Abstract
BackgroundIn resource-limited settings, childbirth remains a matter of life and death. High levels of childbirth fear in primigravid women are inevitable. To date, few studies have explored interventions to reduce childbirth fear in primigravid women. This study aimed to evaluate the efficacy of companion-integrated childbirth preparation (C-ICP) during late pregnancy for reducing childbirth fear and improving childbirth self-efficacy, birth companion support, and other selected pregnancy outcomes in primigravid women.MethodsA quasi-experimental study was carried out using a non-equivalent control group design to recruit a sample of 70 primigravid women in hospital maternity waiting homes in the intervention and control groups, with 35 in each group. The primigravid women and their birth companions in the intervention group received two sessions of companion-integrated childbirth preparation, whereas the control group received routine care. A questionnaire that incorporated the childbirth attitude questionnaire (CAQ), the childbirth self-efficacy inventory (CBSEI), the birth companion support questionnaire (BCSQ), and a review checklist of selected pregnancy outcomes was used to collect data. Pretest and post-test data were analyzed using simple linear regression. Beta coefficients were adjusted at a 95% confidence interval with statistical significance set at a P-value of < 0.05 using Statistical Package for the Social Sciences version 25.ResultsAt pretest, mean scores were similar in the intervention and control groups. At post-test, being in the intervention group significantly decreased childbirth fears (β: = − .866, t (68) = − 14.27, p < .001) and significantly increased childbirth self-efficacy (β: = .903, t (68) = 17.30, p < .001). In addition, being in the intervention group significantly increased birth companion support (β: = − 0.781, t (68) = 10.32, p < .001). However, no statistically significant differences regarding pregnancy outcomes were observed between the study groups (Mann–Whiney U test, p > .05).ConclusionThe findings of our study suggest that C-ICP is a promising intervention to reduce childbirth fear while increasing childbirth self-efficacy and maternal support. We recommend the inclusion of C-ICP for primigravid women during late pregnancy in resource-limited settings.
Highlights
In resource-limited settings, childbirth remains a matter of life and death
It is worth noting that childbirth fear levels are high in early and late pregnancy, suggesting that prompt support of primigravid women throughout pregnancy is vital to maintaining their psychosocial well-being and facilitating childbirth preparations [6]
The results of our study showed a significant reduction of childbirth fear, enhanced childbirth self-efficacy, and increased birth companion social support in the intervention group compared with the control group
Summary
In resource-limited settings, childbirth remains a matter of life and death. High levels of childbirth fear in primigravid women are inevitable. This study aimed to evaluate the efficacy of companion-integrated childbirth preparation (C-ICP) during late pregnancy for reducing childbirth fear and improving childbirth self-efficacy, birth companion support, and other selected pregnancy outcomes in primigravid women. It is worth noting that childbirth fear levels are high in early and late pregnancy, suggesting that prompt support of primigravid women throughout pregnancy is vital to maintaining their psychosocial well-being and facilitating childbirth preparations [6]. The psychosocial well-being of pregnant women, including primigravid women, is overlooked and inadequately screened during antenatal care in resource-limited settings [7]. The failure of the health care providers to offer adequate preparation and psychosocial support results in vulnerable pregnant women, such as primigravid women, turning to alternative, traditional socio-cultural childbirth information. Previous studies have reported that traditional childbirth information is not always helpful, and sometimes gives alarming information resulting in more childbirth fear among vulnerable primigravid women [7, 8]
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