Childbirth Self-efficacy Research Articles

Childbirth self-efficacy and birth related PTSD symptoms: an online childbirth education randomised controlled trial for mothers

BackgroundThis study evaluated an online childbirth education course on childbirth self-efficacy and, subsequent birth related posttraumatic stress disorder (PTSD) symptoms and mother-infant relationship quality.MethodThree group (intervention, passive control, active control) parallel randomised controlled trial. Groups were assigned using computer generated random allocation. For the passive control group participants were instructed to carry on with whatever they were currently undertaking with their pregnancy, while the active control group were asked to read a booklet comprised of twelve birth stories. The purpose of the active control was to check if the act of having an activity to complete would influence outcomes. For the online course group (intervention) participants were asked to complete the online version of a birthing course designed by She Births®. One hundred and twenty-five women residing in Australia between 12 and 24 weeks pregnant were recruited online. Participants were asked to complete their required activity between 24 and 36 weeks pregnant. Childbirth self-efficacy scores were tested pre and post intervention (time one and time 2), PTSD symptoms and mother-infant relationship quality were tested at six weeks and six months postnatal.ResultsThere was no significant interaction by group for childbirth self-efficacy scores. Mean difference scores at time one (pre-intervention) and time two (post-intervention) for each group indicated a trend in the online group towards higher childbirth self-efficacy compared with the two control groups. The main effect of group on birth related PTSD scores was not statically significant at six weeks postnatal or at six months postnatal. The main effect of group on mother-infant relationship scores was not statically significant at six weeks postnatal or six months postnatal.ConclusionsTrends showed childbirth self-efficacy scores to be higher in the intervention group compared with the two control groups, demonstrating effectiveness for the intervention. Paradoxically, PTSD scores were higher in the intervention group compared with the two control groups and therefore also reported poorer mother-infant relationship quality. External factors may be more important than childbirth self-efficacy highlighting the need for a holistic approach that addresses systemic and socio-political influences to improve communication, autonomy, and respectful maternity care.Trial RegistrationThis trial was retrospectively registered with the Australian New Zealand Clinical Trials Registry number: ACTRN12624000241538 on March 11, 2024.

Validity and Reliability of the Turkish Version of the Self-Efficacy Regarding Vaginal Birth Scale: A Methodological Study

Aim: The aim of the study was to test validity and reliability of the Self-efficacy Regarding Vaginal Birth Scale in Turkish. Material and Methods: The methodological study was conducted in a university hospital with 165 pregnant women. The data were collected using "Personal Information Form", "Self-Efficacy Regarding Vaginal Birth Scale and "Childbirth Self-Efficacy Inventory - Short Form". Language validity, content validity, confirmatory factor analyse and criterion-dependence validity and were performed to test the validity of the scale. The scale’s reliability was assessed using the item-total correlation, Cronbach’s alpha, split-half test method and test-retest analysis. Results: The scale content validity index was found above 0.80. In the confirmatory factor analysis, all the goodness of fit indexes had acceptable values. Item-total correlations ranged between 0.167 and 0.809 for each item and were positively correlated with the scale total. In line with the recommendations of experts, no items were removed from the scale. It was determined that the scale was collected under one factor as 9 items. The correlation between the two halves of the scale is 0.76, the Spearman-Brown coefficient is 0.86, and the Gutmann Split-Half coefficient is 0.85. The Cronbach’s alpha coefficient calculated for the overall scale was 0.87. The total correlation of the items and the test-retest correlation showed high reliability with 0.924 (p

Prevalence and determinants of fear of childbirth among pregnant women in Egypt: A cross-sectional study

