The goal of this clinical trial is to prevent postpartum depression in pregnant women. The main questions it aims to answer are: 1. Does the Psychological Empowerment program prevent postpartum depression at 6 weeks after delivery? 2. Does the Psychological Empowerment program improve self-control of the postpartum women at 6 weeks after delivery? 3. Does the Psychological Empowerment program improve the self-efficacy of postpartum women at 6 weeks after delivery? 4. Does the Psychological Empowerment program provide a tendency to have adaptive coping strategies in women 6 weeks after delivery? Researchers will compare the intervention group to a control group with no intervention (routine care) to see if the psychological empowerment program can prevent postpartum depression at 6 weeks after delivery. Participants in the intervention group will : * receive 5 sessions in 3 weeks ( 2 sessions per week) * get follow-up at 2 weeks and 6 weeks after delivery
Postpartum depression (PPD) is a common mental health problem that affects women during pregnancy and after childbirth. Women with postpartum depression may experience persistent sadness, anxiety, stress, low self-confidence, sleep disturbances, difficulty bonding with their baby, and emotional distress that can interfere with daily functioning and family relationships. In Indonesia, the prevalence of postpartum depression remains high, while preventive mental health services for pregnant women are still limited. Maternal care services primarily focus on physical health, with minimal attention given to psychological preparation and emotional well-being during pregnancy. This study aims to evaluate the effectiveness of a Psychological Empowerment Program in preventing postpartum depression among pregnant women in Indonesia. The program is based on Zimmerman's Psychological Empowerment Theory and is designed to strengthen women's perceived control, self-efficacy, coping behaviour during pregnancy and the transition to motherhood. This research will use a randomized controlled trial (RCT) design. Eligible pregnant women in their third trimester, together with their partners, will be randomly assigned to either an intervention group or a control group. Participants in the intervention group will receive the Psychological Empowerment Program in addition to routine antenatal care, while participants in the control group will receive standard antenatal and postnatal care only. The intervention consists of structured weekly sessions delivered through interactive discussions, guided activities, emotional coping exercises, communication training, problem-solving activities, and empowerment-focused education. Topics include understanding emotional changes during pregnancy, increasing self-confidence in motherhood, improving coping strategies,, and building practical parenting skills. Sessions will be facilitated by trained healthcare professionals, including midwives, psychologists, and mental health nurses. (facilitator training will be conducted before the intervention) The study will measure depressive symptoms, self-efficacy, perceived control, and coping strategies before the intervention, after completion of the program, and during the postpartum follow-up period. Standardized questionnaires, including the Edinburgh Postnatal Depression Scale (EPDS), General Self-Efficacy Scale (GSES), Pearlin Mastery Scale, and Brief COPE Inventory, will be used to evaluate outcomes. The findings from this study are expected to provide evidence for culturally appropriate and empowerment-based strategies to prevent postpartum depression in Indonesia. The program may contribute to improving maternal mental health services, strengthening family support systems, and promoting healthier outcomes for mothers, infants, and families.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
PREVENTION
Masking
NONE
Enrollment
92
The Psychological Empowerment Program is a theory-based behavioura intervention designed for pregnant women to prevent postpartum depression. The intervention is based on Zimmerman's Psychological Empowerment Theory and focuses on strengthening perceived control, self-efficacy, and coping behaviour during pregnancy and the transition to motherhood. The program consists of 5 structured sessions conducted in 3 weeks a, each lasting approximately 90 minutes. Sessions are delivered in small groups (12 participants each group) through interactive workshops, guided discussions, role-play activities, coping skills training, communication exercises, problem-solving simulations, and reflective journaling. The intervention includes psychoeducation on postpartum depression, stress management techniques, emotional regulation strategies, assertive communication training, and practical preparation for parenting challenges.
Primary Health Centre Lubuk Begalung
Padang, West Sumatra, Indonesia
Postpartum Depression
Postpartum Depression Symptoms (EPDS) The Edinburgh Postnatal Depression Scale (EPDS) is a 10-item self-report questionnaire used to assess depressive symptoms during the perinatal period. Each item is scored on a 4-point scale (0-3), with total scores ranging from 0 to 30. Higher scores indicate more severe depressive symptoms. A score of 13 or higher is considered indicative of probable postpartum depression and suggests the need for further psychological assessment. Lower scores represent better mental health outcomes and fewer depressive symptoms.
Time frame: - From enrollment to the end of the intervention will take 3 weeks (during pregnancy, participants' gestation age in the range 35-38 weeks) - Follow-up 1: at 2 weeks after delivery - Follow-up 2: at 6 weeks after delivery (each participant may vary)
Perceived Control
Perceived Control measure using Pearlin Mastery Scale The Pearlin Mastery Scale is a 7-item questionnaire that assesses an individual's perceived sense of control over life circumstances. Items are rated on a 4-point Likert scale ranging from 1 ("Strongly agree") to 4 ("Strongly disagree"). Total scores range from 7 to 28. Higher scores indicate a stronger sense of personal mastery and perceived control over life events, whereas lower scores indicate feelings of helplessness and reduced control.
Time frame: - From enrollment to the end of the intervention will take 3 weeks (during pregnancy, participants' gestation age in the range 35-38 weeks) - Follow-up 1: at 2 weeks after delivery - Follow-up 2: at 6 weeks after delivery (each participant may vary)
Self Efficacy
Self-Efficacy measure used The General Self-Efficacy Scale (GSES). GSES is a 10-item self-report instrument measuring an individual's confidence in managing stressful situations and overcoming challenges. Each item is rated on a 4-point Likert scale ranging from 1 ("Not at all true") to 4 ("Exactly true"). Total scores range from 10 to 40. Higher scores indicate greater self-efficacy and stronger confidence in one's ability to cope with difficulties, while lower scores indicate lower perceived self-efficacy.
Time frame: - From enrollment to the end of the intervention will take 3 weeks (during pregnancy, participants' gestation age in the range 35-38 weeks) - Follow-up 1: at 2 weeks after delivery - Follow-up 2: at 6 weeks after delivery (each participant may vary)
Coping Behavior
Coping Behavior will asess usind The Brief COPE Inventory. The Brief COPE Inventory is a 28-item self-report instrument used to assess adaptive and maladaptive coping strategies. Each item is scored on a 4-point Likert scale ranging from 1 ("I haven't been doing this at all") to 4 ("I've been doing this a lot"). Subscale scores are calculated for different coping domains. Higher scores on adaptive coping domains (e.g., active coping, emotional support, positive reframing) indicate better coping abilities, while higher scores on maladaptive coping domains (e.g., denial, behavioral disengagement, self-blame) indicate less effective coping strategies.
Time frame: - From enrollment to the end of the intervention will take 3 weeks (during pregnancy, participants' gestation age in the range 35-38 weeks) - Follow-up 1: at 2 weeks after delivery - Follow-up 2: at 6 weeks after delivery (each participant may vary)
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