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

N/AActive Not RecruitingNCT07015086

Gazi University62 enrolled

Overview

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.

Fear of childbirth may negatively affect women's emotional well-being, perceptions of childbirth, and confidence in their ability to cope with labor. Non-pharmacological approaches that promote positive perceptions of childbirth and support women's coping resources may therefore be beneficial during pregnancy. Positive birth experience sharing may provide pregnant women with positive representations of childbirth, while guided imagery may help them mentally rehearse and approach the childbirth experience in a more positive and manageable way. This study evaluates a combined intervention consisting of positive birth experience sharing and guided imagery in primiparous pregnant women. The intervention is initiated at 26-28 weeks of gestation and is delivered individually and online. During an individual online session, a researcher shares her own positive birth experience and provides participants with an opportunity to ask questions and discuss issues they are curious or concerned about regarding childbirth. The guided imagery component is based on childbirth-focused guided imagery techniques. The original English-language guided imagery instructions were translated into Turkish and reviewed by the research team for clarity, comprehensibility, and suitability for pregnant women. The finalized Turkish script was subsequently recorded as a standardized audio recording. Participants use this recording independently at home throughout the 10-week intervention period. Daily reminders and a structured follow-up chart are used to support and monitor regular practice. Assessments are conducted before randomization, after completion of the 10-week intervention, and during the early postpartum period. The study primarily examines changes in fear of childbirth and childbirth self-efficacy during pregnancy and additionally evaluates fear associated with the actual childbirth experience after birth.

Interventions

Guided Imagery and Positive Birth Experience SharingBEHAVIORAL

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.

Eligibility

Sex: FEMALEMin age: 18 YearsHealthy volunteers:

Medical Language ↔ Plain English

Inclusion Criteria: Aged 18 years or older Primiparous At 26-28 weeks of gestation at enrollment No maternal or fetal complications during the current pregnancy (e.g., gestational diabetes, hypertension, preeclampsia, intrauterine growth restriction, or congenital anomalies) No mental, hearing, visual, language, or other communication problems that could interfere with participation Able to use WhatsApp® and access the online study procedures Willing to participate in the study and provide informed consent Exclusion Criteria: Development of a maternal or fetal complication during the study Birth before 37 weeks of gestation Withdrawal from the study at the participant's request Failure to complete the post-intervention assessment Failure to perform the guided imagery exercise for three consecutive days (intervention group only)

Outcomes

Primary Outcomes

Fear of Childbirth

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.

Time frame: Baseline (26-28 weeks of gestation) and 10 weeks after baseline

Difference of scores of the Labor Self-Efficacy Scale-Short Form.

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.

Time frame: 8 weeks

Childbirth Self-Efficacy

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.