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This is a randomized controlled study was conducted to determine the effect of childbirth preparation and counseling training provided during pregnancy on adaptation to the pregnancy and childbirth process.
This study with primiparous women school at a public hospital in Istanbul. A total of 110 pregnant women were divided into the Basic Education and Counseling Group (BECG; n=55) and the Basic Education Group (BEG; n=55). The BECG received childbirth preparation education plus counseling, while the BEG received only childbirth preparation education.
This is a randomized controlled study. The research was carried out in at a public hospital in Istanbul. This study was conducted at the pregnancy school affiliated with Health Sciences University Haseki Training and Research Hospital in Istanbul, Turkey, between 01 March 2024 and 31 October 2024. The study population consisted of primiparous pregnant women between 20-30 gestational weeks who applied to the pregnancy school.
Research Hypotheses H1: Childbirth preparation education has an effect on pregnancy adaptation. H2: Childbirth preparation education and counseling have an effect on pregnancy adaptation.
H3: Educational status has an effect on participation in childbirth preparation education.
H4: Childbirth preparation education has an effect on reducing fear of childbirth.
H5: Childbirth preparation education and counseling have an effect on reducing fear of childbirth.
Implementation:
Eligible participants who consented were randomized into the BECG and BEG groups. In the first phase, both groups completed the Demographic Information Form, PSAS, and W-DEQ-A. Participants attended childbirth preparation education consisting of four weekly sessions of 4 hours each, totaling 16 hours over one month. This education was routinely provided to both groups at the hospital's pregnancy school, and participants who did not maintain attendance were excluded from the study.
For the BECG, telephone numbers were collected, and participants were provided with a contact number for counseling services. In the second phase, BECG participants received telephone counseling 1-2 times monthly until gestational week 37. Questions asked during counseling were recorded in the Demographic Information Form. The BEG received no intervention during this phase. In the third phase, participants who reached gestational week 37 were contacted, and the relevant sections of the Demographic Information Form, PSAS, and W-DEQ-A were re-administered.
Childbirth Preparation Education Program
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Basic Education and Counseling Group (BECG) | Experimental | The Basic Education and Counseling Group (BECG) participants, attended childbirth preparation education consisting of four weekly sessions of 4 hours each, totaling 16 hours over one month. This education was routinely provided at the hospital's pregnancy school, and participants who did not maintain attendance were excluded from the study. Ayrıca, the BECG, telephone numbers were collected, and were provided with a contact number for counseling services. BECG participants received telephone counseling 1-2 times monthly until gestational week 37. |
|
| No intervention: Control Group | No Intervention | The Basic Education Group (BEG), participants attended childbirth preparation education consisting of four weekly sessions of 4 hours each, totaling 16 hours over one month. BEG, did not receive any intervention or consultancy services other than the education program. |
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Basic Education and Counseling | Behavioral | Description: The Basic Education and Counseling Group (BECG) participants, attended childbirth preparation education consisting of four weekly sessions of 4 hours each, totaling 16 hours over one month. This education was routinely provided at the hospital's pregnancy school, and participants who did not maintain attendance were excluded from the study. Ayrıca, the BECG, telephone numbers were collected, and were provided with a contact number for counseling services. BECG participants received telephone counseling 1-2 times monthly until gestational week 37. |
| Measure | Description | Time Frame |
|---|---|---|
| Educational level of pregnant women | Pregnant women were asked whether their level of education had an impact on their participation in childbirth preparation classes. The educational levels of pregnant women were surveyed as primary school and below, high school, or college and above. | In the first phase, both groups completed this questionnaire. |
| Measure | Description | Time Frame |
|---|---|---|
