Effect of Training Preparation for Childbirth on Fear of Normal Vaginal Delivery and Choosing the Type of Delivery Among Pregnant Women in Hamadan, Iran: A Randomized Controlled Trial

  • Seyedeh Zahra Masoumi Department of Midwifery, Mother & Child Care Research Center, School of Nursing and Midwifery, Hamadan University of Medical Sciences, Hamadan, Iran
  • Farideh Kazemi Department of Midwifery & Reproductive Health, School of Nursing & Midwifery, Shahid Beheshti University of Medical Sciences, Tehran, Iran
  • Khodayar Oshvandi Mail Department of Medical and Surgical Nursing, Mother & Child Care Research Center, School of Nursing and Midwifery, Hamadan University of Medical Sciences, Hamadan, Iran
  • Mozhgan Jalali Social Security Organization, Atiyeh Hospitals, Hamadan, Iran
  • Ali Esmaeili Vardanjani Chronic Diseases (Home Care) Research Center, School of Nursing and Midwifery, Hamadan University of Medical Sciences, Hamadan, Iran
  • Hossein Rafiei Department of Medical and Surgical Nursing, School of Nursing and Midwifery, Qazvin University of Medical Sciences, Qazvin, Iran
Keywords:
Child Birth, Cesarean Section, Fear, Pregnant Women

Abstract

Objective: To examine effect of an educational program on pregnant women’s fear of normal vaginal delivery. Fear of natural childbirth during pregnancy may increase the risk of caesarean section. Educational programs may be effective in reducing women fear of natural childbirth.Materials and methods: This randomized controlled trial conducted from September 2012 to January 2013 in Hamadan, Iran. One hundred fifty eligible women were randomly assigned to group "A" (Intervention group, n = 75) or group "B" (Control group, n = 75). Women in group A, participated in an antenatal educations program for physiologic childbirth in 8 two-hour sessions. A self-designed questionnaire was used to examine women's fear of natural childbirth. Data were analyzed with SPSS.16 software.Results: Baseline characteristics of women were similar in both groups. After intervention the mean fear score in group A compared to group B was significantly reduced (51.7 ± 22.4 vs. 58.7 ± 21.7) (p = 0.007). Physiologic delivery was the first choice of type of child birth after training in pregnant women in group A (58.7%). But delivery in physiologic form had lowest rate in group A (8%).Conclusion: Results of present study showed that educational program could be serving as an important tool in reducing women fear from natural childbirth and in choosing of physiologic birth. And for delivery as a physiological, education and counseling of pregnant women, doctors and midwives are required.

References

James D, Steer P, Weiner C, Gonik B. High risk pregnancy: management options - expert consult. 4th ed ed: Louis, MO: Elsevier Saunder, 2010.

Gary Cunningham F, Leveno K, Bloom S, Spong C, Dashe J, Hoffman B, et al. Williams Obstetrics. 24 edition ed. NewYork: McGraw-Hill Education / Medical, 2014.

World Health Organization. WHO statement on caesarean section rates, 2015. Available from:

http://www.who.int/reproductivehealth/publications/maternal_perinatal_health/cs-statement/en/

Gibbons L, Belizán JM, Lauer JA, Betrán AP, Merialdi

M, Althabe F. The global numbers and costs of additionally needed and unnecessary caesarean sections performed per year: overuse as a barrier to universal coverage. Geneva, World Health Organization: 2010.

Angeja AC, Washington AE, Vargas JE, Gomez R, Rojas I, Caughey AB. Chilean women's preferences regarding mode of delivery: which do they prefer and why? BJOG 2006;113:1253-8.

Bahadori F, Hakimi S, Heidarzade M. The trend of caesarean delivery in the Islamic Republic of Iran. East Mediterr Health J 2014;19: S67-70.

Azami-Aghdash S, Ghojazadeh M, Dehdilani N, Mohammadi M, Asl Amin Abad R. Prevalence and Causes of Cesarean Section in Iran: Systematic Review and Meta-Analysis. Iran J Public Health 2014; 43:545-55.

Hafeez M, Yasin A, Badar N, Pasha M, Akram N, Gulzar B. Prevalence and indications of caesarean section in a teaching hospital. JIMSA 2014;27: 15-6.

Nieminen K, Stephansson O, Ryding EL. Women's fear of childbirth and preference for cesarean section--a cross-sectional study at various stages of pregnancy in Sweden. Acta Obstet Gynecol Scand 2009; 88: 807-13.

Eynsheykh ZD, Shaahmadi F, Taslimi S, Emamiureh F, Moeinaldini S. Investigating the Relationship between Demographic Factors and Choice of Delivery Method in Pregnant Women in the City of Savojbolagh. J Family Reprod Health 2013 ;7:35-8.

