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Birth preference in women undergoing treatment for childbirth fear : A randomised controlled trial

Larsson, Birgitta; Karlström, Annika; Rubertsson, Christine LU ; Ternström, Elin; Ekdahl, Johanna; Segebladh, Birgitta and Hildingsson, Ingegerd (2017) In Women and Birth
Abstract

Background: Childbirth fear is the most common underlying reason for requesting a caesarean section without medical reason. The aim of this randomised controlled study was to investigate birth preferences in women undergoing treatment for childbirth fear, and to investigate birth experience and satisfaction with the allocated treatment. Methods: Pregnant women classified with childbirth fear (≥60 on the Fear Of Birth Scale) (n = 258) were recruited at one university hospital and two regional hospitals over one year. The participants were randomised (1:1) to intervention (Internet-based Cognitive Behaviour Therapy (ICBT)) (n = 127) or standard care (face-to-face counselling) (n = 131). Data were collected by questionnaires in pregnancy... (More)

Background: Childbirth fear is the most common underlying reason for requesting a caesarean section without medical reason. The aim of this randomised controlled study was to investigate birth preferences in women undergoing treatment for childbirth fear, and to investigate birth experience and satisfaction with the allocated treatment. Methods: Pregnant women classified with childbirth fear (≥60 on the Fear Of Birth Scale) (n = 258) were recruited at one university hospital and two regional hospitals over one year. The participants were randomised (1:1) to intervention (Internet-based Cognitive Behaviour Therapy (ICBT)) (n = 127) or standard care (face-to-face counselling) (n = 131). Data were collected by questionnaires in pregnancy week 20-25 (baseline), week 36 and two months after birth. Results: Caesarean section preference decreased from 34% to 12% in the ICBT group and from 24% to 20% in the counselling group. Two months after birth, the preference for caesarean increased to 20% in the ICBT group and to 29% in the counselling group, and there was no statistically significant change over time. Women in the ICBT group were less satisfied with the treatment (OR 4.5). The treatment had no impact on or worsened their childbirth fear (OR 5.5). There were no differences between the groups regarding birth experience. Conclusion: Women's birth preferences fluctuated over the course of pregnancy and after birth regardless of treatment method. Women felt their fear was reduced and were more satisfied with face-to-face counselling compared to ICBT. A higher percentage were lost to follow-up in ICBT group suggesting a need for further research.

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author
publishing date
type
Contribution to journal
publication status
epub
keywords
Caesarean section, Childbirth fear, Counselling, Internet based cognitive behavioural therapy, Randomised controlled trial
in
Women and Birth
publisher
Elsevier
external identifiers
  • scopus:85019011965
ISSN
1871-5192
DOI
10.1016/j.wombi.2017.04.004
language
English
LU publication?
no
id
d1c5a8eb-8b36-4923-b70c-ff6e77a26cb3
date added to LUP
2017-10-27 15:27:13
date last changed
2017-11-14 08:53:22
@article{d1c5a8eb-8b36-4923-b70c-ff6e77a26cb3,
  abstract     = {<p>Background: Childbirth fear is the most common underlying reason for requesting a caesarean section without medical reason. The aim of this randomised controlled study was to investigate birth preferences in women undergoing treatment for childbirth fear, and to investigate birth experience and satisfaction with the allocated treatment. Methods: Pregnant women classified with childbirth fear (≥60 on the Fear Of Birth Scale) (n = 258) were recruited at one university hospital and two regional hospitals over one year. The participants were randomised (1:1) to intervention (Internet-based Cognitive Behaviour Therapy (ICBT)) (n = 127) or standard care (face-to-face counselling) (n = 131). Data were collected by questionnaires in pregnancy week 20-25 (baseline), week 36 and two months after birth. Results: Caesarean section preference decreased from 34% to 12% in the ICBT group and from 24% to 20% in the counselling group. Two months after birth, the preference for caesarean increased to 20% in the ICBT group and to 29% in the counselling group, and there was no statistically significant change over time. Women in the ICBT group were less satisfied with the treatment (OR 4.5). The treatment had no impact on or worsened their childbirth fear (OR 5.5). There were no differences between the groups regarding birth experience. Conclusion: Women's birth preferences fluctuated over the course of pregnancy and after birth regardless of treatment method. Women felt their fear was reduced and were more satisfied with face-to-face counselling compared to ICBT. A higher percentage were lost to follow-up in ICBT group suggesting a need for further research.</p>},
  author       = {Larsson, Birgitta and Karlström, Annika and Rubertsson, Christine and Ternström, Elin and Ekdahl, Johanna and Segebladh, Birgitta and Hildingsson, Ingegerd},
  issn         = {1871-5192},
  keyword      = {Caesarean section,Childbirth fear,Counselling,Internet based cognitive behavioural therapy,Randomised controlled trial},
  language     = {eng},
  publisher    = {Elsevier},
  series       = {Women and Birth},
  title        = {Birth preference in women undergoing treatment for childbirth fear : A randomised controlled trial},
  url          = {http://dx.doi.org/10.1016/j.wombi.2017.04.004},
  year         = {2017},
}