An economic evaluation alongside a randomised controlled trial on psycho-education counselling intervention offered by midwives to address women's fear of childbirth in Australia.
OBJECTIVE
The rate of caesarean section continues to increase, and there is evidence that childbirth fear is a contributing factor. Insufficient evidence is available on the impact of reducing childbirth fear on health-related quality of life and health service use. We undertook an economic evaluation of a psycho-education counselling intervention offered by midwives to address women's fear of childbirth in Australia.


METHODS
Pregnant women (n = 339) with high childbirth fear were randomised to a midwife-led psycho-education intervention for childbirth fear or to usual care. This paper presents the economic evaluation of the intervention based on health-related quality of life and health service use from recruitment to six weeks postpartum (n = 184).


RESULTS
The changes in health-related quality of life after birth (EQ-5D-3L: 0.016 vs. 0.010, p = 0.833, for usual care and intervention) and total health care use cost (AUS$10,110 vs. AUS$9980, p = 0.819) were similar between groups. The intervention did not increase costs; however, in a post hoc analysis, the interventions might be cost-effective for those women with very high childbirth fear.


CONCLUSIONS
This brief psycho-education intervention by midwives did not improve the health-related quality of life of women, and had no impact on overall cost.
Centre for Applied Health Economics, Menzies Health Institute Queensland, Griffith University, Australia. Electronic address: e.turkstra@griffith.edu.au.
Erika
E
Turkstra
Centre for Applied Health Economics, Menzies Health Institute Queensland, Griffith University, Australia.
Gabor
G
Mihala
Centre for Applied Health Economics, Menzies Health Institute Queensland, Griffith University, Australia.
Paul A
PA
Scuffham
Centre for Health Practice Innovation, Menzies Health Institute Queensland, Griffith University, Australia.
Debra K
DK
Creedy
Centre for Health Practice Innovation, Menzies Health Institute Queensland, Griffith University, Australia.
Jenny
J
Gamble
Centre for Health Practice Innovation, Menzies Health Institute Queensland, Griffith University, Australia.
Jocelyn
J
Toohill
Centre for Health Practice Innovation, Menzies Health Institute Queensland, Griffith University, Australia; Gold Coast Hospital, Australia.
Jennifer
J
Fenwick
D000328:Adult; D001315:Australia; D003362:Cost-Benefit Analysis; D003376:Counseling / Q000191:economics*; D036861:Delivery, Obstetric / Q000523:psychology*; D005239:Fear; D005260:Female; D006296:Health Services / Q000706:statistics & numerical data; D006801:Humans; D008880:Midwifery; D009721:Nurse Midwives; D036801:Parturition / Q000523:psychology*; D010353:Patient Education as Topic / Q000191:economics*; D049590:Postpartum Period; D011247:Pregnancy; D037841:Pregnant People / Q000523:psychology; D011788:Quality of Life
Childbirth fear; Health services use; Health-related quality of life; Healthcare cost; Postpartum; Psycho-education