Dissertation for Obtaining a Master's Degree in Midwifery Counseling The Effect of Counseling with Empowerment approach on Anxiety and Labor Self-efficacy in Pregnant Women: A Randomized Controlled Clinical Trial Pregnancy

Abstract

Abstract: Introduction: Prenatal empowerment is defined as satisfaction, increased independence, improved interaction with others and the environment, and spontaneous enhancement of mental energy to achieve successful pregnancy and childbirth. Regarding the importance of mental health of pregnant women and their physical and mental empowerment during this period and its significant impact on the optimization of delivery, the present study investigated the effect of counseling on empowerment approach on pregnancy anxiety and self-efficacy in pregnant women referred to Tabriz health centers.

Materials and Methods: This randomized controlled clinical trial was performed on 70 healthy pregnant women aged 28-32 weeks with first pregnancy in Tabriz from October to March of97. Samples were randomly assigned to intervention and control groups. Participants received empowerment counseling from 28–32 weeks of gestation. Revised Pregnancy Anxiety Questionnaire (PRAQ-R2) and Kameda Pregnancy Empowerment Questionnaire and Child Birth Self Efficacy Questionnaire (CBSE) once at the first visit and again 4-8 after the intervention Interview completed. Data were analyzed using independent t-test and ANCOVA. Results: There was no significant difference between the two groups in terms of demographic characteristics and baseline pregnancy empowerment and anxiety scores and labor self-efficacy (P >0.05). After intervention based on ANCOVA test with baseline score control, The mean score of pregnancy anxiety score was significantly lower in intervention group than in control group, Mean(SD)-9.06; 95% confidence interval: -13.19 to-4.93, p <0.001). The mean score of pregnant women self-efficacy was significantly higher in the intervention group than the control group, Mean (SD)41.45; 95% confidence interval: 26.05 to 56.84, (p <0.001) .The mean score of pregnant women empowerment in the intervention group was higher than the control group, Mean (SD) 3.80; 95% confidence interval: 0.60 to 7.00, (p = 0.021). Conclusion: Based on the results of this study, counseling with physical and mental empowerment approach in pregnant women is effective in reducing pregnancy anxiety and increasing self-esteem and self-efficacy of delivery. Focusing on the different dimensions of empowerment to encourage natural childbirth and create a pleasant delivery experience can be an important step towards achieving the important goal of developing and reducing maternal mortality.