Educational Video, Anxiety, and Mode of Delivery After Previous Cesarean

January 1, 2026 updated by: Wolfson Medical Center

Does an Educational Video Increase Trial of Labor After Cesarean and Reduce Anxiety Among Women With a Prior Cesarean? A Randomized Controlled Trial

This interventional study evaluates whether video-based patient education regarding Trial of Labor After Cesarean (TOLAC) reduces maternal anxiety compared with standard verbal counseling. Pregnant women eligible for TOLAC will be randomized to receive either a structured educational video or routine verbal counseling. Maternal anxiety levels will be assessed using the State-Trait Anxiety Inventory (STAI).

Study Overview

Status

Not yet recruiting

Conditions

Intervention / Treatment

Detailed Description

Trial of labor after cesarean (TOLAC) is a complex clinical decision that may be associated with significant maternal anxiety. Adequate counseling is essential to support informed decision-making; however, the optimal method for delivering information remains unclear.

This randomized interventional study aims to assess whether video-based patient education can reduce anxiety levels compared with standard verbal counseling. Eligible pregnant women planning delivery after a previous cesarean section will be randomly assigned to one of two study arms: video-based educational counseling or standard verbal counseling.

Anxiety will be measured using the validated State-Trait Anxiety Inventory (STAI) questionnaire after counseling. The results of this study may inform future strategies for patient counseling and shared decision-making in women considering TOLAC.

Study Type

Interventional

Enrollment (Estimated)

90

Phase

  • Not Applicable

Contacts and Locations

This section provides the contact details for those conducting the study, and information on where this study is being conducted.

Study Contact

Participation Criteria

Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.

Eligibility Criteria

Ages Eligible for Study

  • Adult
  • Older Adult

Accepts Healthy Volunteers

No

Description

Inclusion Criteria:

  • Pregnant women with a singleton pregnancy.
  • History of one previous cesarean delivery with a low transverse uterine incision.
  • Eligible for a trial of labor after cesarean (TOLAC) according to clinical assessment and Israeli national clinical guidelines.
  • Age 18 years or older.
  • Hebrew-speaking.
  • Ability and willingness to provide written informed consent.

Exclusion Criteria:

  • Medical or obstetric conditions contraindicating vaginal delivery, including but not limited to placenta previa or marginal placenta previa.
  • History of uterine surgery other than one prior low transverse cesarean section that precludes vaginal delivery.
  • History of two or more prior cesarean deliveries.
  • Non-vertex fetal presentation or any presentation unsuitable for a trial of labor.
  • Multiple gestation.
  • Diagnosed severe anxiety disorder or other significant psychiatric disorder that may interfere with participation in the study or completion of questionnaires.

Study Plan

This section provides details of the study plan, including how the study is designed and what the study is measuring.

How is the study designed?

Design Details

  • Primary Purpose: Supportive Care
  • Allocation: Randomized
  • Interventional Model: Parallel Assignment
  • Masking: None (Open Label)

Arms and Interventions

Participant Group / Arm
Intervention / Treatment
Experimental: Experimental: Video-Based Patient Education
Participants receive structured video-based education regarding trial of labor after cesarean.
Behavioral: Video-Based Educational Intervention
A structured educational video providing information on benefits, risks, and expectations of trial of labor after cesarean.
Active Comparator: Active Comparator: Standard Verbal Counseling
Participants receive standard verbal counseling regarding trial of labor after cesarean.
Other: Standard Verbal Counseling
Routine verbal counseling provided by the treating clinician regarding trial of labor after cesarean.

What is the study measuring?

Primary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Maternal Anxiety Level
Time Frame: Immediately after completion of counseling.
Assessment of maternal anxiety using the State-Trait Anxiety Inventory (STAI) questionnaire.
Immediately after completion of counseling.

Secondary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Patient Knowledge Regarding Trial of Labor After Cesarean
Time Frame: Immediately after completion of counseling.
Assessment of patient knowledge regarding trial of labor after cesarean, based on a structured questionnaire developed for the study.
Immediately after completion of counseling.
Rate of Successful Trial of Labor After Cesarean (TOLAC)
Time Frame: From delivery.
Proportion of participants who achieved a successful vaginal birth following a trial of labor after cesarean.
From delivery.
Patient Satisfaction With Counseling Method
Time Frame: Immediately after completion of counseling.
Patient-reported satisfaction with the counseling method received (video-based education or standard verbal counseling), assessed using a Likert-scale questionnaire.
Immediately after completion of counseling.
Maternal Preference for Trial of Labor After Cesarean Versus Elective Repeat Cesarean Delivery
Time Frame: Immediately after completion of counseling.
Participant-reported preference for mode of delivery (trial of labor after cesarean versus elective repeat cesarean delivery) following counseling.
Immediately after completion of counseling.

Collaborators and Investigators

This is where you will find people and organizations involved with this study.

Sponsor

Wolfson Medical Center

Investigators

  • Principal Investigator: Shir Lev, MD, Wolfson Medical Center

Study record dates

These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.

Study Major Dates

Study Start (Estimated)

January 1, 2026

Primary Completion (Estimated)

December 1, 2026

Study Completion (Estimated)

December 1, 2027

Study Registration Dates

First Submitted

January 1, 2026

First Submitted That Met QC Criteria

January 1, 2026

First Posted (Actual)

January 14, 2026

Study Record Updates

Last Update Posted (Actual)

January 14, 2026

Last Update Submitted That Met QC Criteria

January 1, 2026

Last Verified

January 1, 2026

More Information

Terms related to this study

Additional Relevant MeSH Terms

Other Study ID Numbers

  • WOMC-0175-25

Plan for Individual participant data (IPD)

Plan to Share Individual Participant Data (IPD)?

NO

Drug and device information, study documents

Studies a U.S. FDA-regulated drug product

No

Studies a U.S. FDA-regulated device product

No

This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.

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