The Effects of Positive Birth Experience Sharing and Guided Imagery on Childbirth Self-Efficacy and Fear of Childbirth

Condition(s) studied

Investigational drug(s) / intervention(s)

Guided Imagery and Positive Birth Experience Sharing: The positive experience will be shared by one of the researchers and the pregnant women's questions will be answered after the sharing. The mental imagery techniques prepared by Rossman (2015) to facilitate birth will be used for the mental imagery application. After the training, the mental imagery instructions will be given to the pregnant women as an audio recording in mp3 format. The pregnant women will be asked to do the mental imagery once or twice a day for at least 8 weeks. The mental imagery application takes approximately 20 minutes. The pregnant women will be reminded to do the application every day via the Whatsapp® application. The pregnant women will be asked to mark whether they do the application every day or not on the weekly follow-up chart.

Study summary

Brief Summary

This randomized controlled trial evaluates the effects of positive birth experience sharing combined with guided imagery on fear of childbirth and childbirth self-efficacy in primiparous pregnant women. The study is a single-center, two-arm, parallel-group randomized controlled trial using stratified block randomization based on baseline fear of childbirth. A total of 62 pregnant women were randomized in a 1:1 ratio to the intervention group (n=31) or control group (n=31).

Participants were enrolled at 26-28 weeks of gestation. Before randomization, participants completed the Personal Information Form, the Wijma Delivery Expectancy/Experience Questionnaire Version A (W-DEQ-A), and the Childbirth Self-Efficacy Inventory-Short Form (CBSEI-C32) online. Participants were stratified according to their baseline W-DEQ-A scores and then randomly allocated to the intervention or control group.

The intervention was delivered individually and online via WhatsApp. Women in the intervention group participated in an approximately 30-minute individual online session during which one of the researchers shared a positive personal birth experience and answered participants' questions about childbirth. Participants were also provided with a standardized Turkish guided imagery audio recording based on childbirth-focused guided imagery techniques. They were instructed to listen to the approximately 20-minute recording independently once or twice daily for 10 weeks, preferably before bedtime. Daily WhatsApp reminders and a guided imagery exercise follow-up chart were used to support and monitor adherence.

Women in the control group received routine antenatal care and did not receive the positive birth experience sharing or guided imagery intervention. At the end of the 10-week intervention period, participants in both groups completed the W-DEQ-A and CBSEI-C32 online. Within the first three days after childbirth, the W-DEQ-B was administered online and mode of birth was recorded.

Eligibility

Primary outcome measure(s)

• Fear of Childbirth — Baseline (26-28 weeks of gestation) and 10 weeks after baseline
  Fear of childbirth will be assessed using the Wijma Delivery Expectancy/Experience Questionnaire Version A (W-DEQ-A). The scale consists of 33 items, with total scores ranging from 0 to 165. Higher scores indicate greater fear of childbirth.
• Difference of scores of the Labor Self-Efficacy Scale-Short Form. — 8 weeks
  There is a difference between the intervention and control groups in terms of the mean post-test scores of the Labor Self-Efficacy Scale-Short Form.The scale has two sub-dimensions: outcome and adequacy expectations. Each sub-dimension of the scale consists of 16 questions. The lowest score that can be obtained from the scale sub-dimensions is 16, and the highest score is 160. A high score obtained from the sub-dimensions indicates that pregnant women have high adequacy and outcome expectations regarding birth. Responses on the Likert-type scale are scored from 1 to 10. The lowest total score that can be obtained from the scale is 32, and the highest score is 320. High scores obtained from the scale indicate that pregnant women have high levels of self-efficacy in labor.
• Childbirth Self-Efficacy — Baseline (26-28 weeks of gestation) and 10 weeks after baseline
  Childbirth self-efficacy will be assessed using the Childbirth Self-Efficacy Inventory-Short Form (CBSEI-C32). The 32-item scale includes Outcome Expectancy and Efficacy Expectancy subscales. Total scores range from 32 to 320, with higher scores indicating greater childbirth self-efficacy.

Trial sites (1)

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