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Ebe Liderliğindeki Uygulamaların Doğum Beklentisi ve Deneyimi Üzerine Etkisi: Sistematik İnceleme ve Meta-Analiz

Year 2025, Issue: 26, 439 - 450, 31.08.2025
https://doi.org/10.38079/igusabder.1610921

Abstract

Amaç: Bu çalışmanın amacı, ebe liderliğindeki uygulamaların doğum beklentileri ve deneyimleri üzerindeki etkilerini sistematik bir şekilde incelemek ve mevcut kanıtları meta-analiz yöntemiyle değerlendirmektir.
Yöntem: Literatür taraması, Kasım ve Aralık 2024 tarihlerinde PubMed, Cochrane Library, Web of Science ve ULAKBIM gibi dört elektronik veri tabanında yapılmıştır. Yayınlanan makaleler, MeSH terimleri kullanılarak belirlenmiştir. Aramada yalnızca Randomize Kontrollü Çalışmalar (RCT) dahil edilmiştir. Veriler, Review Manager yazılımı ile analiz edilmiştir.
Bulgular: Meta-analize toplamda 936 kadını içeren yedi çalışma dahil edilmiştir. Random etkiler modeline göre, gruplar arasında doğum beklentileri açısından post-test sonuçlarında anlamlı farklar bulunmuştur (MD: -15,58, 95% CI: -30,74 ile -0,42, Z = 2,01, p = 0,04). Ayrıca, post-testte doğum öz-yeterlilik değerlerinde de gruplar arasında anlamlı farklar gözlemlenmiştir (MD: 43,60, 95% CI: 24,53 ile 62,67, Z = 4,48, p < 0,00001).
Sonuç: İncelenen çalışmaların bulgularına göre, ebe tarafından yönlendirilen müdahaleler, hamile kadınların doğum korkusu ve stresini azalttığı, lohusalık döneminde de bu etkinin devam ettiği ve kadınların doğumla ilgili öz-yeterlilik algılarını artırdığı görülmüştür. Ancak, bu müdahaleler düşük kaliteli kanıtlara dayanmaktadır.

