Being told in advance has been tested in a trial
Telling women which physical symptoms to expect, and what to do about them, reduced positive depression screens at three weeks.
Setting expectations sounds like a soft thing. It has been tested the hard way.
540 Black and Latina women were recruited during their hospital stay after birth and randomly assigned to one of two groups. One group got a structured programme that told them in advance which physical symptoms to expect, how to manage them, how to build support around themselves, and where to find help. The other group got a list of community resources and a phone call at two weeks.
| Positive depression screen | Programme | Usual care |
|---|---|---|
| 3 weeks | 8.8% | 15.3% |
| 3 months | 8.4% | 13.2% |
| 6 months | 8.9% | 13.7% |
Only the difference at three weeks reached statistical significance. The three-month and six-month differences point the same way but could have happened by chance. Pooling the whole six months, the odds of screening positive were about a third lower in the programme group. The number of women who needed the programme for one to benefit was 16, with a range running from 9 to 112. That range is honest and it is wide: somewhere between very efficient and barely worth doing.
Two things are still worth taking from it. It is a real randomised trial with a real mental health outcome, which is more than most advice about expectations can claim. And what the programme actually did was teach women about physical symptoms, as a way of protecting their mental health. That is this entire part of the guide, tested.
"What would count as going wrong, and at what point should I stop waiting?"