Full title: Managing the fear of childbirth, developing a care program: a multi-method study

Abstract

Background: Despite the importance of fear of childbirth and the necessity of implementing appropriate care methods to increase women's willingness to childbearing and their more tendency to perform natural childbirth, there is no clear process in this field in the care programs of the country's health system. The present study was designed with the aim of developing a guideline for managing the fear of childbirth in the current context. Methods: This is a multi-method study which was conducted in five stages within the framework of the National Institute for Health and Care Excellence (NICE) guideline. A research committee consisting of five focal and 16 secondary members was formed. The stages included determining the scope of the study, developing guideline (a qualitative study and a systematic review, triangulation of the data, and producing a preliminary draft), consultation stage (validation of the protocol Using nominal group method), as well as revision and publication stages. Results: The clinical guideline of Managing the fear of childbirth with 190 evidence-based recommendations was developed in seven main areas, including the Pre-pregnancy period, pregnancy period, making childbirth more pleasant, training empowerment of employees, improving the service delivery system, social support and clinical guide evaluation methods. Conclusions: We are hoping by applying this clinical guideline in maternal health care settings to move towards an integrated care plan for fear of child birth in the context of our health system. Health care organizations should support to form multi-specialty teams to care for mothers with fear of childbirth. Through holistic care, they can constantly examine the psychological needs of pregnant mothers, including the fear of childbirth, along with their other needs, and manage them correctly.