Telephone support for women during pregnancy and the first six weeks postpartum

• Published in: Cochrane database of systematic reviews 2013-07, Vol.2013 (7), p.CD009338
• Main Authors: Lavender, Tina, Richens, Yana, Milan, Stephen J, Smyth, Rebecca M D, Dowswell, Therese
• Format: Article
• Language: English
• Subjects: Anxiety - prevention & control; Breast Feeding - statistics & numerical data; Care after childbirth; Depression, Postpartum - prevention & control; Female; Humans; Infant, Newborn; Postnatal Care - methods; Pregnancy; Pregnancy & childbirth; Pregnancy Complications - prevention & control; Pregnancy Complications - psychology; Pregnancy Outcome; Prenatal Care - methods; Randomized Controlled Trials as Topic; Telephone; Text Messaging
• ISSN: 1469-493X; 1469-493X
• DOI: 10.1002/14651858.CD009338.pub2

Telephone communication is increasingly being accepted as a useful form of support within health care. There is some evidence that telephone support may be of benefit in specific areas of maternity care such as to support breastfeeding and for women at risk of depression. There is a plethora of telephone-based interventions currently being used in maternity care. It is therefore timely to examine which interventions may be of benefit, which are ineffective, and which may be harmful. To assess the effects of telephone support during pregnancy and the first six weeks post birth, compared with routine care, on maternal and infant outcomes. We searched the Cochrane Pregnancy and Childbirth Group's Trials Register (23 January 2013) and reference lists of all retrieved studies. We included randomised controlled trials, comparing telephone support with routine care or with another supportive intervention aimed at pregnant women and women in the first six weeks post birth. Three review authors independently assessed studies identified by the search strategy, carried out data extraction and assessed risk of bias. Data were entered by one review author and checked by a second. Where necessary, we contacted trial authors for further information on methods or results. We have included data from 27 randomised trials involving 12,256 women. All of the trials examined telephone support versus usual care (no additional telephone support). We did not identify any trials comparing different modes of telephone support (for example, text messaging versus one-to-one calls). All but one of the trials were carried out in high-resource settings. The majority of studies examined support provided via telephone conversations between women and health professionals although a small number of trials included telephone support from peers. In two trials women received automated text messages. Many of the interventions aimed to address specific health problems and collected data on behavioural outcomes such as smoking cessation and relapse (seven trials) or breastfeeding continuation (seven trials). Other studies examined support interventions aimed at women at high risk of postnatal depression (two trials) or preterm birth (two trials); the rest of the interventions were designed to offer women more general support and advice.For most of our pre-specified outcomes few studies contributed data, and many of the results described in the review are based on findings from only one or two stud