Nulliparous pregnant women's narratives of imminent childbirth before and after internet-based cognitive behavioural therapy for severe fear of childbirth: a qualitative study

Abstract

Objective: To describe the expectations concerning imminent childbirth before and after 8 weeks of internet-based cognitive behavioural therapy (ICBT) among nulliparous pregnant women with severe fear of childbirth.

Design: Qualitative study of nulliparous pregnant women's narratives before and after CBT.

Setting: The first ICBT programme for treating severe fear of childbirth.

Sample: Fifteen nulliparous pregnant Swedish women with severe fear of childbirth participating in an ICBT self-help programme.

Methods: Semi-structured open-ended questions over the internet before and after 8 weeks of ICBT. The data were analysed using thematic analysis.

Main outcome measures: The participants' narratives pertaining to five different situations during labour and delivery before and after ICBT.

Results: After therapy, participants described a more realistic attitude towards imminent childbirth, more self-confidence and more active coping strategies. They perceived their partners and the staff as more supportive. They were more aware of the approaching meeting with their baby when giving birth.

Conclusions: Following the ICBT programme, participants changed their attitude towards imminent childbirth from negative to more positive. This was manifested in positive and more realistic expectations regarding themselves, their partner and the staff that would look after them.

Keywords: Active coping; appraisal; delivery; fear of childbirth; internet cognitive behavioural therapy; self-confidence.