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For each woman, pregnancy, childbirth, and maternity are considered as social and emotional processes that are accompanied by important consequences (1). The fear of giving birth involves a spectrum of extreme to a rational fear of delivery. Most women, especially those who are nulliparous, experience a logical fear because of their unfamiliarity with the labor process. Naturally, this fear can be controlled during pregnancy and delivery (2). Based on the reports, the fear of giving birth is the reason for 7%-22% of cesareans in Finland, Sweden, and the United Kingdom (3). Additionally, according to the studies conducted in Iran, the fear of vaginal delivery is reported as the reason for 59% of cesareans (4). However, there are many reasons for the fear of having a vaginal birth, including the fear of pain, death and unexpected problems, the low self-efficacy of childbirth, concerns about postpartum sexual problems, and baby health concerns are among the main causes of the fear of childbirth (FOC) (3). Happiness is a fundamental criterion of mental health which includes anger, fear, disgust, surprise, and sadness (5). Some studies demonstrated that there is an increase in the happiness level during pregnancy, which is associated with self-actualization and the consolidation of gender identity in pregnancy (6, 7). Hagstrom et al, investigating the factors related to happiness in pregnancy, showed that 57% of mothers had a high level of happiness and the remaining mothers reported a moderate level of happiness while none of them expressed a low level of happiness during pregnancy (6). Sable and Libbus discovered that approximately half of the mothers were very happy about their pregnancies despite unwanted pregnancies (7). Although guided imagery is used for relaxation in pregnant women, muscle relaxation technique is a systematic method for adjusting stress and promoting deep relaxation and happiness in pregnant women. This technique can be effectively carried out to adjust the stress, relieve anxiety, and reduce the symptoms or signs of stress. In addition, this technique provides a complete relaxation Abstract Objectives: Giving birth is a unique experience that requires a pregnant woman’s ability to cope with labor pain. Using happiness, this potential can be given to a pregnant woman. This study was performed to compare the effect of muscle relaxation and guided imagery on the happiness and fear of delivery in primiparous women. Materials and Methods: This quasi-experimental study was carried out on a sample 0f 180 primiparous women who referred to healthcare centers in Zahedan during 2017. The subjects were selected by the available sampling method. Then, Brislin’s and Oxford Questionnaires were used to evaluate the fear of childbirth (FOC) and happiness, respectively. Through simple randomization, people who were qualified were included in relaxation, guided imagery, and control groups. Finally, a four-week training program was implemented for individual training. Results: Before the intervention, the mean scores for the FOC in relaxation, guided imagery, and control groups were 39.51 ± 6.91, 44.00 ± 9.30, and 41.56 ± 9.37, respectively, and after the intervention, they were 30.45 ± 6.56, 34.78 ± 9.36 and 41.78 ± 8.69, respectively. Based on the results, the mean scores of the FOC after the intervention showed a significant difference among the groups (P = 0.0001). In addition, the mean scores for happiness were 37.5 ± 15.54, 34.54 ± 17.72, and 36.78 ± 18.97, as well as 54.66 ± 14, 49.63 ± 17.05, and 36.65 ± 18.28 before and after the intervention in relaxation, guided imagery, and control groups, respectively (P = 0.0001). Conclusions: To prevent unnecessary cesarean sections, the current study confirmed the effect of muscle relaxation and guided imagery techniques for reducing the fear of delivery while increasing happiness in pregnant women.

international journal of women's health and reproduction sciences

Comparison of the Effect of Muscle Relaxation and Guided Imagery on Happiness and Fear of Childbirth in Primiparous Women Admitted to Health Care Centers