The effect of the systematic birth preparation program on fear of vaginal delivery and quality of life.

Abstract

The aim of this study was to assess the impact of systematic birth preparation program on fear of vaginal delivery and quality of life (QoL) in pregnant women who request elective cesarean delivery without any obstetric indication. This study was conducted prospectively. A total of 100 women who requested elective cesarean delivery due to psychosocial reasons were included into the study. Women were divided into two groups according to their desire to participate in the systematic birth preparation program. Group A: case group (n = 50) consisted of women who participated in the systematic birth preparation program. Group B: control group (n = 50) received usual antenatal care. All patients were interviewed with questionnaires including the World Health Organization Quality of Life Assessment-BREF (WHOQOL-BREF) and Edinburgh Postnatal Depression Scale (EPDS) at postpartum 6th week. Type of delivery, maternal request for cesarean section, scores for QoL, and postpartum depression were compared between the two groups. Vaginal delivery rate was significantly higher in among the patients who received the systematic birth preparation program (group A: 78%, group B: 56%). Maternal request for elective cesarean section significantly decreased after the systematic birth preparation program (group A: 8%, group B: 28%). In group A, the WHOQOL-BREF-TR mean scores (SD) for physical domain, psychological domain, and environmental domain were significantly higher than the values exhibited in group B. In scores of the postpartum depression scale, there were no significant differences between the two groups (p = 0.075). The current study indicates that systematic birth preparation program may decrease the rate of elective cesarean delivery by reducing fear of vaginal delivery and improve the quality of life at postpartum period.