ProblemFear of childbirth (FOC) is a significant public health concern, and understanding its determinants is crucial for developing effective interventions to support women during pregnancy and childbirth. BackgroundFear of childbirth (FOC) is increasingly recognized as an essential psychological health concern among pregnant women globally. However, research elucidating the prevalence and multifaceted determinants of FOC in the Egyptian context remains scarce. This knowledge is pivotal to informing maternal health practices. AimThis study aimed to investigate FOC prevalence and its determinants among pregnant women in Egypt. MethodsA cross-sectional study was conducted among 460 low-risk pregnant women attending antenatal clinics in El-Beheira Governorate, Egypt, from February 2023 to July 2023. Data were collected using structured questionnaires on sociodemographic and obstetric profiles, the Childbirth Attitude Questionnaire, the Childbirth Self-Efficacy Inventory, and the Multidimensional Scale of Perceived Social Support. ResultsThe prevalence of FOC ranged from mild to severe, with 70.4% of women displaying some degree of fear and 11.3% exhibiting severe FOC. Key determinants associated with greater FOC were younger age, nulliparity, unplanned pregnancy, negative previous birth experiences, and preference for cesarean delivery. An inverse relationship was found between FOC and childbirth self-efficacy. ConclusionsThis study reveals a high FOC prevalence among Egyptian pregnant women, necessitating the need for systematic screening and tailored interventions to mitigate this concern, especially among high-risk groups like young, nulliparous mothers. Fostering childbirth self-efficacy may aid in reducing FOC. These findings can inform the enhancement of holistic maternal health practices in Egypt.

A comparison of childbirth self-efficacy, fear of childbirth, and labor pain intensity between primiparas and multiparas during the latent phase of labor: a cross-sectional study

BackgroundChildbirth is a long-lasting physiological stress. As one of the main stressors, labor pain exists throughout the whole process. Childbirth self-efficacy is the confidence, or belief that they can manage pain during childbirth. This sense of self-efficacy determines how pregnant women deal with labor pain and enables them to regulate their behavior and actively deal with childbirth. However, the difference in pain sensitivity between single births (primiparas) and multiple births (multiparas) has rarely been investigated.ObjectivesThis study is aimed at investigating self-efficacy, fear of childbirth, labor pain of primiparas and multiparas and exploring factors related to the perceived labor pain intensity of pregnant women.DesignProspective cross-sectional study.Setting(s)Labour and delivery in a large academic specialized hospital in Guangzhou, China.ParticipantsA total of 347 women, (182 primiparas and 165 multiparas) were enrolled in the data analysis. Pain was assessed before cervical dilatation (cervical dilatation ≤ 3 cm for the first delivery and ≤ 2 cm for the second delivery).MethodThe general information of participants was obtained by questionnaire and obstetrical records of the subjects were obtained from the electronic medical records extracted from the electronic medical record system (EMRS). Childbirth self-efficacy, fear of childbirth (FOC) and labor pain were compared between primiparas and multiparas. Paired t-test, chi-square test, Mann–Whitney test, univariate and multivariate regression analysis were used to analyze labor pain between the two groups and investigate factors related perceived labor pain intensity.ResultsThe total scores related to fear of childbirth, fetal health, self-control, and labor pain injury of multiparas were notably reduced compared with primiparas (all P < 0.05). The perceived labor pain intensity and duration of the first stage of labor was reduced in the multipara group compared with the primipara group. The childbirth control sense of the multipara was better than that of the primipara. The perceived labor pain intensity was negatively correlated with advanced age (age ≥ 35 years), self-efficacy score, family support, and education (all P < 0.05). In contrast, the perceived labor pain intensity was positively correlated with tension, severe fear of childbirth, and anxiety (P < 0.05). Self-efficacy, gravidity, delivery cognition, and fear of childbirth were independent risk factors for the perceived labor pain intensity in the latent period (all P < 0.05).ConclusionsFear of childbirth is a predictor of perceived labor pain intensity. The extent of labor pain (minimum and maximum) can be predicted by the level of fear the expectant mother has. During the latent phase of labor, self-efficacy, fear of childbirth and labor pain are different between primiparas and multiparas.

