Does Psycho-Education Improve the Obstetric and Maternal Outcomes with Women Have a Fear of Childbirth? A Systematic Review

Yıl 2019, Cilt: 12 Sayı: 1, 82 - 90, 15.01.2019

Nursen Bolsoy Nurcan Çelik Hanife Nurseven Şimşek

Öz

Background: Fear of childbirth affects obstetric and maternal outcomes. One of the interventions to prevent or treat fear of childbirth is antenatal psycho-education. Objectives: The aim of this systematic review is to review the randomized controlled trial which research the obstetric and maternal results of the effect of antenatal psycho-education of women who have childbirth fear. Methods: This systemic review is performed by retrospective scanning of the studies related the subject. “Google Academic”, “Science direct” and “Wiley Interscience” databases were scanned electronically by using “antenatal”, “psycho-education classes” and “fear of childbirth” keywords. All of the abstracts, titles and articles in electronic databases were detected and reached to 1280 studies; then 685 studies that covered last 5 years were examined, and 7 of randomized controlled study which were met the criteria for including were included to the review. Results: These studies has shown that antenatal psycho-education for women who have fear of childbirth is decreased the fear of childbirth. As a result of decreased fear of childbirth; it was reported that vaginal birth rates, positive chilbirth experience, maternal adjustment increased and motherhood positively affected, whereas cesarean delivery rates and postnatal depressive symptoms decreased. Conclusion: Fear of childbirth has become one of the primacy problems that need to be solved. Psycho-education has a positive effect on obstetric and maternal outcomes in women who have a fear of childbirth. It’s supposed that this review could contribute the studies which would be performed on this area.

Anahtar Kelimeler

Antenatal, Psycho-education Classes, Fear of Childbirth

Doğum Korkusu Yaşayan Kadınlarda Psiko-Eğitim Obstetrik ve Maternal Sonuçları İyileştirir mi? Sistematik İnceleme

Öz

Giriş: Doğum korkusu, obstetrik ve maternal sonuçları etkilemektedir. Doğum korkusunu önlemek ya da tedavi etmek için yapılan girişimlerden birisi de antenatal psiko-eğitimdir. Amaç: Bu sistematik incelemenin amacı; doğum korkusu yaşayan kadınlarda antenatal psiko-eğitimin obstetrik ve maternal sonuçlar üzerine etkisini araştıran randomize kontrollü çalışmaları incelemektir. Yöntem: Sistematik inceleme, konuyla ilgili çalışmaların geriye dönük olarak taranması biçiminde gerçekleştirilmiştir. İncelemede “antenatal”, psycho-education classes” ve “fear of childbirth” anahtar kelimeleri kullanılarak “Google Akademik”, “Science Direct” ve “Wiley Interscience” veri tabanları elektronik olarak taranmıştır. Elektronik veri tabanlarındaki tüm özetler, başlıklar ve makaleler incelenmiş ve 1280 çalışmaya ulaşılmış; bu çalışmalardan son 5 yılı kapsayan 685 çalışma incelenmiş ve bu çalışmalardan dahil olma kriterlerini karşılayan 7 randomize kontrollü çalışma dahil edilmiştir. Bulgular: Çalışmalar, doğum korkusu yaşayan kadınlara verilen antenatal psiko-eğitimin doğum korkusunu azalttığını göstermektedir. Azalan doğum korkusu sonucunda; vajinal doğum oranlarının, pozitif doğum deneyiminin, maternal uyumun arttığı ve anneliği olumlu yönde etkilediği, buna karşın sezaryen doğum oranlarının ve postnatal depresif semptomların azaldığı belirtilmektedir. Sonuç: Doğum korkusu günümüzde çözülmesi gereken öncelikli sorunlardan biri haline gelmiştir. Doğum korkusu yaşayan kadınlarda psiko-eğitimin obstetrik ve maternal sonuçlar üzerine olumlu etkilerinin olduğu görülmektedir. Bu sistematik incelemenin konu ile ilgili yapılacak olan çalışmalara katkı sağlayacağı düşünülmektedir.

