Laughter Yoga's Impact on Traumatic Childbirth Preparation

The Effects Of Laughter Yoga-Supported Childbirth Preparation Training On Traumatic Birth Perception, Fear Of Birth, Prenatal Depression, And Attachment: A Randomized Controlled Study

This study will be conducted as a single-center, parallel-group, randomized controlled intervention trial to determine the effects of birth preparation training supported by laughter yoga on the perception of traumatic birth, fear of birth, prenatal depression, and attachment in primiparous women. The research population will consist of pregnant women who attend the Pregnancy Clinic of the Department of Obstetrics and Gynecology at Cebeci Medical Faculty, Ankara University. The study will involve two groups: the first group will receive birth preparation training supported by laughter yoga, while the second group will receive standard birth preparation training. A total of 68 pregnant women, 34 in each group, are planned to participate in the study. Data will be collected using the Introductory Information Form, Traumatic Birth Perception Scale, Prenatal Self-Assessment Scale Fear of Birth Subscale, Edinburgh Depression Scale, and Prenatal Attachment Inventory. These instruments will be administered to the participants three times: before the training, immediately after the training, and one month later. The research data will be analyzed using the Statistical Package for Social Sciences (SPSS) version 24. Descriptive statistics (number, percentage, mean, standard deviation, minimum, and maximum values) will be used for data analysis. Independent samples t-test will be employed for comparisons between two independent groups, paired samples t-test will be used for repeated measures, one-way ANOVA will be used for comparisons among more than two groups, and Pearson correlation analysis will be applied for the relationship between two quantitative variables.

When data do not follow a normal distribution, the Mann-Whitney U test will be used for comparisons between two independent groups, the Wilcoxon signed-rank test will be used for repeated measures, the Kruskal-Wallis test will be used for comparisons among more than two groups, and Spearman correlation analysis will be used for the relationship between two quantitative variables. The reliability of the scales used in the study will be determined using Cronbach's alpha coefficient. Statistical significance will be set at p < 0.05.

Study Overview

• Status: Not yet recruiting
• Conditions: Pregnancy Related; Maternal Distress; Prenatal Stress
• Intervention / Treatment: Other: Laughter Yoga; Other: Standard Childbirth Preparation Training

• Study Type: Interventional
• Enrollment (Estimated): 68
• Phase: Not Applicable

Contacts and Locations

• Study Contact: Name: Serkan Yılmaz, Prof.Dr.; Phone Number: 03123191450; Email: Yilmaz.Serkan@ankara.edu.tr

Study Locations

• Turkey
  • Ankara, Turkey
    • Ankara University

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: Adult; Older Adult
• Accepts Healthy Volunteers: Yes

Description

Inclusion Criteria:

• Women aged 18 years and older.
• Pregnant individuals between 20-26 weeks of gestation (Childbirth preparation training should begin by the 20th week of pregnancy according to the recommendations of the Turkish Ministry of Health, and since the training is planned to last 4 weeks, participants will be recruited before entering the third trimester).
• First-time pregnancies.
• Individuals who understand, speak, and can read and write in Turkish.
• Women who consent to participate in the study.

Exclusion Criteria:

• Women with high-risk pregnancies (such as placenta previa, history of antepartum bleeding, ruptured membranes, preeclampsia, hypertension, diabetes, or other medical conditions, intrauterine growth restriction, multiple pregnancies, fetal anomalies, or any contraindications for normal vaginal delivery, substance or alcohol dependence, chronic illnesses, etc.).
• Individuals diagnosed with psychiatric disorders.
• Those who have received psychotherapy or medication within the last six months prior to the study.
• Pregnant women with prior training or experience in cognitive awareness-based or mind-body methods.

Study Plan

How is the study designed?

