‘I’ve Changed My Mind’, Mindfulness-Based Childbirth and Parenting (MBCP) for pregnant women with a high level of fear of childbirth and their partners: study protocol of the quasi-experimental controlled trial

Abstract

BackgroundApproximately 25 % of pregnant women suffer from a high level of Fear of Childbirth (FoC), as assessed by the Wijma Delivery Expectancy Questionnaire (W-DEQ-A, score ≥66). FoC negatively affects pregnant women’s mental health and adaptation to the perinatal period. Mindfulness-Based Childbirth and Parenting (MBCP) seems to be potentially effective in decreasing pregnancy-related anxiety and stress. We propose a theoretical model of Avoidance and Participation in Pregnancy, Birth and the Postpartum Period in order to explore FoC and to evaluate the underlying mechanisms of change of MBCP.Methods/DesignThe ‘I’ve Changed My Mind’ study is a quasi-experimental controlled trial among 128 pregnant women (week 16–26) with a high level of FoC, and their partners. Women will be allocated to MBCP (intervention group) or to Fear of Childbirth Consultation (FoCC; comparison group). Primary outcomes are FoC, labour pain, and willingness to accept obstetrical interventions. Secondary outcomes are anxiety, depression, general stress, parental stress, quality of life, sleep quality, fatigue, satisfaction with childbirth, birth outcome, breastfeeding self-efficacy and cost-effectiveness. The total study duration for women is six months with four assessment waves: pre- and post-intervention, following the birth and closing the maternity leave period.DiscussionGiven the high prevalence and severe negative impact of FoC this study can be of major importance if statistically and clinically meaningful benefits are found. Among the strengths of this study are the clinical-based experimental design, the extensive cognitive-emotional and behavioural measurements in pregnant women and their partners during the entire perinatal period, and the representativeness of study sample as well as generalizability of the study’s results. The complex and innovative measurements of FoC in this study are an important strength in clinical research on FoC not only in pregnant women but also in their partners.Trial registrationDutch Trial Register (NTR): NTR4302, registration date the 3rd of December 2013.

Examining the content and moderators of women's fears for giving birth: A meta‐synthesis

“…This review synthesises women's reports of their fears for giving birth, highlighting six key elements that were present as distinct components but also related to an overarching element; the "unpredictabil- Findings also highlight several potential mechanisms upon which to base supportive strategies to reduce women's fears for giving birth. Existing intervention studies are few in number, and often limited by small sample sizes or absence of a comparative control group (Veringa et al, 2016). Further research and identification of effective methods to alleviate women's fears for giving birth throughout pregnancy are required.…”

“…Findings also highlight several potential mechanisms upon which to base supportive strategies to reduce women's fears for giving birth. Existing intervention studies are few in number, and often limited by small sample sizes or absence of a comparative control group (Veringa et al., ). Further research and identification of effective methods to alleviate women's fears for giving birth throughout pregnancy are required.…”

Doing no harm in mindfulness-based programs: Conceptual issues and empirical findings

“…Other practices were developed for more specific contemporary purposes. For example, in mindfulness-based childbirth and parenting (MBCP; Veringa et al, 2016 ), participants hold ice cubes for 60 s (the average length of a contraction) while attending mindfully to their breath and the sensations in their hands. This practice is intended to reduce the fear and stress associated with childbirth by teaching a new way of being present with sensations of pain.…”

Effects of an Online Mindfulness Intervention Focusing on Attention Monitoring and Acceptance in Pregnant Women: A Randomized Controlled Trial

“…In particular, the mindfulness‐based interventions have shown promise for treating or preventing diverse psychological problems, as well as for relieving pain and improving well‐being . In recent years, a number of mindfulness programs (eg, mindfulness‐based childbirth and parenting education and mindfulness‐based childbirth education) integrated prenatal education and mindfulness training, most of which have reported reduced rates of anxiety, depression, and stress during pregnancy and have improved childbirth self‐efficacy and mindfulness . However, because of cultural differences, the effectiveness and acceptability of mindfulness interventions for Chinese women need further examination.…”