The Effect of Training Program Given to Multiple Pregnants by Motivational Interview Method on Fear of Birth and Delivery Style

Abstract

Aim: Within the scope of our research, it was aimed to evaluate the effects of the training programs given with the motivational interview attitude given specifically to the mothers with multiple pregnancies on possible fears of childbirth and self-perception. In this direction, case and control studies were conducted with two groups. In summary, it focused on the effect of self-efficacy experienced during birth and self-efficacy experienced at the same time. Material and Methods: Our study was carried out between August 2022 and November 2022 in Adana Seyhan State Hospital Obstetrics and Gynecology Polyclinic with 73 multiple pregnant women (intervention: 37, control: 36) who met the study. More than one pregnant mother in the sample was randomly selected according to the intervention and control groups. "Training Program Based on Motivational Interview Method for Fear of Birth" was given to 37 pregnant women in the case group, four sessions individually, once a week. Results: In obtaining the relevant data within the scope of our study; Descriptive Personal Form, Wijma Birth Expectation/Experience Scale (W-DEQ) Versions A and B, Birth Self-Efficacy Scale (DSS) Short Version and Birth Evaluation Form were used. During the evaluation of the data, descriptive statistics such as the number of patients and the percentage of gender were recorded. Data are shown as mean±standard deviation, median (percentage). Chi-square test, Independent Groups t test, Mann Whitney U test, Wilcoxon test, repeated measures ANOVA test and Friedman test were used in statistical analysis. Conclusion: In the training program conducted with the motivational interview approach with pregnant mothers, it was revealed that possible fears of birth were minimized, positive increases were observed in birth self-efficacy, and the effect on birth types was not much. Looking at the results of the research; In order to minimize the fear of birth in the prenatal period and to increase self-efficacy during birth, it is recommended to include it in nursing care in a training program based on the motivational interview approach for fear of birth.

Keywords

• Birth fears
• Pregnancy
• Self-efficacy at birth
• Mode of delivery
• Motivational Interview
• Nursing
• Pregnancy

References

1. Rouhe H, Salmela-Aro K, Halmesmäki E, Saisto T. Fear of childbirth according to parity, gestational age, and obstetric history. BJOG. 2009;116:67-73.
2. Nieminen K, Stephansson O, Ryding EL. Women's fear of childbirth and preference for cesarean section–a cross-sectional study at various stages of pregnancy in Sweden. Acta Obstet Gynecol Scand. 2009;88:807-13.
3. Çiçek Ö, Mete S. A common problem: fear of childbirth. DEUHFED. 2015;8:263-8.
4. Nilsson C, Hessman E, Sjöblom H, et al. Definitions, measurements and prevalence of fear of childbirth: a systematic review. BMC Pregnancy Childbirth. 2018;18:28.
5. Laursen M, Johansen C, Hedegaard M. Fear of childbirth and risk for birth complications in nulliparous women in the Danish National Birth Cohort. BJOG. 2009;116:1350-5.
6. Hofberg K, Brockington I. Tokophobia: an unreasoning dread of childbirth: a series of 26 cases. Br J Psychiatry. 2000;176:83-5.
7. Saisto T, Halmesmäki E. Fear of childbirth: a neglected dilemma. Acta Obstet Gynecol Scand. 2003;82:201-8.
8. Räisänen S, Lehto SM, Nielsen HS, et al. Fear of childbirth in nulliparous and multiparous women: a population-based analysis of all singleton births in Finland in 1997–2010. BJOG. 2014;121:965-70.

9. Wijma K,Wijma B. A woman afraid to deliver: how to manage childbirth anxiety. Bio-Psycho-Social Obstetrics and Gynecology. 2017:3-31.
10. Miller WR, Rollnick S. Motivational Interviewing, Preparing People for Change, 2nd ed. The Guilford Press: New York, US: 2002.
11. Arkowitz H, Miller W, Rollnick S. Motivational interviewing in the treatment of psychological problems, 2nd ed. The Guilford Press: New York, US. 2015.
12. Smedslund G, Berg RC, Hammerstrøm KT, et al. Motivational interviewing for substance abuse. Cochrane Database Syst. Rev. 2011;11:CD008063.
13. Lindson N, Thompson TP, Ferrey A, et al. Motivational interviewing for smoking cessation. Cochrane Database Syst Rev. 2019;7:CD006936.
14. Ekong G, Kavookjian J. Motivational interviewing and outcomes in adults with type 2 diabetes: a systematic review. Patient Educ Couns. 2016;99:944-52.
15. O’Halloran PD, Blackstock F, Shields N, et al. Motivational interviewing to increase physical activity in people with chronic health conditions: a systematic review and meta-analysis. Clin Rehabil. 2014;28:1159-71.
16. Ryding EL, Lukasse M, Parys ASV, et al. Fear of childbirth and risk of cesarean delivery: a cohort study in six European countries. Birth. 2015;42:48-55.
17. O'Connell M, Leahy-Warren P, Khashan AS, Kenny LC. Tocophobia–the new hysteria?. Obstet Gynaecol Reprod Med. 2015;25:175-7.
18. Stützer PP, Berlit S, Lis S, et al. Elective caesarean section on maternal request in Germany: factors affecting decision making concerning mode of delivery. Arch Gynecol Obstet. 2017;295:1151-6.
19. Duncan LG, Cohn MA, Chao MT, et al. Benefits of preparing for childbirth with mindfulness training: a randomized controlled trial with active comparison. BMC Pregnancy Childbirth. 2017;17;140.
20. Toohill J, Fenwick J, Gamble J, et al. A randomized controlled trial of a psychoeducation intervention by midwives in reducing childbirth fear in pregnant women. Birth. 2014;41:384-94.
21. Ölmez F, Oğlak SC. The prevalance and associated factors of fear of childbirth among pregnant adolescent in Turkey: a cross-sectional study. J Clin Obstet Gynecol. 2021;31:103-10.