The Effects of Antenatal Education and Counseling on Childbirth Fear of Nulliparous Women

November 20, 2019 updated by: Saglik Bilimleri Universitesi Gulhane Tip Fakultesi

The Effects of Antenatal Education and Counseling on Childbirth Fear of Nulliparous Women and Their Attitudes Towards Childbirth

This study investigates the effects of antenatal education and counseling on childbirth preparation and pain management given to nulliparous women during the last trimester on their childbirth fear and childbirth attitudes.

Study Overview

Status

Completed

Conditions

Intervention / Treatment

Detailed Description

Pregnancy is an important period of life that the pregnant women have biological, physiological, emotional and social changes in order to adapt to maternity. Fear of childbirth is a common problem and has a negative impact on the childbirth experience. The prevalence of fear associated with childbirth is around 20% but approximately 6 to 10% of women experience intense fear of labour. In Turkey, it estimated that the prevalence of childbirth fear among the Turkish pregnant women was approximately 21% . Fear of childbirth can cause significant problems during childbirth and the postpartum period. This fear is commonly associated with concern for the baby, pain in childbirth, longer first and second stage of labour and dissatisfaction with the childbirth experiences. Especially nulliparous women experience fear of childbirth more than multipar women. Fear of childbirth has also been implicated in women's requests for caesarean sections and increased rate of elective caesarean sections. Antenatal education is an essential health service throughout the world. Antenatal education during the last trimester may decrease childbirth fear. Also, pregnant women who received antenatal education, had a positive birth experience, better maternal adjustment and fewer symptoms of postnatal depression. The aim of this study was to investigate the effects of antenatal education and counseling on childbirth preparation and pain management given to nulliparous women during the last trimester on their childbirth fear and childbirth attitudes.

This randomized controlled study was conducted at Gulhane Training and Research Hospital, Obstetrics and Gynecology clinic between February 2016 and January 2017. 132 nulliparous women between the 28th and 34th gestational weeks constituted the sample of the study. Data was collected by using personal information questionnaire, the Wijma Delivery Expectancy/Experience Questionairre (W-DEQ) Version A, W-DEQ Version B, and Childbirth Attitudes Questionairre (CAQ). Following the pretest, participants in the intervention group received childbirth preparation education and telephone counseling. Participants in the control group received no intervention other than the routine antenatal follow-up. For both groups, pretest and posttest were conducted during the same days, antenatal evaluation took place between the 38th and the 40th gestational weeks and postnatal evaluation was conducted during the first and the second postnatal days. The IBM SPSS (Statistical package for the Social Sciences) 22.0 package program was used to evaluate the data obtained in the study.

Study Type

Interventional

Enrollment (Actual)

132

Phase

  • Not Applicable

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

18 years to 35 years (Adult)

Accepts Healthy Volunteers

Yes

Genders Eligible for Study

Female

Description

Inclusion Criteria:

  • Nulliparity
  • 28-34th gestational age
  • Single fetus
  • not receive IVF treatment
  • Normal vaginal birth

Exclusion Criteria:

  • Caesarean section

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: Prevention
  • Allocation: Randomized
  • Interventional Model: Parallel Assignment
  • Masking: Double

Arms and Interventions

Participant Group / Arm
Intervention / Treatment
Experimental: Intervention
Pregnant women in intervention group completed the PIQ, W-DEQ-A and CAQ between the 28th and the 34th gestational weeks. Date of the next antenatal follow-up of the participants in the intervention group was recorded and they were given an appointment for the antenatal education. Women, whose date of next antenatal follow-up was unknown, were asked to inform the researchers about their appointment. Following the antenatal follow-up, the pregnant women in the intervention group were given an antenatal childbirth education and an educational brochure after the education. Also, provided telephone counseling to the intervention group one week after the education. Participants in the intervention group filled the W-DEQ-A and CAQ during the 38th and the 40th gestational weeks. Finally, were completed the W-DEQ-B during the first and the second postnatal days.
Behavioral: Education and Counseling
Following the pretests between the 28th and the 34th gestational weeks, nulliparous women in the intervention group received a presentation on childbirth preparation at a room of the obstetrics clinic. The education was completed in two sections in a single day. Each session took about 45 minutes there was a 15-minute break between the sessions. Following the education, the questions of the participants were responded and educational brochures on childbirth preparation were given to the participants. One of the researchers of this study telephoned the participant women in the intervention group one week after the childbirth education and provided counseling service about the demands and the points that the nulliparous women wondered.
No Intervention: Control
Pregnant women in control group completed the PIQ, W-DEQ-A and CAQ between the 28th and the 34th gestational weeks. Participants in the control group filled the W-DEQ-A and CAQ during the 38th and the 40th gestational weeks. Finally, were completed the W-DEQ-B during the first and the second postnatal days.

What is the study measuring?

Primary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Wijma Delivery Expectancy/Experience Questionairre (Version A) (W-DEQ-A)
Time Frame: 10 minutes
Participants filled before and after education and counseling W-DEQ-A was developed by Klaas and Barbro Wijma in Sweden in 1998. Cronbach's alpha of the scale was 0.88 for primiparous women. The scale consisted of 33 items, which are rated on a six-point Likert type scale (zero=do not agree; five=totally agree). Items 2, 3, 6, 7, 8, 11, 12, 15, 19, 20, 24, 25, 27 and 31 were reverse-scored to calculate the women's individual total score. Higher scores indicated greater fear that the pregnant women experienced. Cutting score of the questionnaire was 85.
10 minutes
Wijma Delivery Expectancy/Experience Questionairre (Version B) (W-DEQ-B)
Time Frame: 10 minutes
Participants filled on the first and second days of postpartum W-DEQ-B was developed by Klaas and Barbro Wijma in 1998 in order to determine postpartum pains and the feelings and thoughts of women after childbirth. The questionnaire included 32 items rated on a six-point Likert type scale (zero=not at all; five=extremely). Items 2, 3, 6, 7, 10, 11, 14, 18, 19, 23, 24, 26, and, 30 were reverse scored and higher scores indicated greater postnatal fear of childbirth. The questionnaire had six subscales, namely, concerns about labor pain, loneliness, lack of positive feelings, concerns about childbirth, and concerns about baby.
10 minutes
Childbirth Attitudes Questionnaire (CAQ)
Time Frame: 5 minutes
Participants filled before and after education and counseling CAQ was developed by Lowe in 2000 in order to measure the fear of childbirth. Cronbach's alpha of the scale was 0.83. The questionnaire included 16 items rated on a four-point Likert type scale. Higher scores indicated greater fear.
5 minutes

Collaborators and Investigators

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

Sponsor

Saglik Bilimleri Universitesi Gulhane Tip Fakultesi

Investigators

  • Principal Investigator: Gulten Guvenc, Prof. Dr., University of Health Sciences, Gulhane Faculty of Nursing

Publications and helpful links

The person responsible for entering information about the study voluntarily provides these publications. These may be about anything related to the study.

General Publications

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 (Actual)

February 15, 2016

Primary Completion (Actual)

January 15, 2017

Study Completion (Actual)

January 15, 2017

Study Registration Dates

First Submitted

November 20, 2019

First Submitted That Met QC Criteria

November 20, 2019

First Posted (Actual)

November 21, 2019

Study Record Updates

Last Update Posted (Actual)

November 21, 2019

Last Update Submitted That Met QC Criteria

November 20, 2019

Last Verified

November 1, 2019

More Information

Terms related to this study

Keywords

Other Study ID Numbers

  • 50687469-1491

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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