Pre- and postpartum fear of childbirth and its predictors among rural women in China

BackgroundFear of childbirth (FOC) can influence both maternal and child health. Research on FOC in China is scarce, especially on rural women. This study aimed to assess pre- and postpartum FOC and its predictors among Chinese rural women.MethodsThis was a prospective correlation study. A total of 569 women completed the prenatal questionnaire in the third trimester, and 477 of them completed the postpartum questionnaire within three days after childbirth. Maternal socio-demographic information, clinical information, childbirth self-efficacy and prenatal and postpartum FOC were investigated. FOC was evaluated using the Wijma Childbirth Expectancy/ Experience Questionnaire (WDEQ). Descriptive, bivariate, multivariate linear regression analysis, univariate and multivariate logistic regression analyses were performed.ResultsThe mean pre- and postpartum FOC scores were 64.5 (standard deviation: 25.1) and 64.3 (standard deviation: 23.9), respectively, with 20.8% of women reporting severe fear before childbirth and 18.2% after childbirth. Multivariate linear regression analysis revealed predictors for higher levels of prenatal FOC including higher education level, nullipara, higher monthly household income, lower family support, and lower childbirth self-efficacy (p < 0.05) and the predictors for higher levels of postpartum FOC included unemployed status, lower childbirth self-efficacy, and higher prenatal FOC (p < 0.05). Multivariate logistic regression showed that higher childbirth self-efficacy reduced the likelihood of severe prenatal FOC (OR: 0.99, p < 0.001), while severe prenatal FOC increased the likelihood of severe postpartum FOC (OR: 3.57, p < 0.001).ConclusionThe rural women have high levels of FOC before and after childbirth, with approximately 20% experiencing severe FOC during both periods. Higher education level, nullipara, higher monthly household income, lower family support, and lower childbirth self-efficacy are predictors of heightened prenatal FOC. Unemployed status, lower childbirth self-efficacy, and higher prenatal FOC are predictors of heightened postpartum FOC. Notably, enhancing childbirth self-efficacy emerges as crucial in mitigating severe prenatal FOC, while severe prenatal FOC significantly increases the likelihood of severe postpartum FOC. The development of targeted intervention strategies for the above factors can help reduce women’s FOC level and improve their overall pregnancy and childbirth experience.

Cluster Analysis of Fear of Childbirth, Anxiety, Depression, and Childbirth Self-Efficacy

ObjectiveTo identify clusters of women based on anxiety, depression, fear of birth, and childbirth self-efficacy and factors associated with the clusters. DesignCross-sectional survey. SettingOnline in Sweden. ParticipantsPregnant women (N = 1,419). MethodsWe collected data through online questionnaires. We included scales to measure anxiety, depression, worries about and fear of birth, and self-efficacy in a kappa-means cluster analysis. We calculated odds ratios with 95% confidence intervals between clusters and background variables. ResultsWe identified 4 clusters based on severity: Resourceful–Robust, Resourceful–Fearful, Vulnerable–Fearful, and Fragile–Fearful. Participants in the Resourceful–Fearful and Vulnerable–Fearful clusters were more likely to report mental health problems than those in the Resourceful–Robust cluster. Participants in the Vulnerable–Fearful and Fragile–Fearful clusters were more likely to report mental health problems than those in the Resourceful–Robust cluster. Participants in the Fragile–Fearful cluster were more likely to be multiparous, report that their pregnancy was not normal, and prefer cesarean birth than those in the Resourceful–Robust cluster. ConclusionsWomen with childbirth fear may be vulnerable to anxiety and depression during the perinatal period, although the severity might vary. Self-efficacy might be a mediator against mental health problems. Findings demonstrated levels of severity, and the one-size-fits-all approach in Swedish health care may benefit from a more targeted approach for women with fear of childbirth.

