title: A randomized controlled trial of a psycho-education intervention by midwives in reducing childbirth fear in pregnant women.
abstract: BACKGROUND
  Childbirth fear is associated with increased obstetric interventions and poor emotional and psychological health for women. The purpose of this study is to test an antenatal psycho-education intervention by midwives in reducing women's childbirth fear.
  
  
  METHODS
  Women (n = 1,410) attending three hospitals in South East Queensland, Australia, were recruited into the BELIEF trial. Participants reporting high fear were randomly allocated to intervention (n = 170) or control (n = 169) groups. All women received a decision-aid booklet on childbirth choices. The telephone counseling intervention was offered at 24 and 34 weeks of pregnancy. The control group received usual care offered by public maternity services. Primary outcome was reduction in childbirth fear (WDEQ-A) from second trimester to 36 weeks' gestation. Secondary outcomes were improved childbirth self-efficacy, and reduced decisional conflict and depressive symptoms. Demographic, obstetric & psychometric measures were administered at recruitment, and 36 weeks of pregnancy.
  
  
  RESULTS
  There were significant differences between groups on postintervention scores for fear of birth (p < 0.001) and childbirth self-efficacy (p = 0.002). Decisional conflict and depressive symptoms reduced but were not significant.
  
  
  CONCLUSIONS
  Psycho-education by trained midwives was effective in reducing high childbirth fear levels and increasing childbirth confidence in pregnant women. Improving antenatal emotional well-being may have wider positive social and maternity care implications for optimal childbirth experiences.
authors.affiliation: Griffith Health Institute, School of Nursing & Midwifery, Griffith University, Brisbane, Qld, Australia.
authors.forename: Jocelyn
authors.initials: J
authors.lastname: Toohill
authors.forename: Jennifer
authors.initials: J
authors.lastname: Fenwick
authors.forename: Jenny
authors.initials: J
authors.lastname: Gamble
authors.forename: Debra K
authors.initials: DK
authors.lastname: Creedy
authors.forename: Anne
authors.initials: A
authors.lastname: Buist
authors.forename: Erika
authors.initials: E
authors.lastname: Turkstra
authors.forename: Elsa-Lena
authors.initials: EL
authors.lastname: Ryding
mesh_terms: D000293:Adolescent; D000328:Adult; D001007:Anxiety / Q000523:psychology / Q000628:therapy*; D003376:Counseling / Q000379:methods*; D003661:Decision Support Techniques; D003863:Depression / Q000523:psychology / Q000628:therapy; D005239:Fear / Q000523:psychology*; D005260:Female; D006801:Humans; D008875:Middle Aged; D008880:Midwifery / Q000379:methods*; D036801:Parturition / Q000523:psychology*; D011247:Pregnancy; D064186:Prenatal Education / Q000379:methods*; D020377:Self Efficacy; D016896:Treatment Outcome; D055815:Young Adult
keywords: RCT; childbirth fear; childbirth self-efficacy; decisional conflict; depression; midwife counseling; psycho-education