Study protocol for reducing childbirth fear: a midwife-led psycho-education intervention

Abstract

BackgroundChildbirth fear has received considerable attention in Scandinavian countries, and the United Kingdom, but not in Australia. For first-time mothers, fear is often linked to a perceived lack of control and disbelief in the body’s ability to give birth safely, whereas multiparous women may be fearful as a result of previous negative and/or traumatic birth experiences. There have been few well-designed intervention studies that test interventions to address women’s childbirth fear, support normal birth, and diminish the possibility of a negative birth experience.Methods/designPregnant women in their second trimester of pregnancy will be recruited and screened from antenatal clinics in Queensland, Australia. Women reporting high childbirth fear will be randomly allocated to the intervention or control group. The psycho-educational intervention is offered by midwives over the telephone at 24 and 34 weeks of pregnancy. The intervention aims to review birth expectations, work through distressing elements of childbirth, discuss strategies to develop support networks, affirm that negative childbirth events can be managed and develop a birth plan. Women in the control group will receive standard care offered by the public funded maternity services in Australia. All women will receive an information booklet on childbirth choices. Data will be collected at recruitment during the second trimester, 36 weeks of pregnancy, and 4–6 weeks after birth.DiscussionThis study aims to test the efficacy of a brief, midwife-led psycho-education counselling (known as BELIEF: Birth Emotions - Looking to Improve Expectant Fear) to reduce women’s childbirth fear. 1) Relative to controls, women receiving BELIEF will report lower levels of childbirth fear at term; 2) less decisional conflict; 3) less depressive symptoms; 4) better childbirth self-efficacy; and 5) improved health and obstetric outcomes.Trial registrationAustralian New Zealand Controlled Trials Registry ACTRN12612000526875.

The Fear of Childbirth: A Study in the North of Portugal

“…The identification of pregnant women at risk, their levels childbirth fear, and main causes will likely allow for an early intervention, promoting a better pregnancy experience and a more satisfying childbirth. According to several authors (Saisto et al, 2001;Waldenstrom et al, 2006;Nilsson & Lundgren, 2009;Fenwick et al, 2013), targeted interventions can include education regarding routine labour procedures, sharing experiences, and addressing feelings and beliefs. However, Portugal does not yet have a specific intervention plan targeted at pregnant women experiencing intense childbirth fear.…”

“…Some authors define this fear as "primary fear of childbirth or primary tokophobia" (Nieminen, Stephansson, & Ryding, 2009;Fenwick, Staff, Gamble, Creedy, & Bayes, 2010;Fenwick et al, 2013). According to Fenwick et al (2013), in multiparous women, the cause of fear is often associated with a previous negative labour experience.…”

“…Some authors define this fear as "primary fear of childbirth or primary tokophobia" (Nieminen, Stephansson, & Ryding, 2009;Fenwick, Staff, Gamble, Creedy, & Bayes, 2010;Fenwick et al, 2013). According to Fenwick et al (2013), in multiparous women, the cause of fear is often associated with a previous negative labour experience. The authors describe this as a "secondary fear" or "secondary tokophobia" (Zar, Wijma, & Wijma., 2001;Saisto et al, 2001;Hofberg, & Ward, 2003;Nilsson, Lundgren, Karlström, & Hildingsson, 2012;Fenwick et al, 2013).…”

“…According to Fenwick et al (2013), in multiparous women, the cause of fear is often associated with a previous negative labour experience. The authors describe this as a "secondary fear" or "secondary tokophobia" (Zar, Wijma, & Wijma., 2001;Saisto et al, 2001;Hofberg, & Ward, 2003;Nilsson, Lundgren, Karlström, & Hildingsson, 2012;Fenwick et al, 2013).…”

Psycho-Social Predictors of Childbirth Fear in Pregnant Women: An Australian Study

“…The sample is drawn from participants (n = 1410) who consented to participate in the BELIEF study [23]. Women were between 12 and 24 weeks pregnant, of any parity and any obstetric risk.…”