IMEMR
66.92
Volume 4, Issue 2 (2023)                   J Clinic Care Skill 2023, 4(2): 83-89 | Back to browse issues page
Article Type:
Original Research |

Print XML PDF HTML

History

How to cite this article
Borghei N, Alijani H, Naghinasab Ardehaee F. Effect of Cognitive-Behavioral Education on Fear of Childbirth During Pregnancy; a Clinical Trial. J Clinic Care Skill 2023; 4 (2) :83-89
URL: http://jccs.yums.ac.ir/article-1-188-en.html
Download citation:
BibTeX | RIS | EndNote | Medlars | ProCite | Reference Manager | RefWorks
Send citation to:

Rights and permissions
1- “Counseling and Reproductive Health Research Centre” and “Department of Midwifery, School of Nursing and Midwifery”, Golestan University of Medical Sciences, Gorgan, Iran , borghei2006@yahoo.com
2- “Counseling and Reproductive Health Research Centre” and “Department of Midwifery, School of Nursing and Midwifery”, Golestan University of Medical Sciences, Gorgan, Iran
Abstract   (1733 Views)
Aims: Fear of childbirth (FOB) in pregnant women is critical because it may affect prenatal outcomes. This study aimed to determine the effect of cognitive-behavioral education on fear of childbirth during pregnancy.
Materials & Methods: A clinical trial study with two intervention groups and one control group was conducted among nulliparous women visiting Gorgan health centers in the first six months of 2018. Among 211 nulliparous pregnant women, 104 with a FOB score of 55 or higher were divided into control and intervention groups. The women in the intervention group were randomly assigned to two groups. The first intervention group received conventional prenatal education, the second group received cognitive-behavioral techniques, and the control group received routine prenatal care. The data collection tool was the Wijma Delivery/Expectancy Fear of Childbirth Questionnaire (version A). The data were analyzed using SPSS version 18 and Chi-square, Fisher’s exact test, ANOVA, and Welch. Paired t-test, Wilcoxon tests, ANOVA, and Kruskal-Wallis tests.
Findings: Comparing the rate of change in the scores of FOB indicated significant differences in all fields between the control and cognitive-behavioral techniques groups (p<0.05), but the conventional prenatal education group showed no significant difference (p>0.05). However, the control group exhibited a significant increase in all fields of FOB, while the cognitive-behavioral techniques group showed a significant reduction.
Conclusion: FOB is reduced more in pregnant women with prenatal education based on cognitive-behavioral techniques than conventional education.

 
Keywords:

