The aim of this study is to evaluate the effects of a prenatal psychoeducation program applied to pregnant women with a traumatic perception of birth on the perception of traumatic birth, maternal attachment, breastfeeding and postpartum depression.
Pregnancy and birth are one of the most important experiences in a woman's life. This experience has many physical, hormonal and psychosocial effects on women. The perception of birth varies depending on the culture in which women live. In most societies, birth and motherhood are perceived positively. While some women perceive the experience of giving birth as a positive life experience that strengthens them and helps them grow, some women perceive it as trauma. The perception of traumatic birth negatively affects the health of mother and baby during pregnancy, birth and the postpartum period. The perception of trauma towards birth causes stress and anxiety disorders, fear of birth, weakening of the bond between mother and baby and the relationship between spouses during pregnancy. During the birth process, it paves the way for increased medical interventions, prolonged labor, decreased success of labor management, and an increased desire for cesarean section. Postpartum problems include failure to participate in infant care, inadequate breastfeeding, decreased breast milk supply, poor mother-infant bonding, postpartum depression, deterioration in family relationships, reluctance to consider future pregnancy, and a tendency toward cesarean section in subsequent pregnancies Removing the perception of birth as traumatic and establishing a positive perception of it is crucial for maternal and infant health. Support should be provided to women who perceive birth as traumatic with practices that have been successful in preventing negative birth experiences. This support allows for the elimination of potential problems resulting from birth trauma . Psychoeducation is one of the most successful practices that will eliminate the perception of traumatic birth. Psychoeducation is one of the most effective evidence-based practices emerging in both clinical research and community settings. It is an educational intervention that includes disease-specific information as well as techniques for managing the current situation. Its flexibility allows it to be used across a wide range of illnesses and life challenges. Studies show that psychoeducation intervention reduces pain levels during labor, increases vaginal birth rates, shortens labor duration, positively affects mother-baby bonding and breastfeeding, and reduces postpartum depression rates.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
SUPPORTIVE_CARE
Masking
SINGLE
Enrollment
80
The nurse/midwife-led psychoeducation intervention aims to encourage pregnant women to express their feelings about childbirth. It also provides a counseling framework to help women identify and overcome the distressing elements of childbirth. Psychoeducation allows pregnant women to obtain complete, evidence-based information about labor and to discuss their feelings and thoughts about the method of delivery and birth. Providing evidence-based information by nurses/midwives during psychoeducation helps pregnant women make informed decisions about their birth preferences. In addition to evidence-based information, the psychoeducation intervention includes discussing myths and misconceptions, increasing social support, reinforcing positive coping strategies, and focusing on problem solutions. Nurses/midwives encourage pregnant women to develop a positive birth plan through psychoeducation.
Umraniye Education and Research Hospital
Istanbul, Umraniye, Turkey (Türkiye)
Traumatic Birth Perception Scale (TBPS)
The TBPS was developed in 2016 by Yalnız et al. to determine the level of perception of labor as trauma. The TPAS is used to determine the perceptions of birth among women aged 15-49, receiving preconception counseling, and attending delivery rooms, obstetrics, or postpartum services during pregnancy. The TPAS has a total of 13 items. Each item is rated from 0 (zero) to 10 (ten). The lowest score on the TPAS is 0 (zero), and the highest is 130. As the score on the scale increases, the extent to which women perceive birth as trauma increases. Women who score "0-26" on the scale have a very low perception of birth as traumatic, those who score "27-52" have a low perception, those who score "53-78" have a moderate perception, those who score "79-109" have a high perception, and those who score "105-130" have a very high perception of birth as traumatic. The Cronbach alpha coefficient of the original form of the scale is 0.895.
Time frame: 4 months
Mother-to-Infant Bonding Scale (MIBS)
Developed by Taylor and colleagues (2005) to assess mother-infant attachment from the first days after birth to the 12th week, the PBI allows mothers to express their feelings toward their babies in single words after birth. The PBI is a four-point Likert-type scale consisting of 8 items. Each item is scored between 0 and 3. The items cover both positive and negative emotions. Items 1, 4, and 6 examine positive emotions. These items are scored as 0, 1, 2, or 3. Items 2, 3, 5, 7, and 8 examine negative emotions. They are reverse-scored as 3, 2, or 1, or 0. The lowest possible score on the scale is 0, and the highest is 24. A higher score indicates a problem in the mother-infant bond.
Time frame: 4 months
Breastfeeding Self-Efficacy Scale Short Form (BSES-SF)
Developed by Dennis and Faux, this scale consists of 14 items on a 5-point Likert-type scale. The lowest possible score is 14, and the highest is 70. A higher score indicates higher breastfeeding self-efficacy. The Turkish validity and reliability of the scale were conducted by Aluş-Tokat and Okumuş (2010).
Time frame: 4 months
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Edinburgh Postnatal Depression Scale (EPDS)
It was developed by Cox et al. (1987) to determine the risk of depression in mothers during the postpartum period. It consists of 10 items on a 4-point Likert-type scale. The lowest possible score is 0, and the highest is 30. The cut-off point is 12-13. Women who score 13 or higher are at increased risk of postpartum depression. The validity and reliability of the scale in Turkish was conducted by Engindeniz et al. (1996).
Time frame: 4 months