Increasing a partner's understanding of motherhood significantly reduces postnatal distress and depression in first time mothers with low self esteem.

Intervention: Participants were randomly assigned to the treatment group (empathy; 89 couples), a non-specific control group (baby play; 78 couples) or control (101 couples). All groups consisted of the usual six weekly sessions covering pregnancy, birth, breastfeeding, and a short session on postnatal depression. The empathy group included an extra session on psychosocial issues related to first time parents which aimed to increase the couples’ understanding of each other’s concerns, provide them with strategies to deal with being new parents and help them overcome feelings of stress, isolation, or lack of confidence. Mail outs were sent during follow up to reinforce what was learnt in this extra session. The baby play group also received an extra session and mail outs on how to play with babies, to control for beneficial effects of extra contact or from focusing on life after the baby’s birth. Data were collected from all groups at baseline, six weeks, and six months by separate selfreport and structured interview.