EFEKTIVITAS EDUKASI ANTENATAL TERHADAP KETAKUTAN DAN EFIKASI DIRI PERSALINAN PADA PRIMIPARA: SYSTEMATIC REVIEW

Fear of giving birth due to lack of knowledge causes a decrease in primigravida mothers' confidence in their ability to undergo childbirth. Decreased self-efficacy in childbirth can cause birth complications such as prolonged labor, fatigue and weakness in the mother, which results in the mother's failure to undergo a natural birth. Antenatal education is an appropriate alternative to increase mothers' knowledge of the birth process. The aim of the research was to examine the effectiveness of antenatal education in reducing fear of childbirth and increasing childbirth self-efficacy in primiparous mothers. The structure of this research is a detailed analysis using the PRISMA flow diagram. Researchers applied the PICO method and searched for articles in English published between 2018 and 2023. Some of the databases used included Proquest, PUBMED, Sage Journal, Springer Link, Science Direct, EBSCO, Plos One and Taylor &amp; Francis. Article quality assessment using JBI Critical Appraisal Tools for RCT. Seven articles were identified and analyzed, all articles used a Randomized Controlled Trial design. The research sample numbered 56 to 182, consisting of primiparas in the age range 18-32 years with a gestational age of &lt;34 weeks and was conducted in Saudi Arabia, Turkey, Iran and China. From the literature search, in general it can be concluded that antenatal education provided to primiparous mothers is effective in reducing fear of childbirth and increasing self-efficacy in childbirth.

What are the benefits of antenatal education as a maternal health promotion tool? A systematic review with meta-analysis

Introduction: Antenatal education is a low-cost intervention designed to increase the knowledge of pregnant women on pregnancy and childbirth and reduce fear related to labor pain. However, the impact of antenatal education programs on maternal outcomes is unclear. Objective: To investigate whether structured antenatal education programs affect maternal health outcomes. Methods: Electronic databases were searched from inception to November 2019, and randomized controlled trials investigating antenatal educational programs for low-risk pregnant women were included. Results: A total of 348 studies were identified; nine were included in this review. One study assessed the number of antenatal visits, while three showed that antenatal education programs significantly improved childbirth self-efficacy (outcome expectancy16.00 [95% CI 9.86-22.15] and efficacy expectancy 20.44 [95% CI=13.62-27.25]). Self-diagnosis on labor was investigated in two studies, and five demonstrated that antenatal education increased the frequency of vaginal delivery (odds ratio 1.28 [95% CI 1.01-1.63]) but not episiotomy (as observed in three studies). Conclusion: Structured antenatal education programs may increase childbirth self-efficacy and the frequency of vaginal delivery.

Predictive Power of Self-Efficacy on the Fear of Childbirth in Pregnant Women: Underlying Mechanisms of Social Support as a Mediator and the COVID-19 Fear as a Moderator.

Fear of childbirth (FOC) is a common problem associated with psycho-social factors in pregnant women. This study aimed to determine the mediator of social support and the moderator role of fear of coronavirus disease 2019 (COVID-19) in the relationship between self-efficacy and FOC in pregnant women. This descriptive and cross-sectional study was conducted with 422 pregnant women registered in 18 family health centers. Data were collected with the introductory information form, the Wijma Delivery Expectancy/Experience Questionnaire-A, the Childbirth Self-Efficacy Inventory, the Multidimensional Scale of Perceived Social Support, and the Fear of COVID19 Scale. The SPSS 22 package program and Hayes's process macro 3.2 were used in the analysis of the data. Findings showed that 19.9% of the pregnant women experienced severe FOC. Self-efficacy and social support negatively predicted FOC, while fear of COVID-19 predicted it positively. Perceived social support moderately mediated the relationship between FOC and self-efficacy. Fear of COVID-19 was found to be a marginally effective moderator in the relationship between self-efficacy and FOC. This indicates that as self-efficacy increases in pregnant women with low fear of COVID-19, the FOC is experienced less. In the relationship between self-efficacy and FOC, social support is a key factor in reducing FOC. To reduce the FOC, the social support of pregnant women should be strengthened, and the fear associated with acute crisis periods such as pandemics should be reduced with some preventive measures.

Childbirth Self-Efficacy and Its Associated Factors among Pregnant Women in Arba Minch Town, Southern Ethiopia, 2023: A Cross-Sectional Study.

