The Effect of cognitive-behavioral education on fear of childbirth during pregnancy: A three-groups clinical trial study

Aims: Fear of childbirth (FOB) in pregnant women is critical because it may affect prenatal outcomes. The aim of this study was to determine the effect of cognitive-behavioral education on fear of child birth during pregnancy. Materials & Methods: A clinical trial study with two intervention groups and one control group was conducted among nulliparous women visiting Gorgan health centers in first 6 month of 2018. Among 211 nulliparous pregnant women, 104 women with an FOB score of 55 or higher were divided into control and intervention groups. The women in the intervention group were randomly assigned to two groups. The first intervention group received conventional prenatal education the second group received cognitive-behavioral techniques, and the control group received routine prenatal care. The data collection tool was the Wijma Delivery/Expectancy Fear of Childbirth Questionnaire (version A). The data were analyzed by using SPSS version 18 and Chi-square, Fisher’s exact test, ANOVA, and Welch. Paired t-test, Wilcoxon tests, ANOVA and Kruskal-Wallis tests. Findings: Comparing the rate of change in the scores of FOB indicated significant differences in all fields between the control and cognitive-behavioral techniques groups (p<0.05), but the conventional prenatal education group showed no significant difference (p>0.05). However, the control group exhibited a significant increase all fields of FOB, while the cognitive-behavioral techniques group showed a significant reduction. Conclusion: FOB is reduced in pregnant women with prenatal education based on cognitive-behavioral techniques than conventional education. Thus prenatal education based on CBT may be offered by midwives to reduce FOB in nulliparous pregnant women.