Abstract
BackgroundChildbirth fear is associated with increased obstetric interventions and poor emotional and psychological health for women. The purpose of this study is to test an antenatal psycho-education intervention by midwives in reducing women's childbirth fear.MethodsWomen (n = 1,410) attending three hospitals in South East Queensland, Australia, were recruited into the BELIEF trial. Participants reporting high fear were randomly allocated to intervention (n = 170) or control (n = 169) groups. All women received a decision-aid booklet on childbirth choices. The telephone counseling intervention was offered at 24 and 34 weeks of pregnancy. The control group received usual care offered by public maternity services. Primary outcome was reduction in childbirth fear (WDEQ-A) from second trimester to 36 weeks’ gestation. Secondary outcomes were improved childbirth self-efficacy, and reduced decisional conflict and depressive symptoms. Demographic, obstetric & psychometric measures were administered at recruitment, and 36 weeks of pregnancy.ResultsThere were significant differences between groups on postintervention scores for fear of birth (p < 0.001) and childbirth self-efficacy (p = 0.002). Decisional conflict and depressive symptoms reduced but were not significant.ConclusionPsycho-education by trained midwives was effective in reducing high childbirth fear levels and increasing childbirth confidence in pregnant women. Improving antenatal emotional well-being may have wider positive social and maternity care implications for optimal childbirth experiences.
Highlights
Childbirth fear is associated with increased obstetric interventions and poor emotional and psychological health for women
A one-way between-groups analysis of covariance compared the effectiveness of the intervention in reducing the primary outcome of childbirth fear (W-DEQ A)
No significant differences were reported between women returning all data (n = 198) and women lost to follow-up (n = 141) for age, country of birth, parity, previous mode of birth, marital status, Decisional Conflict Scale (DCS), Edinburgh Postnatal Depression Scale (EPDS), Childbirth Self-Efficacy Inventory (CBSEI), and Wijma Delivery Expectancy/Experience Questionnaire Version A (W-DEQ A) scores
Summary
Childbirth fear is associated with increased obstetric interventions and poor emotional and psychological health for women. The purpose of this study is to test an antenatal psycho-education intervention by midwives in reducing women’s childbirth fear. Participants reporting high fear were randomly allocated to intervention (n = 170) or control (n = 169) groups. The control group received usual care offered by public maternity services. Secondary outcomes were improved childbirth self-efficacy, and reduced decisional conflict and depressive symptoms. Results: There were significant differences between groups on postintervention scores for fear of birth (p < 0.001) and childbirth self-efficacy (p = 0.002). Decisional conflict and depressive symptoms reduced but were not significant. Conclusion: Psycho-education by trained midwives was effective in reducing high childbirth fear levels and increasing childbirth confidence in pregnant women. Improving antenatal emotional well-being may have wider positive social and maternity care implications for optimal childbirth experiences. (BIRTH 41:4 December 2014)
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