The Effect of Birth Preparation Education Given to Pregnant Women on Pregnancy Stress, Fear of Birth and Birth Mode Preference: Prospective Self-Control Study

Yıl 2025, Cilt: 7 Sayı: 1, 31 - 39, 18.02.2025

Hatice Kahyaoğlu Süt , Nermin Kayar , Zeliha Elkan Kiyat

https://doi.org/10.57224/jhpr.1545719

Öz

Aim: This study aimed to examine the effect of birth preparation education given to pregnant women on pregnancy stress, fear of birth and birth type preference.

Materials and Methods: This prospective self-control type study was conducted between September and October 2023. Birth preparation training was given to 20 pregnant women with a gestational age of 12 weeks and above, living in and around Edirne. "Information Form", "Tilburg Distress During Pregnancy Scale" and "Pre-Pregnancy Fear of Birth Scale-Women" were applied to the pregnant women. Data before and after training were compared.

Results: The average age of the pregnant women (n=20) was 29.5±4.3 and the average gestational week was 22.6±5.5. Pregnant women; 65% stated that they preferred vaginal birth and 35% preferred cesarean birth. Tilburg Pregnancy Distress Scale score before training was 18.95±7.3, after training 14.2±7.5 (p=0.004); The "negative affect" subscale score was found to be 15.7±6.9 before the training and 10.9±6.8 after the training (p=0.002). Pre-Pregnancy Fear of Birth Scale score was determined as 38.9±11.5 before the training and 34.4±11.13 after the training (p=0.004). 3 out of 7 pregnant women (42.9%), who stated that they preferred cesarean birth before the training, stated that they changed their preference to natural-vaginal birth after the training (p = 0.625).

Conclusion: In the study, it was determined that birth preparation training given to pregnant women reduced pregnancy stress and fear of birth. However, the birth preparation education provided did not have a significant effect on the choice of birth method. It is important to standardize birth preparation training that encourages natural, that is, vaginal birth, to include current evidence-based practices in the training, and to receive feedback from pregnant women after the training.

Anahtar Kelimeler

Pregnant, preparation for birth, fear of birth, type of birth, stress

Proje Numarası

2021/147

Gebelere Verilen Doğuma Hazırlık Eğitiminin Gebelik Stresi, Doğum Korkusu ve Doğum Şekli Tercihi Üzerine Etkisi: Prospektif Self-Kontrol Çalışma

Öz

Amaç: Bu araştırmada, gebelere verilen doğuma hazırlık eğitiminin gebelik stresi, doğum korkusu ve doğum şekli tercihi üzerine etkisini incelemek amaçlandı.

Gereç ve Yöntem: Prospektif self-kontrol tipte bu çalışma Eylül-Ekim 2023 tarihleri arasında yürütüldü. Edirne ili ve çevresinde yaşayan, 12 hafta ve üzeri gebelik haftasına sahip 20 gebe kadına doğuma hazırlık eğitimi verildi. Gebelere “Bilgi Formu”, “Tilburg Gebelikte Distres Ölçeği” ve “Gebelik Öncesi Doğum Korkusu Ölçeği-Kadın” uygulandı. Eğitim öncesi ve sonrası veriler karşılaşılaştırıldı.

Bulgular: Gebelerin (n=20) yaş ortalaması 29.5±4.3 olup gebelik haftası ortalaması 22.6±5.5’tir. Gebe kadınların; %65’i vajinal doğum, %35’i sezaryen doğum tercih ettiğini belirtti. Tilburg Gebelikte Distres Ölçeği eğitim öncesi puanı 18.95±7.3, eğitim sonrası 14.2±7.5 (p=0.004); “olumsuz duygulanım” alt boyut puanı eğitim öncesi 15.7±6.9, eğitim sonrası 10.9±6.8 (p=0.002) bulundu. Gebelik Öncesi Doğum Korkusu Ölçeği puanı eğitim öncesi 38.9±11.5, eğitim sonrası 34.4±11.13 (p=0.004) olarak belirlendi. Eğitim öncesi sezaryen doğum tercih ettiğini belirten 7 gebeden 3’ü (%42.9), eğitim sonrası tercihini doğal-vajinal doğum yönünde değiştirdiklerini (p=0.625) belirtti.

Sonuç: Çalışmada, gebelere verilen doğuma hazırlık eğitiminin gebelik stresini ve doğum korkusunu azalttığı belirlendi. Ancak verilen doğuma hazırlık eğitimi, doğum şekli tercihi üzerine anlamlı etkili olmadı. Doğal yani vajinal doğumu teşvik edici doğuma hazırlık eğitiminin bir standardizasyonun olması, eğitimde güncel kanıta dayalı uygulamalara yer verilmesi ve eğitim sonrası gebelerden geri bildirim alınması önemlidir.

Anahtar Kelimeler

Gebe, doğuma hazırlık, doğum korkusu, doğum şekli, stres

Etik Beyan

Bu araştırma; 2021/147 Nolu Üniversite Bilimsel Araştırma Projeleri “Öğrenci Bilimsel Araştırma Desteği” ile yürütülmüştür.