Design Details

• Primary Purpose: Supportive Care
• Allocation: Randomized
• Interventional Model: Parallel Assignment
• Masking: Single

Number of Arms

2

Arms and Interventions

Participant Group / Arm	Intervention / Treatment
Experimental: Experimental Group (Laughter Yoga-Supported Childbirth Preparation Training); Similar to the control group, the training will be conducted by the researcher, covering the same content as the standard childbirth preparation training. However, in addition to this, the experimental group will participate in Laughter Yoga sessions lasting 45 minutes each week for a total of 4 sessions. These sessions will include 30 minutes of laughter and breathing exercises, followed by 15 minutes of laughter meditation and relaxation	Other: Laughter Yoga; Laughter Yoga sessions lasting 45 minutes each week for a total of 4 sessions. These sessions will include 30 minutes of laughter and breathing exercises, followed by 15 minutes of laughter meditation and relaxation; Other: Standard Childbirth Preparation Training; the sessions will be conducted in groups of 8 participants. Various educational materials, including visual aids, will be used, and the training will involve presentations, direct instruction, video displays, and question-and-answer sessions
Active Comparator: Control Group (Standard Childbirth Preparation Training); The sessions will be conducted in groups of 8 participants. Various educational materials, including visual aids, will be used, and the training will involve presentations, direct instruction, video displays, and question-and-answer sessions.	Other: Standard Childbirth Preparation Training; the sessions will be conducted in groups of 8 participants. Various educational materials, including visual aids, will be used, and the training will involve presentations, direct instruction, video displays, and question-and-answer sessions

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Traumatic Birth Perception	• Traumatic Birth Perception Scale: Developed by Yalnız et al. (2016) to assess the level of traumatic birth perception among women of reproductive age, this scale consists of 13 items related to feelings of anxiety, fear, and worry when thinking about childbirth. Scoring ranges from 0 to 10 for each item, with a total possible score of 0 to 130. Higher scores indicate a greater perception of traumatic birth. The Cronbach's alpha reliability coefficient for this scale is 0.89 (Yalnız et al., 2017).	It will be administered three times: before the training, immediately after, and one month later.
Birth Fear	• Prenatal Self-Assessment Scale Birth Fear Subscale: This scale, developed by Lederman (1979), evaluates pregnant women's adjustment to motherhood. The Turkish reliability and validity study was conducted by Beydağ and Mete (2008). The Birth Fear Subscale consists of 10 items, with possible scores ranging from 10 to 40. Higher scores indicate greater fear of childbirth. The Cronbach's alpha reliability coefficient for this subscale is reported as 0.79 in Lederman's study and 0.84 in Beydağ and Mete's study.	It will be administered three times: before the training, immediately after, and one month later.
Prenatal Attachment	• Prenatal Attachment Inventory (PBE): Developed by Müller (1993) and adapted to Turkish by Yılmaz and Beji (2013), this 21-item scale assesses emotional experiences and attachment levels during pregnancy. Scores range from 21 to 84, with higher scores indicating stronger attachment. The Cronbach's alpha for this scale is 0.84 (Yılmaz & Beji, 2013), and it will be administered at the same intervals.	It will be administered three times: before the training, immediately after, and one month later.
Prenatal Depression	• Edinburgh Depression Scale: Developed by Cox et al. (1987), this scale assesses the risk, level, and severity of postpartum depression. The Turkish validity and reliability study was conducted by Engindeniz et al. (1996), with an internal consistency coefficient of 0.79. The scale consists of 10 items rated on a 4-point Likert scale. Although designed for postpartum assessment, it will be used during pregnancy. The Cronbach's alpha coefficients for the three trimesters were 0.82, 0.83, and 0.84, respectively (Bergin et al., 2011).	It will be administered three times: before the training, immediately after, and one month later.

Collaborators and Investigators

• Sponsor: Ankara University
• Investigators: Study Chair: İlknur Gönenç, Assoc. Prof. Dr., Ankara University

Study record dates

Study Major Dates

• Study Start (Estimated): December 30, 2024
• Primary Completion (Estimated): September 30, 2025
• Study Completion (Estimated): March 31, 2026

Study Registration Dates

• First Submitted: October 25, 2024
• First Submitted That Met QC Criteria: October 27, 2024
• First Posted (Actual): October 29, 2024

Study Record Updates

• Last Update Posted (Actual): October 29, 2024
• Last Update Submitted That Met QC Criteria: October 27, 2024
• Last Verified: October 1, 2024

More Information

Terms related to this study

• Keywords: Laughter Yoga; Fear of Childbirth; Prenatal Depression; Prenatal Attachment; Perception of Traumatic Birth; Childbirth Preparation Training
• Other Study ID Numbers: Ankara U

Plan for Individual participant data (IPD)

• Plan to Share Individual Participant Data (IPD)?: NO
• IPD Plan Description: Data will be shared when requested and necessary.

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No
• Studies a U.S. FDA-regulated device product: No