| BMC Pregnancy and Childbirth | |
| Study protocol for reducing childbirth fear: a midwife-led psycho-education intervention | |
| Jocelyn Toohill1  Vivian Jarrett1  Elsa L Ryding3  Paul A Scuffham1  Anne Sneddon2  Erika Turkstra1  Anne Buist4  Debra K Creedy1  Jenny Gamble1  Jennifer Fenwick2  | |
| [1] Griffith Health Institute Griffith University, University of Queensland, St Lucia, Brisbane, QLD 4072, Australia;Gold Coast Hospital, Griffith University, Parklands Drive, Southport, Qld, Australia;Department of Women’s & Children’s Health, Karolinska Institute, Stockholm, Sweden;University of Melbourne, Grattan Street, Parkville, VIC 3010, Australia | |
| 关键词: Self-efficacy; EQ-5D; Decisional conflict; Postnatal depression; Randomised controlled trial; Midwife-led counselling; Psycho-education; Childbirth fear; Pregnancy; | |
| Others : 1137845 DOI : 10.1186/1471-2393-13-190 |
|
| received in 2013-09-26, accepted in 2013-10-10, 发布年份 2013 | |
PDF
|
|
【 摘 要 】
Background
Childbirth 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/design
Pregnant 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.
Discussion
This 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 registration
Australian New Zealand Controlled Trials Registry ACTRN12612000526875.
【 授权许可】
2013 Fenwick et al.; licensee BioMed Central Ltd.
【 预 览 】
| Files | Size | Format | View |
|---|---|---|---|
| 20150318032704380.pdf | 305KB | ||
| Figure 1. | 48KB | Image |
【 图 表 】
Figure 1.
【 参考文献 】
- [1]Kjaergaard H, Wijma K, Dykes A, Alehagen S: Fear of childbirth in obstetrically low-risk nulliparous women in Sweden & Denmark. Reprod Infant Psych 2008, 26:340-350.
- [2]Hofberg K, Ward M: A profound dread and avoidance of childbirth (when pathological fear effects the consultation). In Psychological challenges in obstetrics and gynecology: the clinical management J. Edited by Pawson CM. New York: Springer Science; 2007:165-172.
- [3]Johnson R, Slade P: Does fear of childbirth during pregnancy predict emergency caesarean section? BJOG 2002, 109:1213-1221.
- [4]Lowe NK: Self-efficacy for labor and childbirth fears in nulliparous pregnant women. J Psychosom Obstet Gynecol 2000, 21(4):219-224.
- [5]Geissbuehler V, Eberhard J: Fear of childbirth during pregnancy: a study of more than 8000 pregnant women. J Psychosom Obstet Gynecol 2002, 23(4):229-235.
- [6]Joseph S, Bailham D: Traumatic childbirth: what we know and what we can do. RCM Midwives 2004, 7:258-261.
- [7]Fenwick J, Hauck Y, Downie J, Butt J: The childbirth expectations of a self-selected cohort of Western Australian women. Midwifery 2005, 21:23-35.
- [8]Fisher C, Hauck Y, Fenwick J: How social context impacts on women’s fears of childbirth: a Western Australian example. Social Sci Med 2006, 63:64-75.
- [9]Wijma K, Wijma B, Zar M: Psychometric aspects of the W-DEQ: a new questionnaire for the measurement of fear of childbirth. J Psychosom Obstet Gynecol 1998, 19:84-97.
- [10]Fenwick J, Gamble J, Nathan E, Bayes S, Hauck Y: Pre- and postpartum levels of childbirth fear and the relationship to birth outcomes in a cohort of Australian women. J Clin Nurs 2009, 18:667-677.
- [11]Nieminen K, Stephansson O, Ryding E: Women’s fear of childbirth and preferences for caesarean section - a cross sectional study at various stages of pregnancy in Sweden. Acta Obstet Gynecol Scand 2009, 88:807-813.
- [12]Hall WA, Hauck YL, Carty EM, Hutton EK, Fenwick J, Stoll K: Childbirth fear, anxiety, fatigue, and sleep deprivation in pregnant women. J Obstet Gynecol Neonatal Nurs 2009, 38:567-576.
- [13]Zar M, Wijma K, Wijma B: Pre- and postpartum fear of childbirth in nulliparous and parous women. Scand J Behav Therapy 2001, 30:75-84.
- [14]Klein M, Sakala C, Davis-Floyd R, Rooks J: Why do women go along with this stuff? Birth 2006, 33:245-250.
- [15]Fenwick J, Staff L, Gamble J, Creedy DK, Bayes S: Why do women request caesarean section in a normal, healthy first pregnancy? Midwifery 2010, 26:394-400.
- [16]Hofberg K, Ward MR: Fear of pregnancy and childbirth. Postgrad Med J 2003, 79:505-510.
- [17]Sjogren B: Childbirth: expectations, choices, and trends. Lancet 2000, 12:356.
