A Midwife-Led Psychoeducational Intervention to Reduce Pregnancy-Related Anxiety in Low-Risk Pregnant Women

Effectiveness of an Individual Midwife-Led Psychoeducational Intervention in Reducing Pregnancy-Related Anxiety in Pregnant Women

The goal of this clinical trial is to evaluate whether an individualized psychoeducational intervention led by an experienced midwife can reduce pregnancy-related anxiety (PrA) in pregnant women during the second and third trimesters. The main questions it aims to answer are:

• Can individualized midwife-led psychoeducation significantly reduce pregnancy-related anxiety levels as measured by the PRAQ-R2 questionnaire?
• Does this intervention improve women's sense of control, competence, and readiness for childbirth?
• Can the intervention reduce preferences for cesarean section without medical indication among low-risk pregnant women?

Participants will:

• Attend 4-6 individual sessions (approximately 60 minutes each) with a midwife, scheduled every 1-2 weeks
• Complete the Pregnancy-Related Anxiety Questionnaire (PRAQ-R2) at the beginning and end of the intervention to measure anxiety levels
• Receive evidence-based education about the physiological process of childbirth, pain management methods (both pharmacological and non-pharmacological), and medical procedures
• Learn and practice stress-reduction techniques including breathing exercises, relaxation methods, and mindfulness
• Develop an individualized birth plan and practice communication skills for effective interaction with medical personnel
• Work on cognitive strategies to address negative thoughts and build positive affirmations about childbirth

Inclusion Criteria:

• Pregnant women in the second or third trimester of pregnancy
• Elevated level of pregnancy-related anxiety (PrA)
• Low obstetric risk pregnant women (no significant medical contraindications to vaginal delivery)
• Consent to participate in individual psychoeducational sessions
• Ability to communicate in Polish at a level sufficient to understand the materials and participate in the sessions

Exclusion Criteria:

• Pregnant women with severe mental disorders requiring urgent psychiatric intervention
• Women with serious obstetric complications in the current pregnancy requiring intensive medical monitoring (e.g., severe hypertension, imminent preterm delivery requiring hospitalization)
• Patients already undergoing intensive psychotherapy or pharmacotherapy for anxiety
• Lack of consent to participate or inability to attend sessions (e.g., due to logistical reasons)
• Pregnant women whose pregnancy-related anxiety is not the primary concern, with other dominant anxiety disorders (e.g., GAD unrelated to pregnancy) or other priority health needs