Randomized Controlled Trial of Interventions Used by Midwives to Treat Fear of Childbirth.

Abstract

Fear of childbirth affects women worldwide and can have adverse consequences. Midwives have implemented a number of interventions, autonomously or as part of a professional team. However, midwives have been unable to identify the most appropriate intervention for ensuring the reduction or alleviation of this fear to provide the best perinatal outcomes. This study aimed to evaluate the effectiveness of a prenatal educational intervention followed by specific support during childbirth, designed and delivered exclusively by midwives for women with a high fear of childbirth. This randomized controlled trial was performed with two arms in two phases: an online prenatal education phase followed by a support phase during childbirth. Participating women with a high fear of childbirth, which was determined using the Wijma Delivery Expectancy Questionnaire-A-Spanish version, were assigned to the experimental group or the usual care control group at a 1:1 ratio. Women showed a reduction in fear of childbirth in both phases of the study. According to the intention to treat analysis, a significant mean difference was observed in the prenatal stage in favor of the intervention group, as well as a nonsignificant difference in favor of this same group after delivery. The effectiveness of continuous specific prenatal education with preferential support during childbirth by midwives was indicated by improvements in the level of fear of childbirth.