title: Nulliparous pregnant women's narratives of imminent childbirth before and after internet-based cognitive behavioural therapy for severe fear of childbirth: a qualitative study.
abstract: OBJECTIVE
  To describe the expectations concerning imminent childbirth before and after 8 weeks of internet-based cognitive behavioural therapy (ICBT) among nulliparous pregnant women with severe fear of childbirth.
  
  
  METHODS
  Qualitative study of nulliparous pregnant women's narratives before and after CBT.
  
  
  METHODS
  The first ICBT programme for treating severe fear of childbirth.
  
  
  METHODS
  Fifteen nulliparous pregnant Swedish women with severe fear of childbirth participating in an ICBT self-help programme.
  
  
  METHODS
  Semi-structured open-ended questions over the internet before and after 8 weeks of ICBT. The data were analysed using thematic analysis.
  
  
  METHODS
  The participants' narratives pertaining to five different situations during labour and delivery before and after ICBT.
  
  
  RESULTS
  After therapy, participants described a more realistic attitude towards imminent childbirth, more self-confidence and more active coping strategies. They perceived their partners and the staff as more supportive. They were more aware of the approaching meeting with their baby when giving birth.
  
  
  CONCLUSIONS
  Following the ICBT programme, participants changed their attitude towards imminent childbirth from negative to more positive. This was manifested in positive and more realistic expectations regarding themselves, their partner and the staff that would look after them.
authors: Unit of Medical Psychology, Department of Clinical and Experimental Medicine, Faculty of Health Sciences, Linköping University, Linköping, Sweden.
authors: K
authors: K
authors: Nieminen
authors: Department of Behavioural Sciences and Learning, Linköping University, Linköping, Sweden.
authors: A
authors: A
authors: Malmquist
authors: Unit of Gender and Medicine, Department of Clinical and Experimental Medicine, Faculty of Health Sciences, Linköping University, Linköping, Sweden.
authors: B
authors: B
authors: Wijma
authors: Division of Obstetrics and Gynaecology, Department of Women's and Children's Health, Karolinska Institutet, Stockholm, Sweden.
authors: E-L
authors: EL
authors: Ryding
authors: Department of Behavioural Sciences and Learning, Linköping University, Linköping, Sweden.|Division of Psychiatry, Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden.
authors: G
authors: G
authors: Andersson
authors: Unit of Medical Psychology, Department of Clinical and Experimental Medicine, Faculty of Health Sciences, Linköping University, Linköping, Sweden.
authors: K
authors: K
authors: Wijma
mesh_terms: D000223:Adaptation, Psychological; D000328:Adult; D001007:Anxiety / Q000628:therapy*; D001294:Attitude to Health; D015928:Cognitive Behavioral Therapy / Q000379:methods; D036861:Delivery, Obstetric / Q000523:psychology*; D005239:Fear; D005260:Female; D006801:Humans; D007231:Infant, Newborn; D020407:Internet; D017060:Patient Satisfaction; D011247:Pregnancy; D011256:Pregnancy Outcome; D037841:Pregnant People / Q000523:psychology*; D015995:Prevalence; D036301:Qualitative Research; D012307:Risk Factors; D012648:Self Care; D011795:Surveys and Questionnaires; D013548:Sweden / Q000453:epidemiology; D016896:Treatment Outcome
keywords: Active coping; appraisal; delivery; fear of childbirth; internet cognitive behavioural therapy; self-confidence