Childbirth Preparation Research Articles

Strategies for Promoting Positive Childbirth Experiences: Delphi Approach

Background:: The experiences that women gain during childbirth remain with them throughout life. This study aimed to provide strategies to promote positive childbirth experiences. Method:: This Delphi study was conducted in three rounds from September to November 2019. A purposively selected 17 national experts, including obstetricians, reproductive health professionals, and midwives, participated in this study. Results:: Most of the 52 initial strategies in the first round (50 strategies) were approved with a few corrections in the first and second rounds, and 23 strategies were presented in the third-round questionnaire; most panelists agreed upon them. Finally, they approved 73 strategies with five categories: promoting professional support, enhancing control skills, encouraging empowerment, promoting spouse and other important support, and improving childbirth preparation. Conclusion:: The Delphi approach allows for developing a consensus that will serve as a template for education, practice, and future research in maternity care units. Hence, multidimensional approaches are required to promote positive childbirth experiences that can potentially improve mothers’ well-being outcomes.

Women Friendly: The effectiveness of a woman-centered childbirth intervention in Israel

Women with symptoms of post-trauma are vulnerable during childbirth and often lack trust in the medical staff in the delivery rooms. They are therefore in need of a sensitive intervention to prevent the formation or exacerbation of trauma in the perinatal period. This study evaluated the feasibility and efficacy of a “Woman Friendly” (WF)intervention for women with a history of trauma. During this intervention, the women were informed about childbirth and prepared for the delivery. Fourteen mothers aged 28–41 with symptoms of post-trauma who had participated in the WF intervention were interviewed about their experience within six months after giving birth. Interviews were transcribed and analyzed using thematic analysis. Thematic analysis yielded six themes. One theme was during the pre-delivery period: 1) Preparation of the WF document. Four themes were during the delivery: 1) The WF document as an advocate; 2) security and safety; 3) Controlling the situation; and 4) Respect and kindness from the medical staff. The final theme was limitations of the WF intervention. It seems that a birth preparation intervention adapted to the needs of emotionally vulnerable women can help them to have positive birth experience. Childbirth preparation for these women should focus on their sensitivities rather than trauma-processing. The WF intervention holds promise for women with symptoms of post-trauma and should be further evaluated in future research.

Study protocol of a breathing and relaxation intervention included in antenatal education: A randomised controlled trial (BreLax study).

Antenatal education is part of antenatal care in many countries. Physical and mental preparation for childbirth and information on pain management are considered key elements of antenatal education classes. Evidence suggests that women who participate in antenatal education classes appear to benefit in terms of self-efficacy and childbirth experience. In particular, women with increased fear of childbirth benefit from trained breathing and relaxation techniques in antenatal education. However, little is known about the effect of breathing and relaxation techniques on the outcomes of healthy pregnant women without fear of childbirth or who do not have medical or obstetric risks, or on neonatal outcomes. The aim of this study is to test whether including a breathing and relaxation technique in an antenatal education class will improve self-efficacy towards birth compared to a standard antenatal education class. The study will be a two-armed randomised controlled trial (RCT). Healthy pregnant women between the 12th and 30th week of gestation with singleton low-risk pregnancies and who are receiving routine antenatal care will be recruited in a hospital in Switzerland. All women included will attend an 8-hour antenatal education class. The intervention group will additionally practise a breathing and relaxation technique, receive a handbook to guide their exercise practice at home, and be provided with access to an online brochure with video and audio recordings for guidance. Data on maternal and neonatal outcomes will be collected after recruitment, in the 37th week of pregnancy, and two to four weeks postpartum. The effectiveness of including a breathing and relaxation technique in antenatal education classes on women's self-efficacy is discussed as a means to improving women's pregnancy and childbirth outcomes. NCT06003946, SNCTP000005672.