References

  • 1. O'Connell MA, Leahy‐Warren P, Khashan AS, Kenny LC, O'Neill SM. Worldwide prevalence of tocophobia in pregnant women: systematic review and meta‐analysis. Acta Obstetricia et Gynecologica Scandinavica. 2017;96(8):907-920.
  • 2. Jomeen J, Martin CR, Jones C, et al. Tokophobia and fear of birth: a workshop consensus statement on current issues and recommendations for future research. Journal of Reproductive and Infant Psychology. 2021;39(1):2-15.
  • 3. Akın B, Çankaya S. A sense of consistency, perceived stress and fear of childbirth in pregnant women. Turkish Journal of Family Medicine and Primary Care. 2022;16(4):772-778.
  • 4. Arslantaş H, Çoban A, Dereboy F, Sarı E, Şahbaz M, Kurnaz D. Factors affecting the fear of childbirth in the last trimester pregnant women and the relationship between the fear of childbirth and postpartum depression and maternal attachment. Cukurova Medical Journal. 2020;45(1):239-250.
  • 5. Yaylaoğlu Ö, Zengin N. Examining the relationship between fear of childbirth and spiritual well-being in pregnant women: a descriptive study. Turkiye Klinikleri J Health Sci. 2023;8(1):57-64.
  • 6. World Health Organization. (2018). WHO recommendations Intrapartum care for a positive childbirth experience. https://www.who.int/reproductivehealth/publications/intrapartum-care-guidelines/en
  • 7. Çevik A, Avcıbay Vurgeç B. Midwife-led care in postpartum. Journal of Midwifery and Health Sciences. 2022;5(1):37-45
  • 8. Çankaya S, Şimşek B. Effects of antenatal education on fear of birth, depression, anxiety, childbirth self-efficacy, and mode of delivery in primiparous pregnant women: a prospective randomized controlled study. Clin Nurs Res. 2021;30(6):818-829.
  • 9. Asadzadeh L, Jafari E, Kharaghani R, Taremian F. Effectiveness of midwife-led brief counseling intervention on post-traumatic stress disorder, depression, and anxiety symptoms of women experiencing a traumatic childbirth: a randomized controlled trial. BMC Pregnancy and Childbirth. 2020;20(1):1-9. doi: 10.1186/s12884-020-2826-1.
  • 10. Tugwell P, Tovey D. PRISMA 2020. Journal of Clinical Epidemiology, 2021;134:A5-A6.
  • 11. İsbir GG, Serçekuş P. The effects of intrapartum supportive care on fear of delivery and labor outcomes: a single-blind randomized controlled trial. Journal of Nursing Research. 2017;25(2):112-119. doi: 10.1097/JNR.0000000000000129
  • 12. Rouhe H, Salmela-Aro K, Toivanen R, et al. Group psychoeducation with relaxation for severe fear of childbirth improves maternal adjustment and childbirth experience–a randomised controlled trial. Journal of Psychosomatic Obstetrics & Gynecology, 2015;36(1):1-9. doi: 10.3109/0167482X.2014.980722
  • 13. Turkstra E, Mihala G, Scuffham PA, et al. An economic evaluation alongside a randomised controlled trial on psycho-education counselling intervention offered by midwives to address women's fear of childbirth in Australia. Sexual & Reproductive Healthcare. 2017;11:1-6. doi: 10.1016/j.srhc.2016.08.003
  • 14. Van der Meulen RT, Veringa-Skiba IK, Van Steensel FJA, Bögels SM, De Bruin EI. Mindfulness-based childbirth and parenting for pregnant women with high fear of childbirth and their partners: outcomes of a randomized controlled trial assessing short-and longer-term effects on psychological well-being, birth and pregnancy experience. Midwifery. 2023;116:103545. doi: 10.1016/j.midw.2022.103545
  • 15. Veringa‐Skiba IK, De Bruin EI, van Steensel FJ, Bögels SM. Fear of childbirth, nonurgent obstetric interventions, and newborn outcomes: A randomized controlled trial comparing mindfulness‐based childbirth and parenting with enhanced care as usual. Birth. 2022;49(1):40-51. doi: 10.1111/birt.12571
  • 16. Yilmaz Esencan T, Rathfisch G. Effects of yoga and meditation on the birth process. Alternative Therapies in Health and Medicine. 2023;29(1):6-14.
  • 17. Downe S, Finlayson K, Oladapo O, Bonet M, Gülmezoglu AM. What matters to women during childbirth: a systematic qualitative review. PloS One. 2018;13(4): e0194906.
  • 18. Barut S, Uçar T. The relationship between birth self-efficacy perception and fear of childbirth in pregnant women. Mersin University Journal of Health Sciences. 2018;11(2):107-115.
  • 19. Barut S, Uçar T. Effects of motivational interviews on childbirth perceptions and childbirthself-efficacy in nulliparous pregnant women: a randomised-controlled trial. Journal of Reproductive and Infant Psychology. 2022;1-16.
  • 20. Sutcliffe KL, Levett K, Dahlen HG, Newnham E, MacKay LM. How do anxiety and relationship factors influence the application of childbirth education strategies during labor and birth: a bowen family systems perspective. International Journal of Women's Health. 2023;455-465. doi: 10.2147/IJWH.S399588.
  • 21. Association of Women's Health, Obstetric and Neonatal Nurses, (AWHONN). Convention. Denver, Colorado, USA. J Obstet Gynecol Neonatal Nurs. 2011;40Suppl 1:1-134.
  • 22. Dinç H, Yazıcı S, Yılmaz T, Günaydın S. Pregnant education. pregnancy education. Journal of Health Sciences and Professions. 2014;1(1):68-76.
  • 23. Rathfisch G. The Philosophy of Natural Birth Is an Adventure That Has Taken Place for Millions of Years. Istanbul: Nobel Medical Bookstores, 2012.
  • 24. Buran G, Olgaç Z, Karaçam Z. The effect of childbirth preparation classes on women's birth style, fear, and experience: a systematic review. Life Sciences (NWSALS). 2020;15(4):41-54. doi: 10.12739/NWSA.2020.15.4.4B00

The Effect of Midwife-Led Practices on Birth Expectancy and Experience Outcomes: Systematic Review and Meta-Analysis