Fenwick J, Toohill J, Creedy DK, Smith J, Gamble J. Sources, responses and moderators of childbirth fear in Australian women: a qualitative investigation. Midwifery 2015;31:239-46.

Serçekuş P, Okumuş H. Fears associated with childbirth among nulliparous women in Turkey. Midwifery 2009;25: 155-62.

Lukasse M, Schei B, Ryding E, Bidens Study Group. Prevalence and associated factors of fear of childbirth in six European countries. Sexual & Reproductive Healthcare 2014; 5, 99-106.

Matinnia N, Faisal I, Hanafiah Juni M, Herjar AR, Moeini B, Osman ZJ. Fears related to pregnancy and childbirth among primigravidae who requested caesarean versus vaginal delivery in Iran. Matern Child Health J 2015;19: 1121-30.

Campell D. Fear of pain causes a big rise in cesareans 2008. Available from:

https://www.theguardian.com/society/2008/oct/26/health-women

Bonica JJ. The pain of childbirth. 2nd ed. Edinburgh: Livingstone, 1988.

Supporting Healthy and Normal Physiologic

Childbirth: A Consensus Statement by ACNM, MANA, and NACPM. J Perinat Educ 2013; 22: 14–8.

Fabian HM, Rådestad IJ, Waldenström U. Childbirth and parenthood education classes in Sweden. Women's opinion and possible outcomes. Acta Obstet Gynecol Scand. 2005;84:436-43.

Clinical Management Guidelines for Obstetrician-Gynecologists, Number 70, December 2005 (Replaces Practice Bulletin Number 62, May 2005). Intrapartum fetal heart rate monitoring. Obstet Gynecol 2005;106:1453-60. Update in: Obstet Gynecol 2009;114: 192-202.

Sturrock Wa, Johnson Ja. The relationship between childbirth education classes and obstetric outcome. Birth 1990;17: 82-5.

Stoll KH, Hall W. Childbirth Education and Obstetric Interventions Among Low-Risk Canadian Women: Is There a Connection? The Journal of Perinatal Education 2012;21: 229-37.

Lederman RP, Lederman E, Work BA. Relationship of psychological factors in pregnancy to progress in labor. Nurs Res 1979;28: 94-7.

Lowe NK. Self-efficacy for labor and childbirth fears in nulliparous pregnant women. J Psychosom Obstet Gynaecol 2000;21: 219-24.

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: 567-76.

Tsui MH, Pang MW, Melender HL, Xu L, Lau TK, Leung TN. Maternal fear associated with pregnancy and childbirth in Hong Kong Chinese women. Women Health 2006;44: 79-92.

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: 667-77.

Melender HL. Experiences of fears associated with

pregnancy and childbirth: a study of 329 pregnant women. Birth 2002;29: 101-11.

Guidelines for Perinatal Care, 7th ed. Washington, 2012, p 158.

Rouhe H, Salmela-Aro K, Toivanen R, Tokola M, Halmesmäki E, Saisto T. Obstetric outcome after intervention for severe fear of childbirth in nulliparous women - randomised trial. BJOG 2013 ;120: 75-84.

Toohill J, Fenwick J, Gamble J, Creedy DK, Buist A, Turkstra E,et al. A randomized controlled trial of a psycho-education intervention by midwives in reducing childbirth fear in pregnant women. Birth 2014;41: 384-94.

Størksen HT, Garthus-Niegel S, Adams SS, Vangen S, Eberhard-Gran M. Fear of childbirth and elective caesarean section: a population-based study. BMC Pregnancy Childbirth. 2015;15: 221.

Navaee M, Abedian Z. Effect of role play education on primiparous women's fear of natural delivery and their decision on the mode of delivery. Iran J Nurs Midwifery Res 2015; 20:40-6.

Fabian HM, Rådestad IJ, Waldenström U. Childbirth and parenthood education classes in Sweden. Women's opinion and possible outcomes. Acta Obstet Gynecol Scand 2005; 84:436-43.

Saisto T, Toivanen R, Salmela-Aro K, Halmesmäki E. Therapeutic group psychoeducation and relaxation in treating fear of childbirth. Acta Obstet Gynecol Scand 2006;85: 1315-9.

Published
2016-12-21
How to Cite
1.
Masoumi SZ, Kazemi F, Oshvandi K, Jalali M, Esmaeili Vardanjani A, Rafiei H. Effect of Training Preparation for Childbirth on Fear of Normal Vaginal Delivery and Choosing the Type of Delivery Among Pregnant Women in Hamadan, Iran: A Randomized Controlled Trial. J Fam Reprod Health. 10(3):115-121.
Section
Original Articles