Disorders of cervical maturation under wartime stressful conditions

Pregnancy itself is a prerequisite for stress reactions. Even in the physiological course, pregnancy has a certain impact on a woman’s psyche, and some authors even consider it as a crisis situation or a “period of psychological uncertainty”. Women have different types of reactions to pregnancy: from the absence of any psychological problems to neurotic personality development.All the hardships of wartime affect not only the mother’s organism and her psychological state, but also the state of the unborn fetus, which is programmed with certain physical and mental health characteristics for the rest of its life.To prevent these negative effects, pregnant women during the pregravid period and gestation should take preventive measures aimed at strengthening the organism’s defense reactions in adverse conditions. These include a rational nutritious diet, determination of a woman’s personality type by a perinatal psychologist and appropriate psychological practices, and sufficient supplementation of important vitamins and minerals with antioxidant and other protective properties.Pregnancy under the influence of prolonged chronic stress can be complicated not only by purely obstetric and perinatal problems, but also by disorders of the formation of the labour dominant and preparatory processes in the cervix. As a result, this can lead to miscarriage due to the development of tokophobia as a psychological component of these disorders.Cervical maturation before childbirth is a multifactorial process that includes numerous elements, complex processes at the psychological, systemic, tissue, cellular, gene and molecular levels. Comprehensive preparation of a woman’s organism for childbirth in conditions of chronic stress and certain tokophobia (a woman’s fear of childbirth and uncertainty of the future for her and her child during the war) is not only about preventing stressful effects during pregnancy (magnesium complexes with B vitamins – up to the 36th week), conducting a complex of psychoprophylactic therapy and psychophysiological preparation for childbirth from the 37th week, but also in local impact on the cervical state, taking into account changes in connective tissue and correction of the infectious factor at the same time of pregnancy. For this purpose it is advisable and reasonable to prescribe vaginal suppositories based on hyaluronic acid (HA) to accelerate preparatory changes in the cervical tissues by stimulating the synthesis of its own HA and with antibacterial effects due to a complex of plant extracts.

The effect of pregnancy pilates-assisted childbirth preparation training on urinary incontinence and birth outcomes: a randomized-controlled study

PurposeTo examine the effect of pregnancy pilates-assisted birth preparation training on urinary incontinence (UI) including stress urinary incontinence (SUI) and urge urinary incontinence (UUI) during pregnancy, and the postpartum period and birth outcomes.MethodIn this single-center, single-blind, randomized, controlled study, 126 participants who have 28–30 weeks of gestation and nulliparous were randomly assigned to receive either the (n = 63) or control group (n = 63). The study was carried out between March and August 2022. Pregnancy pilates intervention was applied twice in a week, a total of 8 weeks to pilates group. The control group was given routine obstetric and pregnancy care. A personal data form and the Michigan Incontinence Severity Index Form (M-ISI) were used as data collection tools.ResultsThe mean weight gains of the experimental group during pregnancy were significantly lower than the control group. The experimental group had almost twice the rate of vaginal birth than those of the control group. The duration of labor mean score of experimental group was 5 h and 43 min less than the duration of labor of the control group (p < 0.001). After intervention, and postpartum period, the SUI and UUI severity of the experimental group was significantly lower than those of the control group (p < 0.001).ConclusionPilates-assisted childbirth preparation training reduced the severity of UI including SUI and UUI symptoms during pregnancy and the early postpartum. In addition, pilates-assisted childbirth preparation training contributes to decrease in weight gain during pregnancy, the increase in the vaginal birth rate, and the shortening of the duration of labor.Trial registrationNCT06185439

Empowering Pregnant Women: A Community-Based Health Education Intervention to Promote Healthy Behaviors