Childbirth self-efficacy is a pregnant women's perception of their ability to cope with labor stress. Low childbirth self-efficacy is linked to pain intolerance and poor labor progression, which increase the possibility of operative delivery. However, Ethiopia has limited data. So, the aim of this study was to assess childbirth self-efficacy and its factors among pregnant women attending antenatal care in public health facilities in Arba Minch town, Southern Ethiopia, in 2023. To assess childbirth self-efficacy and associated factors among pregnant women attending antenatal care in public health facilities in Arba Minch town, Southern Ethiopia, in 2023. An institution-based cross-sectional study was carried out among 416 women from January 1 to January 30, 2023. A systematic random sampling technique was employed. Data were collected by KoboToolbox through face-to-face interviews using a structured and pretested questionnaire. Modified short-form childbirth self-efficacy inventory was used to score self-efficacy. The Statistical Package for Social Sciences, version 27, was used for data management and analysis. Descriptive statistics were calculated for each variable, and a logistic model was used. Statistical significance was determined at a p value of less than 0.05 and 95% confidence level. A total of 416 pregnant women participated in the study. Two hundred twenty-eight (54.8%) of the pregnant women had low childbirth self-efficacy. Age group in ≤24 years (AOR = 3.80, 95% CI: 1.82-8), primigravida (AOR = 1.51, 95% CI: 1.10-2.86), unplanned pregnancy (AOR = 1.67, 95% CI: 1.02-2.70), poor social support (AOR = 2.17, 95% CI: 1.09-4.30), having anxiety (AOR = 1.30, 95% CI: 1.10-3.64), having poor knowledge of childbirth (AOR = 2.21, 95% CI: 2.09-5.39), and severe fear of childbirth (AOR = 6.40, 95% CI: 2.60-9.80) were statistically significant with low childbirth self-efficacy. The magnitude of low childbirth self-efficacy was high in the study area. Being primigravida, unplanned pregnancy, age ≤ 24 years, severe fear of childbirth, anxiety, poor social support, and poor knowledge were significantly associated with low childbirth self-efficacy. Therefore, giving special attention to these factors during antenatal care would be important.

Effectiveness of Childbirth Self-Efficacy Enhancing Classes on Labor Length and Outcomes among Egyptian Primiparous Women: A Quasi-Experimental Study.

Childbirth self-efficacy has repeatedly been shown to raise satisfaction with childbirth, reduce the need for analgesic, and promote the use of different childbirth alternatives. However, the measures to improve the childbirth self-efficacy had rarely been investigated among Egyptian primiparous women. The aim of this study is to evaluate the effectiveness of childbirth self-efficacy enhancing classes on labor length and outcomes among Egyptian primiparous women. A quasi-experimental research approach was carried out on prospective, consecutive sample of 148 pregnant women at the end of pregnancy. A prenatal education study group (n = 74) and a control group receiving standard antenatal care (n = 74) make up the first and second groups, respectively. Between October 2021 and October 2022, the study was conducted at the antenatal clinic. The following four tools were employed to fulfill the study's objective: A structured interviewing form, a childbirth self-efficacy inventory, a follow-up checklist for monitoring maternal and neonatal outcomes during labor, and three antenatal education sessions to boost childbirth self-efficacy are all examples of tools that can be used. All statistical analyses were performed using SPSS for windows version 20.0. Approximately 68.9% of women in the experimental group gave birth vaginally, compared to 29.7% of those in the control group with (p = .001), according to the study's findings. In the experimental group, regular labor took an average of 8 to 12 h, but it took more than 12 h in the control group. Birth weight (>3000g) in the experimental group compared to (2000-3000 g) in the control group, as well as the Apgar score at 1 min and 5 min, were highly statistically significance between two groups with (p = .001). The means±SD of the childbirth self-efficacy result scores were better in the study group than in control groups regarding length of delivery and vaginal delivery (248.2 ± 19.4 versus 144.6 ± 21.6 and 250.1 ± 18.2 versus 137.9 ± 21.5, respectively). According to the findings of this study, antenatal education classes have a real chance of assisting primiparous women in increasing their childbirth self-efficacy and improving maternal and neonatal outcomes.

