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Effects of extended childbirth education by midwives on the childbirth fear of first‐time mothers: an RCT
Author(s) -
Haapio Sari,
Kaun Marja,
Arffman Martti,
ÅstedtKurki Päivi
Publication year - 2017
Publication title -
scandinavian journal of caring sciences
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.678
H-Index - 66
eISSN - 1471-6712
pISSN - 0283-9318
DOI - 10.1111/scs.12346
Subject(s) - childbirth , medicine , randomized controlled trial , feeling , pregnancy , caesarean section , intervention (counseling) , odds ratio , outpatient clinic , obstetrics , gestation , nursing , psychology , social psychology , genetics , surgery , pathology , biology
Objective This study evaluates how extended childbirth education intervention affects first‐time mothers’ fear of childbirth and its manifestation during pregnancy. Method A randomised controlled trial was conducted. A total of 659 first‐time mothers were recruited before week 14 of gestation during the first ultrasound screening at the hospital's maternity outpatient clinic. The mothers were randomly assigned into an intervention group (n = 338) or a control group (n = 321). The control group received all available regular childbirth education. In addition, the intervention group received an enhanced 2‐hour childbirth education at the maternity hospital. Outcome measurements and statistical analysis The objects of childbirth fears (childbirth‐related fear, fear for the mother's and the child's well‐being, fear related to Caesarean section) were the primary outcomes. The manifestations of childbirth fears (everyday life, stress symptoms and the wish to have a Caesarean section) were the secondary outcomes. These outcomes were measured over 34 weeks of gestation using two parts of the instrument ‘Feelings of Fear and Security Associated with Pregnancy and Childbirth’. Logistic and ordinal linear regression models were used to model the effect of the intervention on the outcomes. Findings The mothers in the intervention group had less childbirth‐related fear than those in the control group [odds ratio ( OR ) 0.58, 95% confidence level ( CL ) 0.38–0.88]. Also, fear influenced the mothers in the intervention group less in everyday life than it did the mothers in the control group [ OR 0.64, 95% CL 0.44–0.94]. Conclusion The effectiveness of the intervention can be considered moderate: one of three objects and one of three manifestations of fears were reduced. The intervention proved most efficient in alleviating relatively limited objects of fears.