Pregnant women in rural areas like Lubuk Alung often face barriers to accessing quality health information and care, leading to suboptimal health behaviors during pregnancy. This study aimed to evaluate the impact of a community-based health education intervention on pregnant women's knowledge, attitudes, and practices regarding healthy behaviors in Lubuk Alung. A quasi-experimental study was conducted with 150 pregnant women (75 intervention, 75 control) in Lubuk Alung. The intervention group received a 12-week program of structured health education sessions delivered by trained community health workers. Sessions covered topics such as nutrition, exercise, antenatal care, childbirth preparation, and breastfeeding. The control group received standard antenatal care. Pre- and post-intervention surveys assessed knowledge, attitudes, and self-reported practices related to healthy behaviors. The intervention group demonstrated significant improvements in knowledge about healthy behaviors (p&lt;0.001), more positive attitudes towards these behaviors (p&lt;0.01), and increased adoption of practices like consuming a balanced diet, engaging in regular physical activity, attending antenatal care visits, and exclusive breastfeeding (p&lt;0.05). The control group showed minimal changes. In conclusion, community-based health education interventions are effective in empowering pregnant women in rural settings. They increase knowledge, shift attitudes, and promote the adoption of healthy behaviors during pregnancy. Such programs should be integrated into routine antenatal care services in areas like Lubuk Alung.

The effect of breastfeeding education with digital storytelling on fathers' breastfeeding self-efficacy.

There is growing evidence that fathers play an important role in the breastfeeding process and that fathers need education about breastfeeding. In our age of rapidly developing technology, the use of new teaching techniques in the education of fathers will provide more effective results. In this study, the effect of breastfeeding education given with digital storytelling method on fathers' breastfeeding self-efficacy was examined. The study is a pretest-posttest randomized controlled trial. The study was conducted with the husbands of 80 pregnant women admitted to the childbirth preparation class of a state hospital. The study included a control group and an intervention of educational videos using a digital storytelling technique. Fathers were recruited from hospital antenatal classes and randomized to one of the two groups. Personal Information Form and Paternal Breastfeeding Self-Efficacy Scale-Short Form were used for data collection. Each father completed data collection forms at the beginning of the study and at 3 months postpartum. The η2 effect size was calculated for significant differences in the independent and dependent groups t test methods used in the analysis. There was a significant difference between the posttest scores of the fathers in the intervention and control groups (p < 0.05). When the effect sizes were analysed, it was found that the increase in the intervention group (t = -24.342) was higher than the control group (t = -8.385). In the current study, the effect of using digital storytelling method in breastfeeding education on fathers' breastfeeding self-efficacy was found to be significantly higher than routine education. It is recommended that this new method be used in education and counselling and that studies be conducted to examine its effect on breastfeeding behaviour and fathers' breastfeeding support.

Childbirth preparation and its facilitating and inhibiting factors from the perspectives of pregnant and postpartum women in Tabriz-Iran: a qualitative study

BackgroundThe World Health Organization recognizes childbirth preparation as an essential component of antenatal care, as it plays a crucial role in reducing maternal mortality and improving women's childbirth experience. Countries worldwide have implemented various interventions to assist women in preparing for childbirth, based on their own resources. This study was conducted with the aim of exploring the perspectives of pregnant and postpartum women on childbirth preparation and the facilitating and inhibiting factors, in Tabriz, Iran.MethodsThis qualitative study was conducted with 25 participants, selected purposively among pregnant women in weeks 37 to 40 of gestation and postpartum women within 10 days to 6 weeks after childbirth. Data collection was done through semi-structured, in-depth individual interviews using an interview guide. The data was analyzed using content analysis method with conventional approach.ResultsThe perspectives of pregnant and postpartum women regarding childbirth preparation revealed that factors such as maternal health during pregnancy, having an antenatal care plan, improving health literacy, and developing a birth plan were identified as crucial elements for effective childbirth preparation. Additionally, mental and emotional preparation, support, financial planning, participation in preparation classes, and awareness of childbirth methods were recognized as facilitators. On the other hand, insufficient mental and emotional preparedness, inadequate support, weak antenatal care, information deficiencies, insufficient physical activity, and a lack of a birth plan were identified as barriers.ConclusionThe findings highlight the multifaceted nature of childbirth preparedness, necessitating the involvement of families, the healthcare system, and the entire community. Utilizing the study results in strategic planning for pre-pregnancy, during pregnancy, and inter-pregnancy care can enhance childbirth preparedness and contribute to achieving Iran's population rejuvenation policy goals.