| Prenatal Self-Assessment Scale (PSAS) | PSAS was developed to measure adaptation to pregnancy and childbirth during the prenatal period. The scale is a structured assessment tool consisting of 79 items rated on a 4-point Likert format (4=does not describe at all, 3=somewhat describes, 2=partially describes, 1=very much describes). Forty-seven items are reverse-scored, and no cut-off point exists. The PSAS contains seven subscales: maternal-fetal health perception, acceptance of pregnancy, internalization of motherhood role, readiness for labor, fear of childbirth, relationship with mother, and relationship with spouse. Total scores range from 79-316, with lower scores indicating optimal maternal adaptation. In this study, the global Cronbach's α was 0.84, with subscale values ranging from 0.73-0.83. |
| Measure | Description | Time Frame |
|---|---|---|
| Wijma Delivery Expectancy/Experience Questionnaire Version A (W-DEQ-A) | W-DEQ-A was developed to measure women's fear of childbirth. Developed by Wijma and colleagues in 1998,15 the Turkish adaptation was performed by Körükcü and Kukulu.17 This 33-item instrument uses a 6-point Likert format (0-5 points). Total scores range from 0-165, with higher scores indicating increased childbirth anxiety. W-DEQ-A scores are classified into four categories: minimal anxiety (≤37), moderate anxiety (38-65), severe anxiety (66-84), and clinical-level anxiety (≥85). The original validation study reported Cronbach's α of 0.89; in the present study, this value was 0.94. |
Inclusion Criteria:
Exclusion Criteria:
Female
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| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Biruni University | Istanbul | Zeytinburnu | 34051 | Turkey (Türkiye) |
| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| Background | 32. Uğuz Y, Karaçam Z. The effect of childbirth preparation education on women's delivery mode and views on childbirth. Adnan Menderes University Faculty of Health Sciences Journal. 2022;6(3). | ||
| 18621452 | Background | Halvorsen L, Nerum H, Sorlie T, Oian P. Does counsellor's attitude influence change in a request for a caesarean in women with fear of birth? Midwifery. 2010 Feb;26(1):45-52. doi: 10.1016/j.midw.2008.04.011. Epub 2008 Jul 14. | |
| Background | 30. Buran G, Olgaç Z, Karaçam Z. The effect of childbirth preparation classes on women's delivery mode, fear, and experience: Systematic review. Life Sciences. 2020;15(4). | ||
| Background | 29. Esencan TY, Karabulut Ö, Yıldırım AD, et al. Delivery mode, first breastfeeding time, and skin-to-skin contact preferences of pregnant women receiving childbirth preparation education. Florence Nightingale Journal of Nursing. 2018;26(1):31-43. |
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We did not obtain permission from the participants to share their data with other researchers.
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| ID | Term |
|---|---|
| D003376 | Counseling |
| ID | Term |
|---|---|
| D008605 | Mental Health Services |
| D004191 | Behavioral Disciplines and Activities |
| D003153 | Community Health Services |
| D006296 | Health Services |
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Single Group Assignment The study included 110 pregnancy to pregnancy school affiliated with Health Sciences University Haseki Training and Research Hospital in Istanbul who consented to participate. Participants were randomized into two groups: the Basic Education and Counseling Group (BECG; n=55) and the Basic Education Group (BEG; n=55). All participants attended childbirth preparation education consisting of four weekly sessions of 4 hours each, totaling 16 hours over one month. This education participants who did not maintain attendance were excluded from the study.
For the BECG, telephone numbers were collected, and participants were provided with a contact number for counseling services. In the second phase, BECG participants received telephone counseling 1-2 times monthly until gestational week 37. Questions asked during counseling were recorded in the Demographic Information Form. The BEG received no intervention during this phase.
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None (Open Label)
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| In the first phase, both groups completed the PSAS. In the third phase, participants who reached gestational week 37 were contacted, and PSAS were re-administered. |
| In the first phase, both groups completed the W-DEQ-A. In the third phase, participants who reached gestational week 37 were contacted, and W-DEQ-A were re-administered. |
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| Background | 26. Subaşı B, Özcan H, Pekçetin S, et al. Effects of delivery education on childbirth anxiety and fear. Selçuk Medical Journal. 2013;29(4):165-167. |
| Background | 25. Barut S, Uçar T. The relationship between birth self-efficacy perception and fear of childbirth in pregnant women. Mersin University Journal of Health Sciences. 2018;11(2):107-115. |
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| D005159 | Health Care Facilities Workforce and Services |