Life satisfaction, general well‐being and costs of treatment for severe fear of childbirth in nulliparous women by psychoeducative group or conventional care attendance

Abstract

Through an association with safer childbirth and equal well-being after delivery, psychoeducative group treatment for nulliparous women with fear of childbirth can be a recommended choice for the same overall costs as conventional treatment.

A cost effectiveness analysis of midwife psycho-education for fearful pregnant women – a health system perspective for the antenatal period

“…Australia has higher rates of childbirth fear compared to other developed countries [1, 10, 11], and worldwide has one of the highest rates of caesarean section [17]. Several studies have reported reduced caesarean section numbers following psycho-education interventions in women with childbirth fear [18–21] but few have reported costs associated with interventions [13, 22, 23]. We have previously reported on a cost analysis of the intervention on women’s quality of life and health service usage to six weeks post birth, demonstrating no additional cost to health services following provision of antenatal midwife-led psycho-education [23].…”

Clinical aspects of childbirth-related anxiety

“…There have been promising results of interventions to address severe FOC (Rouhe et al 2013;2015a;2015b). According to our study, in Sweden the additional societal cost of severe FOC managed in the conventional obstetrical care is around 13.43 million Euros.…”

“…In a randomized controlled trial, a Finnish research group has studied several aspects of a psycho-education involving relaxation in a group (the LINNEA project) (Rouhe et al 2013;2015a;2015b) with pregnant women suffering from phobic FOC (W-DEQ A sum score ≥100). Half of the participants were offered treatment in a group and half followed their ordinary antenatal care program including the possibility of psychosocial support.…”

“…The protocol comprised six group sessions during pregnancy, and two postpartum follow up meetings, one with a psychologist, and another with a midwife. In three reports from the RCT, Rouhe et al (2013;2015a;2015b) showed that women in the treatment group had more spontaneous vaginal deliveries, a lower prevalence of CSs, and lower levels of FOC postpartum as measured with the W-DEQ B than women in the control group. The women in the psychoeducation group also had fewer depressive symptoms postpartum and a better maternal adjustment than the women in the control group.…”

The OptiMUM-study: EMDR therapy in pregnant women with posttraumatic stress disorder after previous childbirth and pregnant women with fear of childbirth: design of a multicentre randomized controlled trial

“…The number of uncomplicated vaginal deliveries was significantly higher among women in the intervention group than among the controls (63.4% versus 47.5%, p  < 0.01), who received care by community nurses and were referred if considered necessary. Because complications lead to more medical costs, a greater number of uncomplicated deliveries reduced medical costs in the intervention group, resulting in group psycho-education being cost-neutral (Rouhe et al, 2015b). In another RCT a telephone psycho-education counselling intervention offered by midwives for 189 pregnant women with FoC was found to be significantly more effective regarding the reduction of childbirth fear levels than care-as-usual (CAU) (clinically meaningful improvement in FoC in 49% versus 26%, p  = 0.002) (Toohill et al, 2014).…”