Analisis Faktor-faktor yang Mempengaruhi Perilaku Ibu Hamil dalam Pemanfaatan Pelayanan Antenatal Care (K4)

One of the efforts made to reduce MMR is the Antenatal Care (ANC) examination program which is mandatory for pregnant women. Antenatal care (ANC) is a planned program in the form of observation, education and medical treatment for pregnant women, to achieve a safe and satisfactory pregnancy process and preparation for childbirth. The aim of this research is to determine the factors that influence the behavior of pregnant women in the use of Antenatal Care (K4) services in the Pancur Batu Community Health Center Work Area in 2023. This research uses a descriptive analytical design using quantitative methods with a cross sectional research design approach. The number of samples in this study was 62 respondents. The conclusion of this study is that there is a relationship between maternal knowledge of integrated antenatal care, p = 0.010 (p &lt; a or 0.010 &lt; 0.05). There is a relationship between the Role of the Family in Integrated Antenatal Care, p= 0.001 (p &lt; a or 0.001 &lt; 0.05). It is recommended that pregnant women pay more attention to their pregnancy, namely by making regular integrated antenatal care visits so that the mother's pregnancy can be monitored by health workers.

RESILIENSI PADA IBU HAMIL TRIMESTER III DI PUSKESMAS WILAYAH KAPANEWON SEWON

Resilience is the ability of an individual to handle stress or pressure, as well as to manage anxiety and depression. Anxiety has been proven to be a mental disorder that occurs in pregnant women during the third trimester. Psychological changes during the third trimester appear more complex, as the condition is largely due to the growing condition of pregnancy and the lack of preparation for childbirth in the mother, who will be more anxious and show fear, silence, and even tears. Individuals with good resilience will feel capable of achieving their goals even when they are in situations of trauma, tragedy, or events that can cause stress. Resilient individuals will remain calm, think carefully, focus, be able to control themselves, and adapt to the changes they experience, thus not easily feeling anxious and depressed. This study aims to understand the resilience of pregnant women at the Sewon Kapanewon Health Center. This study is quantitative with a descriptive quantitative method. The sampling technique used is Aksidental Sampling with a sample size of 84 individuals. The instrument used is the Connor-Davidson Resilience Scale 25 (CD-RISC 25). Based on the results of the CD-RISC 25 questionnaire, the resilience level of pregnant women in the third trimester at Sewon Health Center I and II shows that 67 pregnant women (79.5%) have moderate resilience, 17 pregnant women (20.5%) have high resilience, and no low resilience (0%). The results of this study serve as a source of data and a reference for developing more effective programs or interventions by healthcare professionals in addressing mental health issues.

The Relationship Of Pregnant Women Class Activities To Pregnant Mothers' Readiness In Facing Labor At The Puskesmas Bangun Rejo Village, Deli Regency, Serdang In 2021

Background: Pregnant women class is a study group for pregnant women who get various health information and pregnancy exercises in preparing for childbirth. The number of pregnant women participating in the Maternity Class is 40 people. They do not prepare for childbirth because they feel that they do not need to be prepared in the face of childbirth. The purpose of the study was to determine the relationship between pregnancy exercise class activities and the preparation of pregnant women in preparation for childbirth. Method: This type of research is analytical with a cross sectional approach. The population was 40 pregnant women who took part in the class of pregnant women and all of them were used as research samples. Data were analyzed bivariately using the chi square test at a significance level of 95%. Result: The results showed that pregnant women carried out various activities in the class for pregnant women with the highest frequency in the less category 23 people (57.5%) and 25 people were not ready to give birth (62.5%). There is a relationship between pregnancy exercise class activities with the readiness of pregnant women in facing childbirth (p 0.039 &lt;0.05). Conclusion: It is hoped that the Puskesmas will optimize the implementation of classes for pregnant women through various innovative and interesting activities that can make pregnant women feel at home in participating in pregnancy exercise classes from start to finish.