Anahtar Kelimeler

Antenatal, Psiko-eğitim Sınıfları, Doğum Korkusu

Kaynakça

• Akca, A., Esmer, A. C., Ozyurek, E. S., Aydin, A., Korkmaz, N., Gorgen, H., et al. (2017). The influence of the systematic birth preparation program on childbirth satisfaction. Archives of Gynecology Obstetrics, 295 (5), 1127-1133. https://doi.org/10.1007/s00404-017-4345-5. Akers, J., Aguiar-Ibáñez, R., Sari, A. B. A., Beynon, S., Booth, A., Burch, J., et al. (2009). Centre for reviews and dissemination systematic reviews (CRD). Guidance for undertaking reviews in healthcare. Published by CRD, University of York. Erişim: 15.06.2018. https://www.york.ac.uk/media/crd/Systematic_Reviews.pdf
• Bastos, M. H., Furuta, M., Small, R., McKenzie-McHarg, K., & Bick, D. (2015). Debriefing interventions for the prevention of psycho- logical trauma in women following childbirth. Cochrane Database Systematic Reviews, 4:CD007194. DOI: 10.1002/14651858.CD007194.pub2 Betran, A. P., Torloni, M. R., Zhang, J. J., Gülmezoglu, A. M., & for the WHO Working Group on Caesarean Section. (2015). WHO statement on caesarean section rates. An International Journal of Obstetrics and Gynaecology, 123 (5), 667-670. https://dx.doi.org/10.1111%2F1471-0528.13526
• Brixval, C. S., Axelsen, S. F., Lauemøller, S. G., Andersen, S. K., Due, P., & Koushede, V. (2015). The effect of antenatal education in small classes on obstetric and psycho-social outcomes - a systematic review. Bio Med Central Systematic Reviews, 4:20. https://dx.doi.org/10.1186%2Fs13643-015-0010-x
• Çalık, K., & Aktaş, S. (2011). Gebelikte depresyon: sıklık, risk faktörleri ve tedavisi. Cantone, D., Pelullo, C. P., Cancellieri, M., & Attena, F. (2017). Can antenatal classes reduce the rate of cesarean section in Southern Italy? Women and Birth, 30 (2), e83-e88. https://doi.org/10.1016/j.wombi.2016.09.004
• Clatworthy, J. (2012). The effectiveness of antenatal interventions to prevent postnatal depression in high-risk women. Journal of Affective Disorders, 137 (1-3), 25-34. https://doi.org/10.1016/j.jad.2011.02.029
• Fenwick, J., Gamble, J., Creedy, D. K., Buist, A., Turkstra, E., Sneddon, A., et al. (2013). Study protocol for reducing childbirth fear: a midwife-led psycho-education intervention. Pregnancy and Childbirth, 13 (190), 1-9. https://doi.org/10.1186/1471-2393-13-190.
• Fenwick, J., Staff, L., Gamble, J., Creedy, D. K., & Bayes, S. (2010). Why do women request caesarean section in a normal, healthy first pregnancy? Midwifery, 26 (4),394-400. https://doi.org/10.1016/j.midw.2008.10.011
• Fenwick, J., Toohill, J., Gamble, J., Creedy, D. K., Buist, A., Turkstra, E., et al. (2015). Effects of a midwife psycho-education intervention to reduce childbirth fear on women’s birth outcomes and postpartum psychological wellbeing. Bio Med Central Pregnancy & Childbirth, 15 (284), 1-8. https://doi.org/10.1186/s12884-015-0721-y
• Fenwick, J., Toohill, J., Slavin, V., Creedy, D. K., & Gamble, J. (2017). Improving psychoeducation for women fearful of childbirth: Evaluation of are search translation project. Women and Birth, http://dx.doi.org/10.1016/j.wombi.2017.06.004
• Gagnon, A. J., & Sandall, J. (2007). Individual or group antenatal education for childbirth or parenthood or both. Cochrane Database of Systematic Reviews, 3:64.CD002869. https://doi.org/10.1002/14651858.CD002869.pub2
• Gao, L., Chan, S. W., & Sun, K. (2012). Effects of an interpersonal-psychotherapy-oriented childbirth education programme for Chinese first-time childbearing women at 3-month follow up: Randomised controlled trial. International Journal of Nursing Studies, 49 (3), 274-281. https://doi.org/10.1016/j.ijnurstu.2011.09.010
• Gao, L., Chan, S.W., Li, X., Chen, S., & Hao, Y. (2010). Evaluation of an interpersonal-psychotherapy-oriented childbirth education programme for Chinese first-time childbearing women: a randomised controlled trial. International Journal of Nursing Studies, 47 (10), 1208-1216. https://doi.org/10.1016/j.ijnurstu.2010.03.002
