–40.

    Google Scholar 

  18. Tuomainen AM, Jauhiainen M, Kovanen PT, Metso J, Paju S, Pussinen PJ. Aggregatibacter actinomycetemcomitans induces MMP-9 expression and proatherogenic lipoprotein profile in apoE-deficient mice. Microb Pathog. 2008;44(2):111–7.

    Article  PubMed  Google Scholar 

  19. Alikhah F, Koohestani S, Vaghehdashti T. The role of social media in the life of women (Case study: Rasht). Woman in culture and arts. (Women’s Research). 2018;9(4):491–509.

    Google Scholar 

  20. Boutron I, Altman DG, Moher D, Schulz KF, Ravaud P, CONSORT Statement for Randomized Trials of Nonpharmacologic Treatments. Annals of internal medicine. 2017;167(1):40– 7 updated 2017. Available from: http://www.consort-statement.org/Media/Default/Downloads/Extensions/CONSORT%20Extension%20NPT%202017%20Checklist.docx

  21. Cox JL, Holden JM, Sagovsky R. Detection of postnatal depression. Development of the 10-item Edinburgh postnatal depression scale. Br J Psychiatry. 1987;150:782–6.

    Article  PubMed  Google Scholar 

  22. Mazhari S, Nakhaee N. Validation of the Edinburgh postnatal depression scale in an Iranian sample. Arch Womens Ment Health. 2007;10(6):293–7. https://doiorg.publicaciones.saludcastillayleon.es/10.1007/s00737-007-0204-x.

    Article  PubMed  Google Scholar 

  23. Ahmadi kani Golzar A, GoliZadeh Z. Validation of Edinburgh postpartum depression scale (EPDS) for screening postpartum depression in Iran. J Nurs Educ. 2015;3(3):1–10.

    Google Scholar 

  24. Ayers S, Crawley R, Button S, Thornton A, Field AP, Flood C, et al. Evaluation of expressive writing for postpartum health: a randomised controlled trial. J Behav Med. 2018;41(5):614–26.

    Article  PubMed  PubMed Central  Google Scholar 

  25. Qian J, Zhou X, Sun X, Wu M, Sun S, Yu X. Effects of expressive writing intervention for women’s PTSD, depression, anxiety and stress related to pregnancy: A meta-analysis of randomized controlled trials. Psychiatry Res. 2020;288:112933.

    Article  PubMed  Google Scholar 

  26. Horsch A, Tolsa JF, Gilbert L, du Chene LJ, Muller-Nix C, Bickle Graz M. Improving maternal mental health following preterm birth using an expressive writing intervention: A randomized controlled trial. Child Psychiatry Hum Dev. 2016;47(5):780–91.

    Article  PubMed  Google Scholar 

  27. Behineh Sadat R, Jahangir K, Maryam Z, Somayeh Z, Azam B. Efectiveness of Written Emotional Disclosure in the Symptoms of Postpartum Depression n Iranian Mothers. Iranian Psychological Association, Al-Zahra University. 2015(1).

  28. Qian J, Zhou X, Sun X, Wu M, Sun S, Yu X. Effects of expressive writing intervention for women’s PTSD, depression, anxiety and stress related to pregnancy: A meta-analysis of randomized controlled trials. Psychiatry Res 2020 Jun:288:112933. https://doiorg.publicaciones.saludcastillayleon.es/10.1016/j.psychres.2020.112933.

  29. Mohammadi A, Bahri N, Hadizadeh-Talasaz F. The effect of expressive writing about thoughts and feelings of childbirth experiences on Post-traumatic stress disorder and postpartum depression: A systematic review. J Isfahan Med School. 2021;38(604):948–57.

    Google Scholar 

Download references

Acknowledgements

This paper was extracted from a master’s thesis in midwifery. We wish to express our gratitude to the Deputy of Research and Technology of Gonabad University of Medical Sciences for their cooperation and assistance, the managers of Shahid Rahimi Hospital in Birjand for their support in sampling, and also all the participants who took part in this study.

Funding

N/A.

Author information

Authors and Affiliations

  1. Department of Midwifery, Faculty of Medical Sciences, Birjand Branch, Islamic Azad University, Birjand, Iran

    Sara Mohammadi

  2. Department of Midwifery, School of Nursing and Midwifery, Mashhad University of Medical Sciences, Mashhad, Iran

    Fatemeh Hadizadeh Talasaz

  3. Nursing and Midwifery Care Research Center, Mashhad University of Medical Sciences, Mashhad, Iran

    Fatemeh Hadizadeh Talasaz

  4. Department of Epidemiology & Biostatistics, School of Health, Social Development & Health Promotion Research Center, Gonabad University of Medical Sciences, Gonabad, Iran

    Fatemeh Mohammadzadeh

  5. Department of Basic Sciences, School of Medicine, Gonabad University of Medical Sciences, Gonabad, Iran

    Jahanshir Tavakolizadeh

  6. Department of Midwifery, Faculty of Medicine, Reproductive Health and Population Research Center, Gonabad University of Medical Sciences, Gonabad, Iran

    Narjes Bahri

Authors
  1. Sara Mohammadi
    View author publications

    You can also search for this author inPubMed Google Scholar

  2. Fatemeh Hadizadeh Talasaz
    View author publications

    You can also search for this author inPubMed Google Scholar

  3. Fatemeh Mohammadzadeh
    View author publications

    You can also search for this author inPubMed Google Scholar

  4. Jahanshir Tavakolizadeh
    View author publications

    You can also search for this author inPubMed Google Scholar

  5. Narjes Bahri
    View author publications

    You can also search for this author inPubMed Google Scholar

Contributions

SM, NB, FH, JT, and FM contributed to the conception or design of the research protocol. SM, NB, FH, JT, FM formulated and revised the research protocol critically for important intellectual content. All of the authors reviewed the drafts and approved the final version of the article.

Corresponding author

Correspondence to Narjes Bahri.

Ethics declarations

Ethics approval and consent to participate

By the Declaration of Helsinki, all participants provided written informed consent for the study. The Regional Committee on Ethics in Medical Research approved the ethical trial at Gonabad University of Medical Sciences (Approval ID: IR.GMU.REC.1397.133). All the experimental protocols for involving humans were based on national/institutional guidelines in the manuscript. This study was also registered at the Iranian Registry of Clinical Trials (IRCT20190610043859N1). All participants’ information was kept in a personal file and collected in a locked office with limited access.

Consent for publication

Not applicable.

Competing interests

The authors declare no competing interests.

Additional information

Publisher’s note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Electronic supplementary material

Below is the link to the electronic supplementary material.

Supplementary Material 1

Rights and permissions

Open Access This article is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License, which permits any non-commercial use, sharing, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if you modified the licensed material. You do not have permission under this licence to share adapted material derived from this article or parts of it. The images or other third party material in this article are included in the article’s Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by-nc-nd/4.0/.

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Mohammadi, S., Talasaz, F.H., Mohammadzadeh, F. et al. The impact of expressive writing of deep feelings about labor experiences on postpartum depression: a randomized clinical controlled trial. BMC Psychol 13, 365 (2025). https://doiorg.publicaciones.saludcastillayleon.es/10.1186/s40359-025-02659-3

Download citation

  • Received:

  • Accepted:

  • Published:

  • DOI: https://doiorg.publicaciones.saludcastillayleon.es/10.1186/s40359-025-02659-3

Keywords

BMC Psychology

ISSN: 2050-7283

Contact us