The Effect of Hypnobirthing Relaxation on the Anxiety Level of Primigravida Mothers in the Third Trimester in Facing Childbirth Preparation at Bpm Nurlina Sirait, Sst Dumai City in 2023

The Effect of Hypnobirthing Relaxation on the Anxiety Level of Primigravida Mothers in the Third Trimester in Facing Childbirth Preparation at Bpm Nurlina Sirait, Sst Dumai City in 2023

Understanding and Involving the Perspective of Pregnant Women as Users When Designing the Framework of e-Health and Exercise Interventions during Pregnancy: Preliminary Study.

Health and exercise technology may promote a healthy lifestyle during pregnancy. The objective of this cross-sectional study was to understand and involve the perspective of pregnant women as users in the design of a framework for future e-health and exercise interventions during pregnancy. Pregnant women replied to a questionnaire aimed at understanding their physical activity patterns, needs, and preferences regarding the use of mobile applications (apps). The main results showed that one-third of the women did not practice any type of exercise during pregnancy. Women preferred to exercise in a gym, outdoors, or at home. The majority already had or were currently using a fitness app, but never used any pregnancy-specific app. Most women agreed that it was important to have a specific app for pregnancy to improve knowledge about recommendations on lifestyle, have direct contact with health and exercise professionals, have social interaction with other mothers, and have guidance on preparation for childbirth and postpartum recovery. Understanding and involving the perspective of pregnant women as users will allow researchers to improve the design of a pregnancy-specific app and future e-health and exercise interventions during pregnancy. These preliminary results will lead to the development of the "active pregnancy app" focused on the promotion of an active and healthy lifestyle during pregnancy and postpartum.

Intervensi Non Farmakologi untuk Menurunkan Kecemasan dan Ketakutan Persalinan pada Trimester III Kehamilan

This study aims to identify non-pharmacological interventions that can reduce anxiety and fear during childbirth in the third trimester of pregnancy. Using the PRISMA method, the research method used is a systematic review through searching 6 (six) databases, namely ProQuest, Scopus, Pubmed, Science Direct, and Taylor &amp; Francis. The results of research from 11 articles included in the analysis show that non-pharmacological interventions that can reduce pregnant women's anxiety levels regarding pregnancy and childbirth are providing education and training in preparation for childbirth carried out face to face (P &lt; 0.001), Iyengar yoga (P &lt; 0 .05), and the application of lavender oil as aromatherapy (P&lt;0.001) as well as mindfulness-based antenatal education (P&lt;0.001). Meanwhile, non-pharmacological interventions that can reduce the level of fear during childbirth are simulation-based childbirth preparation education combined with mindfulness (P&lt;0.01), online-based antenatal education about childbirth preparation (P&lt;0.05), Mindfulness-Based Childbirth and Parenting (MBCP) with a partner (P&lt; 0.05), simulation-based childbirth education (P&lt; 0.05), psychodrama (P&lt; 0.001) and psychotherapy (P&lt; 0.001). In conclusion, non-pharmacological interventions given to pregnant women in the third trimester of pregnancy can reduce the level of anxiety and fear of childbirth. Keywords: Non-Pharmacological Intervention, Anxiety, Pregnancy, Fear of Childbirth

Effectiveness of Childbirth Education and Hypnobirthing Assistance in Improving Labor Outcome

Background: Childbirth education and assistance with hypnobirthing is an autohypnosis technique, namely an effort to instill positive intentions through suggestion into the soul or subconscious mind during pregnancy and preparation for childbirth. This study aims to analyze the effectiveness of childbirth education and assistance with hypnobirthing in improving childbirth outcomes. Subjects dan Methode: The Randomized Controlled Trial (RCT) study was conducted at the Pratama D'Maryam Clinic, Yogyakarta from August to December 2023. A total of 154 pregnant women were selected for this study. Dependent variables are anxiety, depression, complications, and delivery time. The independent variables are childbirth education and assistance with hypnobirthing. Therapy is given 2 times a week with a duration of 3 hours. The study instrument is a questionnaire. Data analysis used Independent T-Test. Results: Providing childbirth education accompanied by assistance with hypnobirthing is effective in reducing anxiety levels in pregnant women (Effect Size= 1.22; p&lt;0.001), reducing depression levels (Effect Size= 1.19; p&lt;0.001), and shortening labor time (Effect Size= 0.08; p = 0.016). Conclusion: Providing childbirth education accompanied by assistance with hypnobirthing is effective in reducing anxiety levels in pregnant women, reducing depression levels, and shortening labor time.