• Haapio, S., Kaunonen, M., Arffman, M., & Astedt-Kurki, P. (2017). Effects of extended childbirth education by midwives on the childbirth fear of first-time mothers: an RCT. Scandinavian Journal of Caring Sciences, 31 (2), 293-301. https://doi.org/10.1111/scs.12346
• Ip, W. Y., Tang, C. S., & Goggins, W. B. (2009). An educational intervention to improve women’s ability to cope with childbirth. Journal of Clinical Nursing, 18 (15), 2125-2135. https://doi.org/10.1111/j.1365-2702.2008.02720.x
• Karabulut, Ö., Çoşkuner-Potur, D., Doğan-Merih, Y., Cebeci-Mutlu, S., & Demirci, N. (2016). Does antenatal education reduce fear of childbirth? International Nursing Review, 63 (1), 60-67. https://doi.org/10.1111/inr.12223
• Khunpradit, S., Tavender, E., Lumbiganon, P., Laopaiboon, M., Wasiak, J., & Gruen, R. L. (2011). Non-clinical interventions for reducing unnecessary caesarean section. Cochrane Database Systematic Reviews, 6:CD005528. https://doi.org/10.1002/14651858.CD005528.pub2
• Kızılırmak, A., & Başer, M. (2016). The effect of education given to primigravida women on fear of childbirth. Applied Nursing Research, 29, 19-24. https://doi.org/10.1016/j.apnr.2015.04.002
• Kjærgaard, H., Wijma, K., Dykes, A. K., & Alehagen, S. (2008). Fear of childbirth in obstetrically low-risk nulliparous women in Sweden and Denmark. Journal of Reproductive and Infant Psychology, 26, 340-50. https://doi.org/10.1080/02646830802408498
• Kordi, M., Bakhshi, M., Masoudi, S., & Esmaily, H. (2017). Effect of childbirth psychoeducation program on the level of fear of childbirth in primigravid women. Evidence Based Care Journal, 7 (3), 26-34. http://dx.doi.org/10.22038/ebcj.2017.25676.1575
• Köse, M. R., Bora-Başara, B., Güler, C., Soytutan-Çağlar, İ., Özdemir, T. A., Aygün, A., et al. (2017). T. C. Sağlık Bakanlığı sağlık istatistikleri yıllığı 2016. Sağlık Araştırmaları Genel Müdürlüğü, Sağlık Bakanlığı, Ankara, 1083, SB-SAGEM-2017/4. https://dosyasb.saglik.gov.tr/Eklenti/13183,sy2016turkcepdf.pdf?0 (Erişim: 29.12.2017).
• Larkin, P., & Begley, C. M. (2009). Women’s experiences of labour and birth: an evolutionary concept analysis. Midwifery, 25 (2), e49-e59. https://doi.org/10.1016/j.midw.2007.07.010
• Larsson, B., Karlström, A., Rubertsson, C., Ternström, E., Ekdahl, J., Segebladh, B., et al. (2017). Birth preference in wmen undergoing treatment for childbirth fear: A randomised controlled trial. Women and Birth, 30 (6), 460-467. https://doi.org/10.101/j.wombi.2017.04.004
• Lincoln, T. M., Wilhelm, K., & Nestoriuc, Y. (2007). Effectiveness of psychoeducation for relapse, symptoms, knowledge, adherence and functioning in psychotic disorders: A meta-analysis. Schizophrenia Research, 96 (1-3), 232–245. https://doi.org/10.1016/j.schres.2007.07.022
• Lukasse, M., Schei, B., & Ryding, E. L. (2014). Prevalence and associated factors of fear of childbirth in six European countries. Sexual & Reproductive Healthcare, 5 (3), 99-106. https://doi.org/10.1016/j.srhc.2014.06.007
• Miniati, M., Callari, A., Calugi, S., Rucci, P., Savino, M., & Mauri, M., et al. (2014). Interpersonal psychotherapy for postpartum depression: a systematic review. Archives of Women’s Mental Health, 17 (4), 257-268. https://doi.org/10.1007/s00737-014-0442-7
• Moher, D., Shamseer, L., Clarke, M., Ghersi, D., Liberati, A., Petticrew, M., et al. (2015). Preferred reporting ıtems for systematic review and meta-analysis protocols (PRISMA-P) 2015 Statement. Systematic Reviews, 4 (1), 1. doi: 10.1186/2046-4053-4-1
• Nahcivan, N., & Seçginli, S. (2017). How are the methodological quality of quantitative studies included in systematic review? Turkiye Klinikleri Halk Sağlığı Hemşireliği Özel Dergisi, 3 (1), 10-9. http://www.atifdizini.com/article/tr-sistematik-derlemeye-dahil-edilen-nicel-arastirmalarin-metodolojik-kalitesi-nasil-degerlendirilir-124606.html
