Background Studies show that childbirth fear is a common problem among Iranian women. Therefore, most Iranian women prefer caesarean section for giving birth. This study investigated the effectiveness of a psychoeducational intervention by midwives (birth emotions - looking to improve expectant fear (BELIEF)) on decreasing childbirth fear and self-efficacy among first-time pregnant women who were afraid of giving birth. Methods A number of 80 pregnant women participated in the study. They had received a score of ≥66 on the Wijma delivery expectancy/experience questionnaire. They were randomly assigned into two groups: intervention (n = 40) and control groups (n = 40). The intervention group received two face-to-face counseling sessions based on the BELEF protocol in the 24th and 34th weeks of pregnancy. Between these two sessions, it also received eight telephone-counseling sessions once a week. The control group only received the prenatal routine care. The outcome measures were childbirth fear, childbirth self-efficacy, and childbirth preference. Results The intervention group showed significantly more reduction in childbirth fear and more increase in childbirth self-efficacy compared to the control group. In addition, more women in the intervention group reported that they preferred to give normal vaginal birth than women in the control group. Conclusion The BELIEF protocol could be an effective approach in reducing childbirth fear and increasing childbirth self-efficacy among first-time pregnant women who are afraid of giving birth. Trial registration number IRCT20101219005417N3, Date of Registration: 19-12-2018.

Background: Studies show that childbirth fear is a common problem among Iranian women. Therefore, most Iranian women prefer caesarean section for giving birth. This study investigated the effectiveness of a psychoeducational intervention by midwives (birth emotions - looking to improve expectant fear (BELIEF)) on decreasing childbirth fear and self-efficacy among first-time pregnant women who were afraid of giving birth.Methods: A number of 80 pregnant women participated in the study. They had received a score of ≥ 66 on the Wijma delivery expectancy/experience questionnaire. They were randomly assigned into two groups: intervention (n = 40) and control groups (n = 40). The intervention group received two face-to-face counseling sessions based on the BELEF protocol in the 24th and 34th weeks of pregnancy. Between these two sessions, it also received eight telephone-counseling sessions once a week. The control group only received the prenatal routine care. The outcome measures were childbirth fear, childbirth self-efficacy, and childbirth preference. Results: The intervention group showed significantly more reduction in childbirth fear and more increase in childbirth self-efficacy compared to the control group. In addition, more women in the intervention group reported that they preferred to give normal vaginal birth than women in the control group.Conclusion: The BELIEF protocol could be an effective approach in reducing childbirth fear and increasing childbirth self-efficacy among first-time pregnant women who are afraid of giving birth. Trial registration number: IRCT20101219005417N3, Date of Registration: 19-12-2018.

Background The present study investigated the effectiveness of a Psycho-Education Intervention by Midwives (BILIEF protocol) in decreasing childbirth fear and childbirth self-efficacy among fearful first pregnant women in Iran. Methods From among 171 pregnant women screened to participate in the study, 80 women who got score ≥ 66 on the Wijma Delivery Expectancy/Experience Questionnaire were recruited. They were randomly assigned into two groups: intervention (n = 40) and control group (n = 40). The intervention group received two face-to-face counseling sessions in the 24th week and 34th week of pregnancy. Between this two counseling sessions, intervention group had 8 weekly telephone counseling sessions. The control group only received the prenatal routine care. The outcome measures were childbirth fear, childbirth self-efficacy, and childbirth preference. Results At the post-test, the intervention group showed significantly higher reduction in childbirth fear and higher increase in childbirth self-efficacy compared to the control group. Also, at posttest more women in the intervention group reported that they preferred to give birth via normal vaginal birth than women in the control group. Conclusions The BILIEF protocol could be effective approach to improve childbirth fear and childbirth self-efficacy in fearful first pregnant women. Trial registration number IRCT20101219005417N3, Date of Registration: 12-19-2018.

​Background: Studies showed that childbirth fear is a prevalent problem among Iranian women and therefore most Iranian women prefer caesarean section as method of birth. However, there is no published study that explore effectiveness of psychoeducational interventions on childbirth fear among Iranian women. Thus, present study investigated the effectiveness of a Psychoeducation Intervention by Midwives (Birth Emotions- Looking to Improve Expectant Fear (BELIEF)) in decreasing childbirth fear and childbirth self-efficacy among fearful first pregnant women in Iran. Methods: One-hundred-seventy-one pregnant women who referred to six governmental antenatal clinics of healthcare centers of Zanjan city screened to participate in the study. Among them, 80 women who got score ≥ 66 on the Wijma Delivery Expectancy/Experience Questionnaire were recruited. They were randomly assigned into two groups: intervention (n = 40) and control group (n = 40). The intervention group received two face-to-face counseling sessions based on the BELEF protocol in the 24th week and 34th week of pregnancy. Between this two counseling sessions, intervention group had 8 weekly telephone counseling sessions. The control group only received the prenatal routine care. The outcome measures were childbirth fear, childbirth self-efficacy, and childbirth preference. Results: At the post-test, the intervention group showed significantly higher reduction in childbirth fear and higher increase in childbirth self-efficacy compared to the control group. Also, at post-test more women in the intervention group reported that they preferred to give birth via normal vaginal birth than women in the control group. Conclusions: The BELIEF protocol could be effective approach to improve childbirth fear and childbirth self-efficacy in fearful first pregnant women. Trial registration number: IRCT20101219005417N3, Date of Registration: 19-12-2018.