- [18]Waldenström U, Hildingsson I, Ryding EL: Antenatal fear of childbirth and its association with subsequent caesarean section and experience of childbirth. BJOG 2006, 113:638-646.
- [19]Ryding EL, Persson A, Onell C, Kvist L: An evaluation of midwives’ counseling of pregnant women in fear of childbirth. Acta Obstet Gynecol Scand 2003, 82:10-17.
- [20]Halvorsen L, Nerum H, Oian P, Sorlie T: Is there an association between psychological stress and request for caesarean section? Tidsskr Nor Laegeforen 2008, 128:1388-1391.
- [21]Sjogren B: Fear of childbirth and psychosomatic support. Acta Obstet Gynecol Scand 1998, 77:819-825.
- [22]Ryding EL: Investigation of 33 women who demanded a caesarean section for personal reasons. Acta Obstet Gynecol Scand 1993, 72:280-285.
- [23]Sjogren B, Thomassen P: Obstetric outcome of 100 women with severe anxiety over childbirth. Acta Obstet Gynecol Scand 1997, 76:948-952.
- [24]Saisto T, Toivanen R, Salmela-Aro K, Halmesmaki E: Therapeutic group psychoeducation and relaxation in treating fear of childbirth. Acta Obstet Gynecol Scand 2006, 85:1315-1319.
- [25]Cox J, Holden J, Sagousky R: Detection of postnatal depression development of the 10 item Edinburgh depression scale. BMJ 1987, 150:782-786.
- [26]Lowe NK: Maternal confidence for labour: development of the childbirth self-efficacy inventory. Res Nurs Health 1993, 16:141-149.
- [27]Drummond J, Rickwood D: Childbirth confidence: validating the childbirth self-efficacy inventory (CBSEI) in an Australian sample. J Adv Nurs 1997, 26:613-622.
- [28]O’Connor A: User manual - decisional conflict scale [internet]. 1993. [Updated 2010; cited 01/02/11]. Available from http://decisionaid.ohri.ca/docs/develop/User_Manuals/UM_Decisional_Conflict.pdf webcite
- [29]Shorten A, Shorten B, Keogh J, West S, Morris J: Making choices for childbirth: a randomized controlled trial of a decision-aid for informed birth after cesarean. Birth 2005, 32:252-261.
- [30]Fenwick J, Gamble J, Mawson J: Women’s experiences of caesarean section and vaginal birth after caesarean: a birthrites initiative. Int J Nurs Pract 2003, 9:10-17.
- [31]Williams A: The EuroQol instrument. In EQ-5D concepts and methods: a developmental history. Edited by Kind P, Brooks R, Rabin R. Dordrecht: Springer; 2005.
- [32]Queensland Centre for Mothers and Babies: The having a baby in Queensland book - your choices during pregnancy and birth 2010. Available from: http://www.qcmb.org.au/the_having_a_baby_in_queensland_book/menu/research_projects webcite
- [33]Johnston C, Mash E: A measure of parenting satisfaction and efficacy. J Clin Child Psychol 1989, 18:167-175.
- [34]Gamble J, Creedy DK, Moyle W, Webster J, McAllister M, Dickson P: Effectiveness of a counseling intervention after a traumatic childbirth: a randomized controlled trial. Birth 2005, 32:11-19.
- [35]Gamble J, Creedy DK: A counselling model for postpartum women after distressing birth experiences. Midwifery 2009, 25:e21-e30.
- [36]Fenwick J, Gamble J, Hauck Y: Reframing birth: a consequence of cesarean section. J Adv Nurs 2006, 56:121-130.
- [37]Horey D, Weaver J, Russell H: Information for pregnant women about caesarean birth. Cochrane Database Syst Rev 2004, (Issue 1):CD003858.
- [38]Fraser W, Maunsell E, Hodnett E, Moutquin J: Randomized controlled trial of a prenatal vaginal birth after cesarean section education and support program. Am J Obstet Gynecol 1997, 176:419-425.
- [39]McGrath P, Ray-Barruel G: The easy option? Australian findings on mothers’ perception of elective caesarean as a birth choice after a prior caesarean section. Int J Nurs Pract 2009, 15:271-279.
- [40]Stapleton H, Kirkham M, Thomas G: Qualitative study of evidence based leaflets in maternity care. BMJ 2002, 324:639.
- [41]David S, Fenwick J, Bayes S, Martin T: A qualitative analysis of the content of telephone calls made by women to a dedicated ’next birth after caesarean' antenatal clinic. Women Birth 2010, 23:166-171.
- [42]Montgomery A, Emmett C, Fahey T, Jones C, Ricketts I, Patel R, et al.: Two decision aids for mode of delivery among women with previous caesarean section: randomised controlled trial. BMJ 2007, 334:1305.
- [43]Gravic Inc: Remark Office OMR. PA: Malvern; 2011.
- [44]Schafer J, Graham J: Missing data: our view of the state of the art. Psych Methods 2002, 7:147-177.
PDF