Randomized Controlled Trial of Interventions Used by Midwives to Treat Fear of Childbirth

Abstract

Background: Fear of childbirth affects women worldwide and can have adverse consequences. Midwives have implemented a number of interventions, autonomously or as part of a professional team. However, midwives have been unable to identify the most appropriate intervention for ensuring the reduction or alleviation of this fear to provide the best perinatal outcomes. Objective: This study aimed to evaluate the effectiveness of a prenatal educational intervention followed by specific support during childbirth, designed and delivered exclusively by midwives for women with a high fear of childbirth. Method: This randomized controlled trial was performed with two arms in two phases: an online prenatal education phase followed by a support phase during childbirth. Participating women with a high fear of childbirth, which was determined using the Wijma Delivery Expectancy Questionnaire–A–Spanish version, were assigned to the experimental group or the usual care control group at a 1:1 ratio. Results: Women showed a reduction in fear of childbirth in both phases of the study. According to the intention to treat analysis, a significant mean difference was observed in the prenatal stage in favor of the intervention group, as well as a nonsignificant difference in favor of this same group after delivery. Discussion: The effectiveness of continuous specific prenatal education with preferential support during childbirth by midwives was indicated by improvements in the level of fear of childbirth.