References
1. Sadock BJ, Sadock VA. Kaplan and sadock's synopsis of psychiatry: Behavioral sciences/clinical psychiatry. Pennsylvania: Lippincott Williams and Wilkins; 2011. [link]
2. Fraser D, Cooper M. Myles textbook for midwives: The world's favourite midwifery textbook!. London: Churchill Livingstone; 2009. [link]
3. 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(4):394-400. [DOI:10.1016/j.midw.2008.10.011]
4. Salmela-Aro K, Read S, Rouhe H, Halmesmäki E, Toivanen RM, Tokola MI, et al. Promoting positive motherhood among nulliparous pregnant women with an intense fear of childbirth: RCT intervention. J Health Psychol. 2012;17(4):520-34. [DOI:10.1177/1359105311421050]
5. Sydsjö G, Sydsjö A, Gunnervik C, Bladh M, Josefsson A. Obstetric outcome for women who received individualized treatment for fear of childbirth during pregnancy. Acta Obstet Gynecol Scand. 2012;91(1):44-9. [DOI:10.1111/j.1600-0412.2011.01242.x]
6. Nasiry F, Sharifi S. Relationship between fear of childbirth and personality type in pregnant women. Iran J Obstet Gynecol Infertility. 2013;16(66):18-25. [Persian] [link]
7. Leeman LM, Plante LA. Patient-choice vaginal delivery?. Ann Fam Med. 2006;4(3):265-8. [DOI:10.1370/afm.537]
8. Alijani H, Borghei NS, Behnampour N. Fear of childbirth in pregnancy and some of its effective factors. J Res Dev Nurs Midw. 2019;16(1):59-68. [Persian] [DOI:10.29252/jgbfnm.16.1.60]
9. Fuglenes D, Aas E, Botten G, Øian P, Kristiansen IS. Why do some pregnant women prefer cesarean? The influence of parity, delivery experiences, and fear. Am J Obstet Gynecol. 2011;205(1):45. e1-9. [DOI:10.1016/j.ajog.2011.03.043]
10. 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(5):567-76. [DOI:10.1111/j.1552-6909.2009.01054.x]
11. Pournamdarian S, Birashk B, Farid AA. The clarification of contribution of metacognitive beliefs in explaining the symptoms of depression, anxiety and stress in nurses. Knowl Res Appl Psychol. 2012;13(49):86-94. [Persian] [link]
12. Najafi Sharjabad F, Keshavarz P, Moradian Z. Survey on the prevalence and influencing factors for choosing Normal vaginal delivery among pregnant women in Bushehr City, 2015. Community Health J. 2018;11(1):20-9. [Persian] [link]
13. Andaroon N, Kordi M, Kimiaei SA, Esmaeili H. Relationship between Intensity of fear of childbirth with choosing mode of delivery in primiparous women. Iran J Obstet Gynecol Infertility. 2017;20(5):68-75. [Persian] [link]
14. Fenwick J, Gamble J, Creedy DK, Buist A, Turkstra E, Sneddon A, et al. Study protocol for reducing childbirth fear: A midwife-led psycho-education intervention. BMC Pregnancy Childbirth. 2013;13(1):190. [DOI:10.1186/1471-2393-13-190]
15. Perry S, Lowdermilk D. Clinical Companion for Maternity Nursing. Amsterdam: Elsevier; 2007. [link]
16. Riley LE, Stark A, Kilpatrick S, Papile L. Guidelines for perinatal care. 7th ed. Washington (DC): American Academy; 2012. [link]
17. Gagnon AJ, Sandall J. Individual or group antenatal education for childbirth or parenthood, or both. Cochrane Database Syst Rev. 2007;2007(3):CD002869. [DOI:10.1002/14651858.CD002869.pub2]
18. Brixval CS, Axelsen SF, Andersen SK, Due P, Koushede V. The effect of antenatal education in small classes on obstetric and psycho-social outcomes: A systematic review and meta-analysis protocol. Syst Rev. 2014;4:20. [DOI:10.1186/s13643-015-0010-x]
19. Farajzadegan Z, Zamani AR, Valiani M, Golshah E. Evaluation of "facility of physiologic delivery program" in selective hospitals of Isfahan, Iran. J Isfahan Med School, 2011;28(122):1814-9. [Persian] [link]
20. Ahmadi FZ. Application of the principles of Vella's dialogue education in antenatal education programs: A qualitative research. Iran J Med Educ. 2013;13(5):373-87. [Persian] [link]
21. Butler AC, Chapman JE, Forman EM, Beck AT. The empirical status of cognitive-behavioral therapy: A review of meta-analyses. Clin Psychol Rev. 2006;26(1):17-31. [DOI:10.1016/j.cpr.2005.07.003]
22. Arch JJ, Dimidjian S, Chessick C. Are exposure-based cognitive behavioral therapies safe during pregnancy?. Arch Womens Ment Health. 2012;15(6):445-57. [DOI:10.1007/s00737-012-0308-9]
