Using expressive writing as an intervention to improve postnatal wellbeing

Background: There is a lack of evidence on effective universal self-help interventions for women to improve wellbeing after birth (NICE, 2014). Disclosing personal thoughts and feelings through expressive writing is associated with improved physical and psychological health in many other groups [Sexton & Pennebaker, 2009] so may be helpful after birth. Aim and Objectives: The study aimed to evaluate the effect of expressive writing on postnatal psychological and physical health. Method: Women (N = 839) were randomly allocated to one of three conditions: ‘expressive writing’, ‘control writing’ or ‘treatment as usual’. Women completed measures of psychological and physical health at baseline and one month later. After baseline measures were completed women in the writing conditions undertook either an expressive writing task about something they were finding stressful, or a control writing task where they described a room. Results: Women rated their stress as significantly lower after the expressive writing task. However, there were no differences between women in the expressive writing, control writing and normal care groups in health outcomes at 1 and 6 months. Overall, women’s physical health significantly improved over time, whereas mental health showed no change (mood, anxiety, depression) and mental health related quality of life worsened. Threshold analysis identified a trend for women with poor mental health at baseline benefitting more from expressive writing but this was not significant. Interpretation: Writing tasks are not effective as a universal intervention for postnatal women. However, for women who have mental health symptoms at baseline, taking time to focus and write about stress may improve mood. Conclusions: Further research is needed to examine whether it might be effective as a targeted intervention for women with poor mental health