ANTENATAL EDUCATION STRATEGIES DESIGNED TO SUPPORT MOBILITY IN LABOUR: A SCOPING REVIEW PROTOCOL

Empowering women for labour mobility is acknowledged as a component of good midwifery care, yet challenges persist in hospital settings. While the benefits of antenatal education are recognised as supporting labour mobility, specific details and correlations with outcomes remain deficient. A comprehensive synthesis of interventions empowering women for labour mobility is lacking. This study aims to map strategies in antenatal education for labour mobility, utilising JBI methodology. The review will centre on antenatal education, highlighting crucial information for strategies to enhance women’s decision-making and childbirth self-efficacy, fostering labour mobility and upright positions during labour.

Development and evaluation of the psychometric properties of a digital questionnaire for the evaluation of perinatal psychosocial needs

BackgroundIf the purpose of maternal education is for women to take control of their own health and that of their family in the process, it is essential to have a simple instrument that allows them to self-assess, globally, how prepared they are to face future childbirth and maternity. As there is nothing similar in our area, the objective of this study was to design a complete, specific measurement questionnaire, with good metric quality and in digital format, for the assessment of perinatal psychosocial needs.MethodsA cross-sectional study was carried out, to evaluate the psychometric properties of a digital measurement questionnaire. The questionnaire was developed in 4 steps following the recommendations of the International Test Commission. The participants were 263 pregnant women who were recruited in primary health care appointments in the Basque Healthcare Service (Osakidetza); they completed the newly created questionnaire and all the test selected as gold standard. Their mean age was 33.55 (SD = 4.73). The analysis of the psychometric characteristics was based on mixed expert judgment procedures (focus group of healthcare professionals, item assessment questionnaire and interviews with users) and quantitative procedures (EFA, CFA, association with the gold standard and classification agreement index, ordinal alpha and McDonald's omega).ResultsThe final version of the questionnaire was made up of 55 items that evaluate 8 aspects related to perinatal psychosocial well-being (anxious-depressive symptoms, pregnancy acceptance, partner support, coping, internal locus of control, childbirth self-efficacy, perception of childbirth as a medicalized event, and fear of childbirth). Various tests were made of the validity and reliability of the scores, providing metric guarantees for their use in our context.ConclusionsThe use of this complete, quick-to-use tool with good psychometric properties will allow pregnant women to take stock of their situation, assess whether they have the necessary resources in the psychological and social sphere, and work together with midwives and other health professionals in the areas that are lacking.

Childbirth self-efficacy and fear of childbirth and their predictors in adolescent and adult pregnant women referring to health centres of Urmia-Iran: a cross-sectional study

ObjectiveAdolescent pregnancy as a growing phenomenon in the world has been investigated from different aspects. However, the examination of childbirth fear and self-efficacy has received less attention. Therefore, this study...

Effects of the web-based birth preparation programme and motivational interviews on primigravida women: Randomized-controlled study.

This study aimed to identify the effects of a web-based birth preparation programme based on the Health Belief Model and supported by motivational interviews on fear of childbirth, self-efficacy and the labour process in primigravida women. The study was conducted in a single-blind, randomized controlled design with 73 pregnant women. The Birth Health Belief Scale, the Wijma Delivery Expectation/Experience Questionnaire A-B, the Childbirth Self-efficacy Scale and the Labour Process Assessment forms were used to collect data. Five sessions of motivational interviews were held with the pregnant women in the experimental group, while those in the control group were administered placebo education. Fear of birth was lower, and the birth self-efficacy total score was higher in the experimental group. None of the groups indicated significant differences in terms of their mode of delivery. Health Belief Model-based web-based birth preparation programme and motivational interviews were found to reduce the fear of birth, increase self-efficacy and positively affect the birth process in primigravida women.

Perceived Childbirth Self-Efficacy and Its Associated Factors Among Pregnant Women in South-Central Ethiopia.