23. Martin C, Jones C, Marshall C, Jomeen J. Childbirth-related fear, tokophobia, and cognitive behavioral therapy. Handbook of Lifespan Cognitive Behavioral Therapy. Cambridge: Academic Press; 2023 [DOI:10.1016/B978-0-323-85757-4.00043-2]
24. Poorjandaghi M, Vakilian K, Khorsandi M, Abdi M. Effect of cognitive-behavioral therapy focused on self-esteem on fear of childbirth: A counseling approach in prenatal care and a randomized clinical trial. Int J Womens Health Reproduct Sci. 2022;10(1):31-7 [DOI:10.15296/ijwhr.2022.07]
25. Nunes LRC, Coutinho FC, Andréa dos Santos V. Fear of childbirth: A review of interventions based on cognitive-behavioral therapy. Psicologia: Teoria e Prática. 2022;24(1). [DOI:10.5935/1980-6906/ePTPCP14089.en]
26. Hossein Khanzadeh A, Rostampour A, Khosrojavid M, Nedaee N. Effectiveness of cognitive-behavioral education on anxiety during pregnancy and delivery method in primiparous women. J Nurs Educ. 2017;5(6):24-32. [Persian] [DOI:10.21859/jne-05064]
27. Ghalehkhani Safat S, Iravani M, Sayah Bargard M, Latify M. Efficacy of cognitive behavioral therapy-based self-management intervention on labor outcome in nulliparous women. J Mazandaran Univ Med Sci. 2018;28(160):123-32. [Persian] [link]
28. Khoursandi M, Vakilian K, Torabi Goudarzi M, Abdi M. Childbirth preparation using behavioral-cognitive skill in childbirth outcomes of primiparous women. J Babol Univ Med Sci. 2013;15(4):76-80. [Persian] [link]
29. Nieminen K, Andersson G, Wijma B, Ryding EL, Wijma K. Treatment of nulliparous women with severe fear of childbirth via the internet: A feasibility study. J Psychosom Obstet Gynecol. 2016;37(2):37-43. [DOI:10.3109/0167482X.2016.1140143]
30. 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(2):84-97. [DOI:10.3109/01674829809048501]
31. Abedi P, Hazeghi N, Afshari P, Fakhri A. The validity and reliability of persian version of wijma delivery expectancy/experience questionnaire (version a) among Iranian nulliparous women. Glob J Health Sci. 2017;9(2):269. [DOI:10.5539/gjhs.v9n2p269]
32. Uçar T, Golbasi Z. Effect of an educational program based on cognitive behavioral techniques on fear of childbirth and the birth process. J Psychosom Obstet Gynaecol. 2019;40(2):146-55. [DOI:10.1080/0167482X.2018.1453800]
33. Ghazaie M, Davoodi I, Neysi A, Mehrabizadeh Honarmand M, BasakNejad S. Effectiveness of cognitive behavioral therapy and psychoeducation on fear of natural childbirth and its related variables. Q Appl Psychol. 2018;12(1):103-25. [Persian] [link]
34. Dareshouri Mohammadi Z, Bosaknejad S, Sarvghad S. A survey on the effectiveness of stress management training with cognitive-behavioral group therapy approach on state/trait anxiety, pregnancy anxiety and mental health of primiparous women. Jentashapir J Cell Mol Biol. 2012;3(4):e94054. [link]
35. Imanparast R, Bermas H, Danesh S, Ajoudani Z. The effect of cognitive behavior therapy on anxiety reduction of first normal vaginal delivery. J Shahid Sadoughi Uni Med Sci. 2014;22(1):974-80. [link]
36. Rondung E, Ternstrom E, Hildingsson I, Haines HM, Sundin O, Ekdahl J, et al. Comparing internet-based cognitive behavioral therapy with standard care for women with fear of birth: Randomized controlled trial. JMIR Ment Health. 2018;5(3):e10420. [DOI:10.2196/10420]
37. Azizi M, Kamali M, Elyasi F, Shirzad M. Fear of childbirth in Iran: A systematic review of psychological intervention research. Int J Reprod Biomed. 2021;19(5):401-420. [DOI:10.18502/ijrm.v19i5.9250]
38. Ternström E, Hildingsson I, Haines H, Karlström A, Sundin Ö, Ekdahl J, et al. A randomized controlled study comparing internet-based cognitive behavioral therapy and counselling by standard care for fear of birth -A study protocol. Sex Reprod Healthc. 2017;13:75-82. [DOI:10.1016/j.srhc.2017.06.001]
39. Guszkowska M. The effect of exercise and childbirth classes on fear of childbirth and locus of labor pain control. Anxiety Stress Coping. 2014;27(2):176-89. [DOI:10.1080/10615806.2013.830107]
40. Jaddoe VW. Antenatal education programmes: do they work?. Lancet. 2009;374(9693):863-4. [DOI:10.1016/S0140-6736(09)61610-X]