Influence of Integrating Childbirth Preparation Program on Birth Outcomes among Pregnant Women in Western Kenya

Childbirth education and preparation has been fronted as key element in enhancing maternal and neonatal health and preventing some adverse outcomes. There is paucity of literature in Kenyan setting linking maternal childbirth education and maternal and neonatal outcomes. The study aimed to assess the effect of an educational intervention in childbirth and its influence on maternal and neonatal outcomes among expectant women in western Kenya. A Quasi-experimental design was utilised. The health facilities were selected by simple random sampling. Expectant women were enrolled at antenatal care services and allocated to either the control group or the intervention group. Those in the intervention group went through 2 hourly sessions of childbirth preparation teaching twice in the course of the 32nd–35th weeks of gestation. Investigation and assessment on specific maternal and neonatal outcomes was done within 48 hours following delivery. Chi-square and independent t tests were used to determine the statistical difference. More mothers in the control experienced prolonged labour 12% compared to 2.2% in the intervention (P&lt;0.001). Progression failure was high in the control 8.9% compared to 1.1% in the intervention (P=0.001). The control had more cases of augmentation 11% compared to 2.7% in the intervention (P=0.004). Higher APGAR scores were recorded in the intervention group at 1 and 5 minutes compared to the control (P&lt;0.001). Few cases of birth asphyxia were in the intervention 1.6% compared to 5.8% in the control (P&lt;0.001). The intervention program aimed at enhancing childbirth knowledge and improving self- efficacy offered prior to birth was successful in reducing adverse birth outcomes in mothers and their neonates in the intervention group. A program aimed at enhancing women’s’ self- efficacy and improving their knowledge on childbirth should be structured and incorporated in the routine antenatal care to reduce some adverse maternal and neonatal health outcomes associated with fear anxiety and uncertainty related to inadequate childbirth knowledge.

Pemanfaatan Buku Kesehatan Ibu dan Anak (KIA) Dalam Persiapan Persalinan

Objective: Abstract Breast milk (mother's milk) is the only natural food for babies. Preparation for childbirth is everything that is understood and prepared in terms of welcoming the birth of a child by pregnant women. Preparation for childbirth is an important part of the delivery process, aimed at improving optimal health before childbirth. Based on 2018 Riskesdas data regarding ownership of KIA books in Indonesia, there are still 24.9% of pregnant women who do not have KIA books. This research aims to determine the use of Maternal and Child Health (KIA) books in preparation for childbirth at the Jagir Surabaya Community Health Center. Methods: This research is a quantitative research with a descriptive design. In this research, the sample collection technique used purposive sampling with a population of 45 respondents and a sample of 40 respondents. The data collection technique used in this research is primary data in the form of a questionnaire. Results: The results of the research showed that 40 pregnant women (100%) carried the MCH book during the examination well, 21 pregnant women (52.5%) read the MCH book well, and 30 pregnant women applied the contents of the MCH book well (75%). Conclusion: The use of the MCH book can be assessed from three aspects, including bringing the MCH book when carrying out examinations, reading the contents of the MCH book, and applying the messages contained in the MCH book, one of which is regarding childbirth preparation.