Childbirth self-efficacy has been identified as a significant indicator of a positive childbirth experience. It is, however, the most neglected aspect of maternal care, and evidence in this regard was lacking in Ethiopia. Therefore, this study aimed to assess perceived childbirth self-efficacy and its associated factors among pregnant women in the Gurage zone, southern Ethiopia. The current study was conducted from April to May 2022 using a facility-based cross-sectional study design. We used a systematic sampling technique and selected a total of 423 women. To collect the data, we utilized an interviewer-administered questionnaire containing a childbirth self-efficacy inventory scale. Multiple linear regression analysis was employed to discover the factors influencing a woman's self-efficacy during childbirth. The current study included 423 pregnant women in total. This study revealed that the overall mean score for perceived childbirth self-efficacy was 489.06 (SD = 65.77). Social support (β = 0.214, P< 0.001), psychological well-being (β = 0.254, P< 0.001), education status at the secondary level (β = 0.151, P< 0.001), no fundal pressure (β = 0.11, P = 0.010), and planned pregnancy (β = 0.10, P =0.013) were positively associated with childbirth self-efficacy. Fear of childbirth (β = 0.19, P< 0.001), Primipara women (β = 0.14, P< 0.001), women who had experienced discomfort during vaginal examination (β = 0.10, P = 0.009), and women who experienced the inability to push (β = 0.10, P = 0.013) were negatively associated with childbirth self-efficacy. The overall mean score for the perceived childbirth self-efficacy was high when compared to the previous studies conducted in Australia. Healthcare professionals should create multifaceted strategies to support childbirth self-efficacy, such as relaxation techniques, prenatal psycho-education to reduce childbirth fear, enhance psychological well-being and encourage social support, particularly partner support during pregnancy and childbirth.

Training on Childbirth Preparation on the Self-Efficacy and Psychological State of Pregnant Women in Kakamega County

Pregnant women’s ability to cope with childbirth pain is a significant indicator of self-efficacy during labour. The link between antenatal childbirth knowledge and self-efficacy is largely unknown. This study assessed the impact of training in childbirth preparation on women’s self-efficacy and their psychological status during childbirth in Western Kenya. We used a quasi-pre-test post-test CBS EI design to assess training intervention pinned on self-efficacy theory. Participants were assigned either to the control group or the intervention group at the antenatal care clinic. A pre-test on self-efficacy was performed using the childbirth self-efficacy inventory scale (CBSEI-16). The intervention group received two sessions of 2 hours each of the training between the 3rd–and 33rd weeks of gestation. Evaluation of outcome measures was conducted at the end of the 36th week of gestation and within 48 hours after delivery for childbirth self-efficacy and fear and anxiety, respectively. Childbirth self-efficacy was determined by the CBSEI-16, while fear and anxiety were determined using a five-point Likert scale. Statistical significance was determined by independent t-tests. Mothers in the intervention group had higher post-test scores for Outcome Expectancy (OE) and Efficacy Expectancy (EE), P&lt;0.001. Mothers in the intervention group were more likely to be in control and felt more capable with less fear and anxiety than in the control group P&lt;0.001. Data presented here suggest that training in childbirth preparation improved self-efficacy and decreased anxiety and fear

Effect of Group Psycho-Educational Interventions on Child birth fear and Child birth Self-efficacy among Primiparous women.

Child birth related fear and low self-efficacy for child birth found common among primiparous women. Antenatal group psycho-educational interventions have been used as important strategies to address child birth fear and self-efficacy. Thus, this study aimed to find out the status of child birth fear among antenatal women and effect of group psycho-educational interventions among primiparous women. One group pretest-posttest design was adopted. Total 307 primigravida women attending antenatal outpatient department of two hospitals within Kathmandu valley were selected through purposive sampling technique. Data was collected from March to July 2020. Child birth fear was assessed by using validated tool i.e.Wijma Delivery Expectancy/Experience Questionnaire (W-DEQ) and Child birth self-efficacy was assessed by using childbirth self- efficacy tool. Primigravida women with moderate level of child-birth fear, were intervened for group psycho-education based on PRIME Model by nurses who were research team members. Paired t-test was used to compare differences in mean scores on child birth fear and child birth self-efficacy before and after intervention. Moderate level of child birth fear was found among 24.8% of participants. Low child-birth self-efficacy was found among 42.0% participants. The overall mean score before providing group psycho-educational interventions to experimental group on child-birth fear was 54.0±2.09 and on child birth self-efficacy was 78.0±28.64 with p<0.001 and after providing group psycho-educational interventions child-birth fear was reduced to 47.8±2.44 and child birth self-efficacy was 105.2±19.6 with p<0.001. Group psycho-educational interventions based on PRIME approach led by nurses have significant effects in reducing child-birth fear and increasing child-birth self-efficacy. Therefore, provision of group psycho-educational interventions along with routine antenatal service need to be considered in clinical settings in Nepalese context.

