Maternal Depression, Women’s Empowerment, and Parental Investment: Evidence from a Randomized Control Trial

Last registered on September 09, 2019


Trial Information

General Information

Maternal Depression, Women’s Empowerment, and Parental Investment: Evidence from a Randomized Control Trial
Initial registration date
September 08, 2019

Initial registration date is when the trial was registered.

It corresponds to when the registration was submitted to the Registry to be reviewed for publication.

First published
September 09, 2019, 9:57 AM EDT

First published corresponds to when the trial was first made public on the Registry after being reviewed.



Primary Investigator

University of Melbourne

Other Primary Investigator(s)

Additional Trial Information

Start date
End date
Secondary IDs
ISRCTN 65316374
We evaluate the medium-term impacts of treating maternal depression on women’s mental health, financial empowerment, and parenting decisions. We leverage variation induced by a cluster- randomized control trial that provided psychotherapy to 903 prenatally depressed mothers in rural Pakistan. It was one of the world’s largest psychotherapy interventions, and it dramatically reduced postpartum depression. Seven years after psychotherapy concluded, we returned to the study site to find that impacts on women’s mental health had persisted, with a 17% reduction in depression rates. The intervention also improved women’s financial empowerment and increased both time- and money-intensive parental investments by between 0.2 and 0.3 standard deviations.
External Link(s)

Registration Citation

Baranov, Victoria. 2019. "Maternal Depression, Women’s Empowerment, and Parental Investment: Evidence from a Randomized Control Trial." AEA RCT Registry. September 09.
Experimental Details


The intervention group received a 16-session Early Multimodal Intervention (EMI), based on cognitive behavioral therapy, delivered by 40 trained Lady Health Workers (LHWs) to mothers in the intervention group. Control group received an enhanced antenatal and postnatal follow-up by a different group of LHWs (16 structured visits monitored by the research team).

Intervention Start Date
Intervention End Date

Primary Outcomes

Primary Outcomes (end points)
At the 7-year follow-up, the key outcomes are women's mental health (depression, depression severity, recovery trajectory), decision-making (empowerment, parental investment, parental style, fertility), and child development (physical, cognitive, and socio-emotional).
Primary Outcomes (explanation)

Secondary Outcomes

Secondary Outcomes (end points)
Secondary Outcomes (explanation)

Experimental Design

Experimental Design
The groups were randomized on the basis of union council (smallest rural administrative area with population of approximately 10 - 15,000).

The study was conducted in two rural sub-districts of Rawalpindi district in Northern Punjab, Pakistan. The study area consisted of 40 union councils with a population of 500,000. All women in the study area, in their third trimester of pregnancy, formed the study population.

All recruited subjects were interviewed by trained and clinically experienced members of the research team using the Structured Clinical Interview for Diagnostic and Statistical Manual of Mental Disorders IV (SCID DSM-IV), a semi-structured interview for the diagnosis of psychiatric disorder. Recruitment continued for about one year until 450 women meeting the SCID criteria for current major depressive episode were recruited into each arm of the study.
Experimental Design Details
Randomization Method
Randomization of the union councils was carried out by the trial center in Rawalpindi.
Randomization Unit
Clusters (union councils).
Was the treatment clustered?

Experiment Characteristics

Sample size: planned number of clusters
Sample size: planned number of observations
Sample size (or number of clusters) by treatment arms
20 control union councils, 20 treatment
Minimum detectable effect size for main outcomes (accounting for sample design and clustering)

Institutional Review Boards (IRBs)

IRB Name
IRB Approval Date
IRB Approval Number


Post Trial Information

Study Withdrawal

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Is the intervention completed?
Data Collection Complete
Data Publication

Data Publication

Is public data available?

Program Files

Program Files
Reports, Papers & Other Materials

Relevant Paper(s)

Reports & Other Materials