Year 2025, Issue: 26, 439 - 450, 31.08.2025
https://doi.org/10.38079/igusabder.1610921

Abstract

Aim: The objective of this study was to conduct a systematic review of the birth expectations and experiences associated with midwife-led interventions, and to perform a meta-analysis of the existing evidence.
Method: The literature review was carried out between November and December 2024 across four electronic databases: PubMed, Cochrane Library, Web of Science, and ULAKBIM. Articles were identified using MeSH-based keywords. Only Randomized Controlled Trials (RCTs) were included in this unrestricted search. The data were analyzed using the Review Manager software.
Results: A total of seven studies, involving 936 women, were included in the analysis. According to the results of the random effects model, significant differences in birth expectations were observed between the groups in the post-test (MD: -15.58, 95% CI: -30.74 to -0.42, Z = 2.01, p = 0.04). Additionally, the results showed significant differences in childbirth self-efficacy values between the groups in the post-test (MD: 43.60, 95% CI: 24.53 to 62.67, Z = 4.48, p < 0.00001).
Conclusions: Consistent with the findings of the studies included in the review, midwife-led interventions were shown to reduce childbirth-related fear and stress in pregnant women and during the puerperium, while also enhancing their perception of self-efficacy for childbirth. These interventions contribute to low-quality evidence.