• Ngai, F. W., Chan, S. W., & Ip, W. Y. (2009). The effects of a childbirth psychoeducation program on learned resourcefulness, maternal role competence and perinatal depression: a quasi-experiment. International Journal of Nursing Studies, 46 (10), 1298–1306. https://doi.org/10.1016/j.ijnurstu.2009.03.007
• Nieminen, K., Andersson, G., Wijma, B., Ryding, E. L., & Wijma, K. (2016). Treatment of nulliparous women with severe fear of childbirth via the internet: a feasibility study. Journal of Psychosomatic Obstetrics & Gynecology, 37 (2), 37-43. https://doi.org/10.3109/0167482X.2016.1140143
• Nieminen, K., Stephansson, O., & Ryding, E. (2009). Women’s fear of childbirth and preferences for caesarean section - a cross sectional study at various stages of pregnancy in Sweden. Acta Obstetricia et Gynecologia Scandinavica, 88 (7), 807-813. https://doi.org/10.1080/00016340902998436
• Psikiyatride Güncel Yaklaşımlar, 3 (1), 142-162. http://dergipark.ulakbim.gov.tr/pskguncel/article/view/5000076380
• Razurel, C., Antonietti, J. P., Rulfi, F., Pasquier, N., Domingues-Montanari, S., & Darwiche, J. (2017b). The impact of pre- and post-natal psycho-educational intervention on the construction of parenthood. Archives of Women’s Mental Health, 20 (3), 469-472. https://doi.org/10.1007/s00737-017-0720-2
• Razurel, C., Avignon, V., Gerdy, P., & Bouton, J. (2017a). Postpartum psycho-educational interviews to promote adaptation in new mothers: A preliminary study. Journal of Nursing Education and Practice, 7 (2), 1-9. https://doi.org/10.5430/jnep.v7n2p1
• Rouhe, H., Salmela-Aro, K., Toivanen, R., Tokola, M., Halmesma ̈ki, E., & Saisto, T. (2013). Obstetric outcome after intervention for severe fear of childbirth in nulliparous women-randomised trial. An International Journal of Obstetrics and Gynaecology, 120 (1), 75-84. https://doi.org/10.1111/1471-0528.12011
• Rouhe, H., Salmela-Aro, K., Toivanen, R., Tokola, M., Halmesmäki, E., Ryding, E. L., et al. (2015). Group psychoeducation with relaxation for severe fear of childbirth improves maternal adjustment and childbirth experience – a randomised controlled trial. Journal of Psychosomatic Obstetrics & Gynecology, 36 (1), 1-9. https://doi.org/10.3109/0167482X.2014.980722
• Saisto, T., Toivanen, R., Salmela-Aro, K., & Halmesmaki, E. (2006). Therapeutic group psychoeducation and relaxation in treating fear of childbirth. Acta Obstetricia et Gynecologica Scandinavica, 85 (11), 1315-1319. https://doi.org/10.1080/00016340600756920
• Salmela-Aro, K., Read, S., Rouhe, H., Halmesmäki, E., Toivanen, R. M., Tokola, M. I., et al. (2012). Promoting positive motherhood among nulliparous pregnant women with an intense fear of childbirth: RCT intervention. Journal of Health Psychology, 17 (4), 520-534. https://doi.org/10.1177/1359105311421050
• Toohill, J., Callander, E., Gamble, J., Creedy, D. K., & Fenwick, J. (2017). A cost effectiveness analysis of midwife psycho-education for fearful pregnant women-a health system perspective for the antenatal period. Bio Med Central Pregnancy & Childbirth, 17, 217. https://dx.doi.org/10.1186%2Fs12884-017-1404-7
• Toohill, J., Fenwick, J., Gamble, J., & Creedy, D. K. (2014). Prevalence of childbirth fear in an Australian sample of pregnant women. Bio Med Central Pregnancy & Childbirth, 14, 275. https://doi.org/10.1186/1471-2393-14-275
• Toohill, J., Fenwick, J., Gamble, J., Creedy, D. K., Buist, A., Turkstra, E., et al. (2014). A randomized controlled trial of a psycho-education intervention by midwives in reducing childbirth fear in pregnant women. Birth, 41 (4), 384-394. https://dx.doi.org/10.1111%2Fbirt.1213
• Xia, J., Merinder, L. B., & Belgamwar, M. R. (2011). Psychoeducation for schizophrenia. Cochrane Database Systematic Reviews, 6, CD002831. DOI: 10.1002/14651858.CD002831.pub2.
• Yohai, D., Alharar, D., Cohen, R., Kaltian, Z., Aricha-Tamir, B., Aion, S. B., et al. (2018). The effect of attending a prenatal childbirth preparedness course on labor duration and outcomes. Journal of Perinatal Medicine, 46 (1), 1-6. https://doi.org/10.1515/jpm-2016-0345