Childbirth experiences among women with fear of birth randomized to internet-based cognitive therapy or midwife counseling

Abstract

Background: Although women with fear of birth often report negative birth experiences, few studies have focused on their experiences in the long term. The aim of this study was to compare birth experiences a year after childbirth in two groups of women receiving treatment for experiencing fear of birth during pregnancy. Methods: As part of the U-CARE: Pregnancy Trial, a prospective multicenter randomized controlled trial comparing the effects of internet-based cognitive behavioral therapy (iCBT) and standard care among pregnant women with fear of birth. Women were recruited at three Swedish hospitals following a screening procedure that assessed their fear of birth. Data were collected online with the Childbirth Experience Questionnaire (CEQ), one question about the overall birth experience, and questions about personal background, collected before randomization. Results: A total of 181 women responded to the follow-up questionnaire a year after childbirth. Approximately half of participants reported a less positive birth experience. Preferred mode of birth, actual mode of birth, marital status and psychiatric history were associated with the domains of the CEQ. However, no statistically significant differences emerged between the treatment groups. Conclusions: Being randomized to receive iCBT or counseling with midwives for fear of birth was not associated with perceptions of the birth experience assessed a year after birth. Most participants reported less-than-positive birth experiences and scored low on the domain of the CEQ reflecting Own capacity. In response, additional research remains necessary to identify the best model of care that might facilitate positive experiences with giving birth among women with fear of birth.

Interventions to treat fear of childbirth in pregnancy: a systematic review and meta-analysis

“…Six studies examined cognitive behavioural therapy (CBT) delivered online ( n = 2; Baylis, Ekdahl, Haines, & Rubertsson, 2019 ; Hildingsson & Rubertsson, 2019 ; Larsson et al, 2017 ; Larsson, Hildingsson, Ternström, Rubertsson, & Karlström, 2019 ; Nieminen et al, 2015 ; Nieminen, Andersson, Wijma, Ryding, & Wijma, 2016 ; Rondung et al, 2018 ) or face-to-face ( n = 4; Kordi, Bakhshi, Masoudi, & Esmaily, 2017 ; Saisto, Salmela-Aro, & Nurmi, 2001 ; Sydsjö et al, 2015 ; Uçar & Golbasi, 2019 ). Studies either had no control group ( n = 1; Nieminen et al, 2015 , 2016 ) or compared the intervention to other talking therapies ( n = 2; Baylis et al, 2019 ; Hildingsson & Rubertsson, 2019 ; Larsson et al, 2017 , 2019 ; Rondung et al, 2018 ; Saisto et al, 2001 ) or standard medical care (SMC; n = 3; Kordi et al, 2017 ; Sydsjö et al, 2015 ; Uçar & Golbasi, 2019 ). Two studies had a low risk of bias and the rest medium.…”

“…Three studies examined enhanced midwifery care, including a continuity of care model (n = 2; Hildingsson, Rubertsson, Karlström, & Haines, 2018;Hildingsson, Karlström, Rubertsson, & Haines, 2019;Hildingsson et al, 2019;Lyberg & Severinsson, 2010a, 2010b or a midwife-led visit to a delivery suite (Sydsjö et al, 2014). One study had a high risk of bias, and the remaining had a medium risk of bias.…”

Women’s childbirth experiences in the Swedish Post-term Induction Study (SWEPIS): a multicentre, randomised, controlled trial

“…The CEQ has been used in several studies in Sweden and has been shown to have good internal and external validity. [41][42][43][44] The advantages of CEQ and CEQ2 are that they measure the multidimensional experience of labour and birth. However, there might be dimensions of the childbirth experience that are difficult to capture with a questionnaire.…”

Design of the Maternal Website EMAeHealth That Supports Decision-Making During Pregnancy and in the Postpartum Period: Collaborative Action Research Study

“…The availability of computer-based educational programs has also been shown to be associated with greater self-efficacy and a more positive attitude toward breastfeeding [ 19 ]. However, the determinants of its effectiveness remain to be explored, since the results vary depending on the behavior studied [ 20 ], the time of measurement [ 21 ], or the population studied [ 22 ].…”