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This randomized controlled trial assessed whether midwife-led psychosocial counseling combined with family support improves postpartum depression outcomes and maternal functioning among primiparous women. 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BMC Pregnancy and Childbirth (2026) 26:31  \n[https://doi.org/10.1186/s12884-025-08523-x](https://doi.org/10.1186/s12884-025-08523-x)  \nBMC Pregnancy and Childbirth  \nRESEARCH Open Access  \nMidwife-led psychosocial counseling with family support on postpartum depression and maternal functioning: a randomized controlled trial  \nAzam Aghebatbekheir 1, Zohreh Mahmoodi2, Mitra Rahimzadeh3, Atefeh Zandifar4 and Sara Esmaelzadeh Saeieh5*  \nAbstract  \nBackground The postpartum period is a critical phase that can impact maternal mental health and functional adaptation. This study evaluated the effect of midwife-led psychosocial counseling with family support on postpartum depression and maternal functioning among primiparous women.  \nMethod This randomized controlled trial enrolled 56 primiparous women aged 15–45 years who were recruited from healthcare centers in Tehran, Iran. Participants were selected through convenience sampling and randomly assigned to intervention and control groups using a four-block randomization protocol. The intervention group received three individualized 120-minute sessions of midwife-led psychosocial counseling, with a family member support person present; these sessions were administered at 3-5, 15-30, and 42 days postpartum. The control group received routine postpartum care. The Edinburgh Postnatal Depression Scale and the Barkin Index of Maternal Functioning were administered before, immediately after, and one month post-intervention.  \nResults Repeated measures analysis revealed that depression scores declined over time in both groups; however, between-group differences were not statistically significant (P = 0 . 07, CI [-1 .45-2. 94] . Furthermore, repeated measures analysis indicated that maternal functioning improved significantly in the intervention group compared to the control group (p = 0 . 02, CI [0 .58-7. 03], η² = 0 . 075) .  \nDiscussion Midwife-led psychosocial counseling with family participation significantly enhances maternal functioning in the early postpartum period. However, no statistically significant between-group effect was observed for postpartum depression, indicating that improvements in depressive symptoms may require longer follow-up or more intensive approaches.  \nTrial registration The study was registered in the Iranian Clinical Trials Registry with NO (IRCT20231209060304N1) on 2024/2/20 .  \nKeywords Postpartum, Depression, Maternal, Midwife, Companion  \n*Correspondence:  \nSara Esmaelzadeh Saeieh [Esmaelzadeh1360@gmail.com](Esmaelzadeh1360@gmail.com)  \nFull list of author information is available at the end of the article  \n© The Author(s) 2025. 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://creati](http://creati)[vecommons.org/l](vecommons.org/l)icenses/by-nc-nd/4.0/.  \nAghebatbekheir et al. BMC Pregnancy and Childbirth (2026) 26:31  \nIntroduction  \nPostpartum depression (PPD) is one of the most common mood disorders after childbirth, affecting 10–15% of women globally [1] and up to 27% in the Middle East [2], with Iranian prevalence e","cbCailsJS41Epvcy","https://ap.wps.com/l/cbCailsJS41Epvcy","pdf",1424624,"English","# Abstract\n## Background\n## Method\n## Results\n## Discussion\n## Trial registration\n# Introduction","[{\"question\":\"What intervention was tested in the randomized controlled trial?\",\"answer\":\"The intervention group received three individualized, midwife-led psychosocial counseling sessions with a family support person present, delivered at 3–5, 15–30, and 42 days postpartum.\"},{\"question\":\"How did postpartum depression scores change over time?\",\"answer\":\"Depression scores declined over time in both the intervention and control groups, but the between-group differences were not statistically significant.\"},{\"question\":\"What effect did the counseling have on maternal functioning?\",\"answer\":\"Maternal functioning improved significantly in the intervention group compared with the control group, indicating a beneficial effect in the early postpartum period.\"}]","Midwife-led psychosocial counseling with family support on postpartum depression and maternal functioning: a randomized controlled trial | PDF",1790736079,25]