Effect of Counselling with Men on the Social Support and Perceived Stress of their Pregnant Wives: A Randomized Controlled Clinical Trial

Abstract

Abstract Introduction: Social support of mothers during pregnancy is essential for maternal and fetal health. Considering the importance of the role of spouses in the process of pregnancy and the positive effects of men's participation in pregnancy and its impact on the future health of society, this study aimed to determine the effect of counseling with men on the perceived stress and social support of pregnant women (primery outcomes), anxiety and depression in pregnant women, men's anxiety and stress, women's weighing, neonatal anthropometric indices and frequency of cesarean delivery and preterm labor (secondary outcomes). Materials and Method: This randomized controlled clinical trial was conducted on spouses of pregnant women referring to health centers of Ardabil city. The perceived social support questionnaire was completed by pregnant women. Women who received low and moderate score of perceived social support were included in the study and allocated into two groups of counseling (51 persons) and control group (n = 51 people) through block randomization method. Four group counseling sessions (60 minutes, in groups of 7 to 10) were presented at intervals of one week and for four consecutive weeks by a researcher for the intervention group's spouses. Perceived Social support questionnaire, perceived stress, Edinburgh depression, Spilberger's state and trait anxiety for pregnant women, and Spilberger's state and trait anxiety and perceived stress questionnaires for men before and four weeks after intervention were completed through interview by the researcher. Also, the weight of pregnant women was measured four weeks after the intervention by the researcher. Participants were followed up until delivery, and the anthropometric indices of the newborn and type of delivery and the gestational age at the time of delivery were recorded based on maternal delivery records in the relevant checklist. Data were analyzed by Chi-square, t-test and covariance analysis. Results: Fifty participant in the counseling group and 51 in the control group were followed up and analyzed by the end of the study. The two groups of counseling and control were in terms of socio-demographic characteristics and baseline perceived social support, perceived stress, state and trait anxiety, and depression scores (P>0.05). Based on ANCOVA test with adjusting the baseline score, in the counseling group compared to the control group, the mean score of perceived social support increased significantly in 4 weeks after the end of intervention (Adjusted Mean Difference: 12.7; 95% Confidence Interval: 6.9 to 18.5; P<0.001). Four weeks after the intervention and with adjusting the baseline values, there was no significant difference between groups in terms of the mean score of the perceived stress (1.1; -1.4 to 3.7; P= 0.385) state anxiety (-1.2; -4.2 to 1.6; P= 0.393); trait anxiety (-.3; -3.2 to 2.6; P= 0.829) and depression (0.7; -0.9 to 2.4; P= 0.382). Four weeks after the end of intervention, the mean score of state anxiety (-2.4, -4.7 to -0.2, P= 0.030) in men was significantly lower in the counseling group than in the control group, but in terms of the mean scores of trait anxiety (-0.8; -3.2 to 1.5; P= 0.472) and perceived stress (-0.4; -2.5 to 1.5; P= 0.635), there was no significant difference between the two counseling and control groups. There was no significant difference between groups in terms of frequency of cesarean delivery (P= 0.324) and preterm labor (P= 0.448) and also newborn height (P= 0.852), weight (P= 0.297) and head circumference (P= 0.196). Conclusion: Counseling with spouses of pregnant women can increase the perceived social support of pregnant women and decrease the level of anxiety in men, therefore counseling with fathers is recommended as a complementary, effective and non-invasive intervention in controlling their psychological problems and improving the health status of pregnant mothers.