Factors predicting self-efficacy during birth in Chinese women: a cross-sectional study

Background/Aims Self-efficacy can promote optimism during childbirth and a better transition from pregnancy to motherhood. This study's aim was to examine maternal childbirth self-efficacy during the latent phase of labour, and identify related predictors, among low-risk Chinese pregnant women. Methods A predictive correlational study was conducted among 122 low-risk pregnant women. Questionnaires were used to collect data on self-efficacy, with standard multiple linear regression analysis applied to determine its predictors. Results The mean score for childbirth self-efficacy was 225 (standard deviation=47.86), which indicated moderate self-efficacy during labour. Professional support (P&lt;0.001), childbirth knowledge (P&lt;0.01) and parity (P&lt;0.05) were significant predictors. Conclusions This study highlighted that professional support, childbirth knowledge and parity can affect childbirth self-efficacy, which could enhance women's coping ability and promote a successful birth. Healthcare professionals could increase maternal self-efficacy through providing enhanced emotional and information support, ensuring that women are given adequate information about the birth process and by providing support for primiparous women during the latent phase of labour.

Effect of Intolerance of Uncertainty on Fear of Childbirth in Primiparas : A Moderated Mediating Model

To explore the mediating effect of childbirth self-efficacy on the impact pathway of intolerance of uncertainty on the fear of childbirth in primiparas in the second and third trimesters and the potential moderating effect of perceived partner responsiveness. A total of 429 primiparas in their second and third trimesters completed the survey, which included general information questionnaire, Intolerance of Uncertainty Scale, Childbirth Self-Efficacy Inventory, Perceived Partner Responsiveness Scale, and Childbirth Attitudes Questionnaire. Rank sum test was used to compare the scores for the fear of childbirth among different groups and Spearman's correlation was used to analyze the scores for all the scales. In addition, the data were centrally processed by using PROCESS V3.4.1 Model 4 (a simple mediation model), Model 5 (the direct path of the mediation model was regulated), and non-parametric Bootstrap method to test the mediation effect and moderation effect. The study showed that 54.31% of the participants experienced fear of childbirth. Their scores for intolerance of uncertainty, childbirth self-efficacy, and perceived partner responsiveness were 15.00 (8.00), 240.00 (75.00), and 72.00 (19.00), respectively. There were significant differences in the scores for the fear of childbirth scale among pregnant women of different age groups, gestational weeks, employment statuses, and average per capita monthly income of the family ( P<0.05). According to our findings, intolerance of uncertainty directly and positively impacted on fear of childbirth ( β=0.76, P<0.001), with childbirth self-efficacy playing partial mediation role between them, its indirect effect being 0.05 and the contribution rate being 6.17%. In addition, after the scores of Perceived Partner Responsiveness Scale were added to the model, perceived partner responsiveness had no significant predictive effect for fear of childbirth, but the product term of the scores for Perceived Partner Responsiveness Scale and Intolerability Uncertainty Scale had significant predictive effect for fear of childbirth ( β=0.01, P<0.05), which suggested that perceived partner responsiveness also played a moderating role between intolerance of uncertainty and fear of childbirth. Health care providers can help primiparas reduce fear of childbirth and improve their childbirth experience by reducing perceived intolerance of uncertainty, improving family support, and teaching coping strategies.