Developing A guide to coping with the fear of childbirth and evaluation of efficiency

This study was conducted to develop an evidence-based practice guide to coping with childbirth and to evaluate of the developed guide effects. The study was conducted in two stages, involving methodological and randomly controlled experimental phases. The first stage of the research was conducted methodologically and develop an evidence-based practice guidelines for coping with childbirth. In the second stage of the research, randomly controlled experimentally, the effectiveness of the individual counseling program included in the guide was evaluated. This trial was conducted on 1 August 2018 and 1 April 2020, on seventy pregnant women (37 interventions and 33 controls) who are followed up during pregnancy at the Family Health Center No. 2, 5 and 12 and Aydın Gynecology and Pediatric Hospital. In addition to routine care, intervention group received the individual counseling program which developed in the light of the literature. The data was obtained through Information Form about Women, Wijma Delivery Expectancy/Experience Questionnaire A and B Version, Spielberger State Anxiety Inventory, The Childbirth Self-Efficacy Inventory and Postpartum Information Form. The data were analyzed by descriptive statistics, chi-square, t-test, Fisher test and Mann-Whitney test. Evidence of the effectiveness of interventions during the guideline development phase was obtained from the review of 13 randomized controlled trials, 13 pretest-posttest control group quasi-experimental studies, and 5 pretest-posttest controlled quasi-experimental studies. The studies were gathered under ten intervention titles that are effective in reducing fear of chilbirth. Its have been identified that psycho-educational group therapy, antenatal education, individual counseling program, intrapartum supportive care, cognitive behavior therapy, heart rate variability biofeedback, antenatal hypnosis training, group art therapy, Roy Adaptation Model based intermittent labor support, and self-efficacy oriented psychological counseling. The post-intervention Wijma Delivery Expectancy/Experience Questionnaire mean scores in the intervention group (30.81±20.64) statistically significantly lower than control group (67.94±27.37) (t=-6.450; p=0.000). It was observed that women in the intervention group (59.5%) gave more normal births than those in the control group (39.4%) and women in the control group (18.2%) requested more cesarean delivery than in the intervention group (8.1%). However, in the statistical evaluation, these differences were not significant. It was found that the rate of women preferring normal birth as a future was higher in women in the intervention group (75.7%) than in the control group (48.5%) and these differences were statistically significant (χ2=5.524; p=0.019). The study revealed that the individual counseling program using before birth in primiparous women reduces the fear of chilbirth but does not affect the birth outcomes. By integrating the individual counseling program into the routine antenatal care can reduce fear of childbirth and turn birth experiences of women into a more positive state.