Effectiveness of Childbirth Education on Nulliparous Women’s Knowledge of Childbirth Preparation, Pregnancy Anxiety and Pregnancy Outcomes

Abstract

Background: The emerging number of cesarean sections among nulliparous women due to high pregnancy-related anxiety is a major concern of maternity care providers. Childbirth preparations enable women to cope with pregnancy anxiety and enhance pregnancy outcomes. Limited studies evaluated the impact of childbirth educational interventions on pregnancy-specific anxiety and pregnancy outcomes. Objectives: The aim of this study was to evaluate the effectiveness of childbirth educational intervention on nulliparous women’s knowledge on childbirth preparation, pregnancy anxiety, and pregnancy outcomes. Methods: A randomized controlled trial approach with a two-group pretest/ posttest design was used among hundred nulliparous third trimester pregnant women. All participants were pretested for their knowledge on childbirth preparation and pregnancy anxiety level using knowledge questionnaire, state trait anxiety inventory, and pregnancy-specific anxiety inventory. The experimental group (n = 50) received three sessions of childbirth education. All participants were post- tested before delivery, and their pregnancy outcomes were noted from labor records. Data were collected from a major maternity hospital in Kerala, India. GLM repeated measures analysis and paired t-test were used for data analysis. Results: The experimental group demonstrated a significantly higher level of knowledge on childbirth preparation (P < 0.001), with high reported mean knowledge scores of (54.30 ± 3.86) childbirth preparation than the control group (31.08 ± 1.96). A lower mean scores of pregnancy-specific anxiety among experimental group (102 ± 4.65) (P < 0.001) compared to control group (139.96 ± 4.9) signifies the relevance of childbirth education in reducing pregnancy-specific anxiety. Significant reductions of caesarean birth (50%) among nulliparous women along with a 12% increase in newborn’s birth weights were the main positive birth outcomes. Conclusions: Childbirth education significantly reduced pregnancy-specific anxiety and the adverse pregnancy outcomes. The emerging number of cesarean sections on maternal request due to childbirth anxiety could be reduced by empowering nulliparous women through childbirth education.