References

  • 1. O'Connell MA, Leahy‐Warren P, Khashan AS, Kenny LC, O'Neill SM. Worldwide prevalence of tocophobia in pregnant women: systematic review and meta‐analysis. Acta Obstetricia et Gynecologica Scandinavica. 2017;96(8):907-920.
  • 2. Jomeen J, Martin CR, Jones C, et al. Tokophobia and fear of birth: a workshop consensus statement on current issues and recommendations for future research. Journal of Reproductive and Infant Psychology. 2021;39(1):2-15.
  • 3. Akın B, Çankaya S. A sense of consistency, perceived stress and fear of childbirth in pregnant women. Turkish Journal of Family Medicine and Primary Care. 2022;16(4):772-778.
  • 4. Arslantaş H, Çoban A, Dereboy F, Sarı E, Şahbaz M, Kurnaz D. Factors affecting the fear of childbirth in the last trimester pregnant women and the relationship between the fear of childbirth and postpartum depression and maternal attachment. Cukurova Medical Journal. 2020;45(1):239-250.
  • 5. Yaylaoğlu Ö, Zengin N. Examining the relationship between fear of childbirth and spiritual well-being in pregnant women: a descriptive study. Turkiye Klinikleri J Health Sci. 2023;8(1):57-64.
  • 6. World Health Organization. (2018). WHO recommendations Intrapartum care for a positive childbirth experience. https://www.who.int/reproductivehealth/publications/intrapartum-care-guidelines/en
  • 7. Çevik A, Avcıbay Vurgeç B. Midwife-led care in postpartum. Journal of Midwifery and Health Sciences. 2022;5(1):37-45
  • 8. Çankaya S, Şimşek B. Effects of antenatal education on fear of birth, depression, anxiety, childbirth self-efficacy, and mode of delivery in primiparous pregnant women: a prospective randomized controlled study. Clin Nurs Res. 2021;30(6):818-829.
  • 9. Asadzadeh L, Jafari E, Kharaghani R, Taremian F. Effectiveness of midwife-led brief counseling intervention on post-traumatic stress disorder, depression, and anxiety symptoms of women experiencing a traumatic childbirth: a randomized controlled trial. BMC Pregnancy and Childbirth. 2020;20(1):1-9. doi: 10.1186/s12884-020-2826-1.
  • 10. Tugwell P, Tovey D. PRISMA 2020. Journal of Clinical Epidemiology, 2021;134:A5-A6.
  • 11. İsbir GG, Serçekuş P. The effects of intrapartum supportive care on fear of delivery and labor outcomes: a single-blind randomized controlled trial. Journal of Nursing Research. 2017;25(2):112-119. doi: 10.1097/JNR.0000000000000129
  • 12. Rouhe H, Salmela-Aro K, Toivanen R, et al. Group psychoeducation with relaxation for severe fear of childbirth improves maternal adjustment and childbirth experience–a randomised controlled trial. Journal of Psychosomatic Obstetrics & Gynecology, 2015;36(1):1-9. doi: 10.3109/0167482X.2014.980722
  • 13. Turkstra E, Mihala G, Scuffham PA, et al. An economic evaluation alongside a randomised controlled trial on psycho-education counselling intervention offered by midwives to address women's fear of childbirth in Australia. Sexual & Reproductive Healthcare. 2017;11:1-6. doi: 10.1016/j.srhc.2016.08.003
  • 14. Van der Meulen RT, Veringa-Skiba IK, Van Steensel FJA, Bögels SM, De Bruin EI. Mindfulness-based childbirth and parenting for pregnant women with high fear of childbirth and their partners: outcomes of a randomized controlled trial assessing short-and longer-term effects on psychological well-being, birth and pregnancy experience. Midwifery. 2023;116:103545. doi: 10.1016/j.midw.2022.103545
  • 15. Veringa‐Skiba IK, De Bruin EI, van Steensel FJ, Bögels SM. Fear of childbirth, nonurgent obstetric interventions, and newborn outcomes: A randomized controlled trial comparing mindfulness‐based childbirth and parenting with enhanced care as usual. Birth. 2022;49(1):40-51. doi: 10.1111/birt.12571
  • 16. Yilmaz Esencan T, Rathfisch G. Effects of yoga and meditation on the birth process. Alternative Therapies in Health and Medicine. 2023;29(1):6-14.
  • 17. Downe S, Finlayson K, Oladapo O, Bonet M, Gülmezoglu AM. What matters to women during childbirth: a systematic qualitative review. PloS One. 2018;13(4): e0194906.
  • 18. Barut S, Uçar T. The relationship between birth self-efficacy perception and fear of childbirth in pregnant women. Mersin University Journal of Health Sciences. 2018;11(2):107-115.
  • 19. Barut S, Uçar T. Effects of motivational interviews on childbirth perceptions and childbirthself-efficacy in nulliparous pregnant women: a randomised-controlled trial. Journal of Reproductive and Infant Psychology. 2022;1-16.
  • 20. Sutcliffe KL, Levett K, Dahlen HG, Newnham E, MacKay LM. How do anxiety and relationship factors influence the application of childbirth education strategies during labor and birth: a bowen family systems perspective. International Journal of Women's Health. 2023;455-465. doi: 10.2147/IJWH.S399588.
  • 21. Association of Women's Health, Obstetric and Neonatal Nurses, (AWHONN). Convention. Denver, Colorado, USA. J Obstet Gynecol Neonatal Nurs. 2011;40Suppl 1:1-134.
  • 22. Dinç H, Yazıcı S, Yılmaz T, Günaydın S. Pregnant education. pregnancy education. Journal of Health Sciences and Professions. 2014;1(1):68-76.
  • 23. Rathfisch G. The Philosophy of Natural Birth Is an Adventure That Has Taken Place for Millions of Years. Istanbul: Nobel Medical Bookstores, 2012.
  • 24. Buran G, Olgaç Z, Karaçam Z. The effect of childbirth preparation classes on women's birth style, fear, and experience: a systematic review. Life Sciences (NWSALS). 2020;15(4):41-54. doi: 10.12739/NWSA.2020.15.4.4B00
There are 24 citations in total.

Details

Primary Language English
Subjects Obstetrics and Gynocology Nursing
Journal Section Articles
Authors

Fatma Şule Bilgiç 0000-0002-5950-2553

Aysu Yıldız Karaahmet 0000-0003-1134-9016

Fatma Azizoğlu 0000-0002-7102-9797

Early Pub Date August 30, 2025
Publication Date August 31, 2025
Submission Date December 31, 2024
Acceptance Date July 28, 2025
Published in Issue Year 2025 Issue: 26

Cite

JAMA Bilgiç FŞ, Yıldız Karaahmet A, Azizoğlu F. The Effect of Midwife-Led Practices on Birth Expectancy and Experience Outcomes: Systematic Review and Meta-Analysis. IGUSABDER. 2025;:439–450.

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