The effect of communication techniques training on fear of childbirth among primigravid women

Abstract

Abstract Background: Fear of childbirth (FOC) is considered as one of the factors influencing the increase of elective cesarean section, and following repeated sections. Various interventions have been used in different studies to reduce FOC. However, an effective and appropriate method has not been identified yet. The present study aimed to evaluate the effect of communication techniques training(Haptonomy) on FOC (primary outcome), maternal-fetal attachment (MFA), and pregnancy anxiety (secondary outcomes) among primigravid women‎. Methods: This quasi-experimental study was conducted on 68 primigravid women with a gestational age of 24-28 weeks who referred to health centers in Khoy, with a FOC score above 65. Participants were randomly assigned into the intervention and control groups by stratified block randomization based on the high and severe FOC. The intervention group (n=34) received communication techniques training in groups of 3 people in 5 sessions, once a week for 45-60 minutes and control group received routine antenatal care. The data were collected using Wijma Delivery Expectancy/Experience Questionnaire-version A, Cranley’s MFA Scale, and Revised Pregnancy Related Anxiety Questionnaire, before the intervention and at gestational age of 35-37 weeks. The data were analyzed by SPSS24 software. The chi-square, independent t-test, and ANCOVA were used to analyze the data. Results: After intervention and controlling the effect of baseline score, the mean (SD) score of FOC was 70.44 (12.41) and 94.12 (14.13) in the intervention and control groups, respectively [Adjusted mean difference (AMD): -23.67, 95% CI:- 28.12 to -19.23, P <0.001]. Further, the mean (SD) of the total score of pregnancy anxiety was 20.24 (6.06) in the intervention group and 33.82 (6.75) in the control group after intervention [AMD: -13.57, 95% CI: -16.54 to -10.60, p <0.001]. Also, The mean (SD) of the total score of MFA was 108.55 (18.55) in the intervention group and 98.42 (15.81) in the control group prior to the intervention [AMD: 10.12, 95% CI: 6.44 to 13.8, p <0.001]. Conclusion: The results of the present study revealed the effectiveness of communication techniques training in reducing FOC, pregnancy anxiety and increasing MFA through labeling childbirth as a more physiologic, positive feeling and attitude towards pregnancy, touch and interaction with the fetus. Therefore, communication techniques training is recommended among mothers with high FOC and pregnancy anxiety.