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Randomized Controlled Trial
. 2014 Dec;41(4):384-94.
doi: 10.1111/birt.12136. Epub 2014 Oct 9.

A randomized controlled trial of a psycho-education intervention by midwives in reducing childbirth fear in pregnant women

Jocelyn Toohill  1 , Jennifer Fenwick, Jenny Gamble, Debra K Creedy, Anne Buist, Erika Turkstra, Elsa-Lena Ryding
Affiliations
Free PMC article
Randomized Controlled Trial

A randomized controlled trial of a psycho-education intervention by midwives in reducing childbirth fear in pregnant women

Jocelyn Toohill et al. Birth. 2014 Dec.
Free PMC article

Abstract

Background: Childbirth fear is associated with increased obstetric interventions and poor emotional and psychological health for women. The purpose of this study is to test an antenatal psycho-education intervention by midwives in reducing women's childbirth fear.

Methods: Women (n = 1,410) attending three hospitals in South East Queensland, Australia, were recruited into the BELIEF trial. Participants reporting high fear were randomly allocated to intervention (n = 170) or control (n = 169) groups. All women received a decision-aid booklet on childbirth choices. The telephone counseling intervention was offered at 24 and 34 weeks of pregnancy. The control group received usual care offered by public maternity services. Primary outcome was reduction in childbirth fear (WDEQ-A) from second trimester to 36 weeks' gestation. Secondary outcomes were improved childbirth self-efficacy, and reduced decisional conflict and depressive symptoms. Demographic, obstetric & psychometric measures were administered at recruitment, and 36 weeks of pregnancy.

Results: There were significant differences between groups on postintervention scores for fear of birth (p < 0.001) and childbirth self-efficacy (p = 0.002). Decisional conflict and depressive symptoms reduced but were not significant.

Conclusion: Psycho-education by trained midwives was effective in reducing high childbirth fear levels and increasing childbirth confidence in pregnant women. Improving antenatal emotional well-being may have wider positive social and maternity care implications for optimal childbirth experiences.

Keywords: RCT; childbirth fear; childbirth self-efficacy; decisional conflict; depression; midwife counseling; psycho-education.

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Figures

Figure 1
Figure 1
Validated measures used in the study.
Figure 2
Figure 2
The Consolidated Standards of Reporting Trials (CONSORT) flow diagram.
See this image and copyright information in PMC

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