Open AccessLife satisfaction, general well‐being and costs of treatment for severe fear of childbirth in nulliparous women by psychoeducative group or conventional care attendance
Author(s) -
Rouhe Hanna,
SalmelaAro Katariina,
Toivanen Riikka,
Tokola Maiju,
Halmesmäki Erja,
Saisto Terhi
Publication year - 2015
Publication title -
acta obstetricia et gynecologica scandinavica
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.401
H-Index - 102
eISSN - 1600-0412
pISSN - 0001-6349
DOI - 10.1111/aogs.12594
Subject(s) - medicine , childbirth , psychoeducation , pregnancy , attendance , patient satisfaction , randomized controlled trial , obstetrics , vaginal delivery , prenatal care , nursing , intervention (counseling) , population , surgery , genetics , environmental health , economic growth , economics , biology
Objective Fear of childbirth is a common reason for seeking cesarean section. It is important to consider outcomes and costs associated with alternative treatment and delivery mode. We compared well‐being and costs of group psychoeducation and conventional care for fear of childbirth. Design Randomized controlled trial. Population A total of 371 nulliparous women scoring over the 95th centile in the Wijma Delivery Expectancy Questionnaire (W‐ DEQ ) during the first trimester. Setting Finland, data from obstetrical patient records and questionnaires. Methods Randomization to group psychoeducation with relaxation (six sessions during pregnancy, one after childbirth, n = 131), or surveillance and referral on demand ( n = 240). Main outcome measures All costs in maternity care during pregnancy, delivery and postnatally according to Diagnoses Related Groups. Life satisfaction and general well‐being 3 months after childbirth (by a Satisfaction with Life Scale and Well‐being Visual Analogue Scale). Results The groups did not differ in total direct costs (€3786/woman in psychoeducative group and €3830/woman in control group), nor in life satisfaction or general well‐being. Although only 76 (30%) of the women assigned to the surveillance were referred to special maternity care and 36 (15%) attended advanced prenatal classes, costs in the psychoeducation group did not exceed the costs of the controls, mostly because of the greater number of uncomplicated vaginal deliveries (63% vs. 47%, p = 0.005). Conclusions Through an association with safer childbirth and equal well‐being after delivery, psychoeducative group treatment for nulliparous women with fear of childbirth can be a recommended choice for the same overall costs as conventional treatment.