The Influence of Gentle Birth on the Anxiety of TM III Primigravida Mothers in Preparation for Childbirth at TPMB Diah Arista, Wringinpitu Village, Tegaldlimo District”

Anxiety during pregnancy triggers changes in physical activity, nutrition and sleep, which have an impact on changes in the mother's mood and fetal development. The research design used was pre-experimental designs, using a one group pre test-post test design approach, in this study the population was Primigravida Mothers in Preparation for Childbirth, sampling using the Accidental Sampling technique obtained a sample of 30 respondents to determine the influence between the two variables The Wilcoxon statistical test was carried out with a significance level of 0.05. The research results obtained before the Gentle Birth were carried out, most of the respondents experienced a level of anxiety in preparation for the moderate category of birth, 17 respondents (56.7%) and after the Gentle Birth, almost all respondents experienced a level of anxiety in preparation for the mild category of birth, 28 respondents (93.3%) . Based on the results of the Wilcoxon statistical test with the SPSS 25 for Windows program, the calculated Z value was -4.964&gt; Ztable -1.645 or Asymp. Sig. (2-tailed) of p-value 0.000 &lt;alpha 0.05 then H0 is rejected and H1 is accepted. The position of gentle birth in a birth is to convey an understanding of how childbirth is considered a natural thing that is part of the human life cycle.&#x0D; Key words : Gentle Birth, Anxiety, Primigravida, Childbirth.

Doula-Supported Births and Outcomes Among DONA International Doulas, 2000-2012

Introduction: Doula care has been shown to decrease maternal morbidity and mortality&amp;nbsp;given the physical, emotional, and informational support that doulas provide during&amp;nbsp;pregnancy and birth. Although usage of doulas and coverage of doula services have been&amp;nbsp;increasing, several people are still unaware of the benefits doulas provide. In this study,&amp;nbsp;we sought to describe characteristics related to doulas and doula-supported women on&amp;nbsp;a national scale, including location, method of referral, childbirth settings and providers,&amp;nbsp;and obstetric outcomes. Methods: We examined doula-supported births by year, state, urban/rural location, maternal age, and characteristics related to doulas, doula-supported birthing women, childbirth settings, providers, and obstetric outcomes. The sample population consisted of doula-assisted births (n=12,675) from 2000 to 2012 based on records from Doulas of North America (DONA) International. We used t tests or Pearson&amp;rsquo;s chi-squared test (X2) for continuous and categorical variables. Results: Doulas reported that the vast majority (73.2%) of all doula-supported women birthed by spontaneous vaginal birth and fewer than 1 in 5 (18.2%) women birthed by unplanned cesarean. Nearly 3 out of 4 (73.2%) women had some form of childbirth preparation instruction. Information regarding the source of referrals to doulas suggests that over half (52.9%) of birthing women found a DONA-member doula from a source other than a hospital system or DONA International. About half (49.7%) of birthing women supported by doulas were self-pay clients. Overall, few doulas (1.3%) received third-party reimbursements for their paraprofessional services. The vast majority (95.3%) of doula-supported births in the sample occurred in urban areas of the United States. Conclusions: This is the largest analysis of doula-supported births from the largest US doula certifying organization, which is critical for understanding how widespread access to doula services has the potential to significantly improve health outcomes for women and their infants during birth. Additionally, the data suggest there is a need for increased referrals and increased insurance coverage and potentially a heightened need for doula services in rural areas.

Impact of Hypnotherapy on Fear, Pain, and the Birth Experience: A Systematic Review.

In recent times, research has been conducted on the use of hypnosis during childbirth preparation and its effects on pain, fear, and overall childbirth experience. The main objective of this study was to analyze the published scientific literature on the use of hypnotherapy during childbirth preparation and the outcomes achieved during labor. A systematic literature review was conducted following the PRISMA 2020 protocol, with a search performed on the PubMed, Cinahl, Scopus, and WOS databases. Studies meeting inclusion criteria, including randomized controlled trials (RCTs), were evaluated for methodological quality using the PEDro scale. The searches yielded a total of 84 results, from which 7 RCTs of high scientific quality were selected. Each article examined the impact of a hypnosis intervention during pregnancy and the results obtained during labor. The analysis covered the use of epidural anesthesia, pharmacological analgesia during labor, self-reported pain, labor duration, type of delivery, fear of childbirth, and childbirth experience. The results demonstrated benefits in reducing fear and pain during labor, along with an enhancement in the overall childbirth experience. Hypnotherapy can be a valuable resource for reducing fear and pain during labor and improving the lived childbirth experience.