Destekleyen Kurum

Trakya Üniversitesi

Proje Numarası

2021/147

Kaynakça

• Hajipour L, Mohtasham Amiri Z, Montazeri A, Torkan B, Hosseini Tabaghdehi M. The effects of prenatal classes on the quality of life in pregnant women. J Holist Nurs Midwifery 2017; 27 (1): 45-51. https://doi.org/10.18869/acadpub.hnmj.27.1.45
• Soltanni F, Esmaeili M, Mohammadi Y, Aghababaei S. The effect of prenatal counseling on the knowledge and performance about postpartum care in primigravida women. Avicenna J Nurs Midwifery Care 2019; 27 (5) :344-351. https://doi.org/10.30699/ajnmc.27.5.344
• .Yılmaz Esencan T, Karabulut Ö, Demir Yıldırım A, Abbasoğlu DE, Külek H, Şimşek Ç ve ark. Doğuma Hazırlık Eğitimi Alan Gebelerin Doğum Şekli, İlk Emzirme Zamanı ve Ten Tene Temas Tercihleri. Florence Nightingale Journal of Nursing 2018;26(1):31-43. https://doi.org/10.26650/FNJN.387192
• Mutambudzi M, Meyer JD, Warren N, Reisine S. Effects of psychosocial characteristics of work on pregnancy outcomes: a critical review. Women & Health 2011; 51(3): 279-297. https://doi.org/10.1080/03630242.2011.560242
• Tang X, Lu Z, Hu D, Zhong X. Influencing factors for prenatal stress, anxiety and depression in early pregnancy among women in Chongqing, China. J Affect Disord 2019; 253: 292-302. https://doi.org/10.1016/j.jad.2019.05.003
• Hofberg K, Ward MR. Fear of childbirth, tocophobia, and mental health in mothers: the obstetric-psychiatric interface. Clin Obstet Gynecol 2004; 47(3): 527-534. https://doi.org/10.1097/01.grf.0000132527.62504.ca
• Margareta Z, Wijma K, Wijma B. Pre-and postpartum fear of childbirth in nulliparous and parous women. Scandinavian J Behaviour Therapy 2001; 30(2): 75-84. https://doi.org/
• 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 Obstet Gynecol Scand 2017; 96(8): 907-920. https://doi.org/10.1111/aogs.13138
• Hellerstein S, Feldman S, Duan T. China's 50% caesarean delivery rate: is it too high?. BJOG. 2015; 122(2): 160-164. https://doi.org/10.1111/1471-0528.12971
• WHO statement on caesarean section rates. https://www.who.int/reproductivehealth/publications/maternal_perinatal_health/cs-statement/en/ Erişim Tarihi: 10.07.2021
• Topaktaş G, Beylik U. Türkiye sezaryen oranı durum analizi ve politika önerileri. JGON 2024; 21(2): 102-13. 12.Bahrami N, Simbar M, Bahrami S. The effect of prenatal education on mother's quality of life during first year postpartum among Iranian women: A randomized controlled trial. Int J Fertil Steril 2013; 7(3): 169-174.
• Byrne J, Hauck Y, Fisher C, Bayes S, Schutze R. Effectiveness of a Mindfulness-Based Childbirth Education pilot study on maternal self-efficacy and fear of childbirth. J Midwifery Womens Health 2014; 59(2): 192-197. https://doi.org/10.1111/jmwh.12075
• .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. Clinical Nursing Research 2021; 30(6): 818-829. https://doi.org/10.1177/1054773820916984 15.Bıyık İ, Aslan MM. Gebelikte eğitimin doğum korkusu ve sezaryen oranlarına etkisi. Kocaeli Med J. 2020; 9(2): 77-82.
• Shi Y, Wang D, Yuan Y, Jiang Y, Zeng Q, Chang C. The effect of prenatal education curriculum on mother's prenatal examination utilization, delivery mode and recovery status: a cross-sectional survey in China. Environ Health Prev Med. 2015;20(6):397-403. https://doi.org/10.1007/s12199-015-0480-4
• Kaya Y. Sayik D. Kaya Usta E. Palas Karaca P. Bilgin M. Effect of Pregnancy School on Distress During Pregnancy Osmangazi Journal of Medicine 2020; 42(2): 188-194. https://doi.org/10.20515/otd.537863
• Özçoban FA, Karaman E. Androgojik yaklaşım ile verilen doğuma hazırlık eğitiminin doğum ve doğum sonrası sürece etkisinin değerlendirilmesi. Celal Bayar Üniversitesi Sağlık Bilimleri Enstitüsü Dergisi 2019; 6(4): 215-221. https://doi.org/10.34087/cbusbed.520701
• Pop VJ, Pommer AM, Pop-Purceleanu M, Wijnen HA, Bergink V, Pouwer F. Development of the Tilburg Pregnancy Distress Scale: the TPDS. BMC Pregnancy Childbirth. 2011; 11(1): 80. https://doi.org/10.1186/1471-2393-11-80
• Çapık A, Pasinlioğlu T. Validity and reliability study of The Tilburg Pregnancy Distress Scale into Turkish. J Psychiatric and Mental Health Nursing. 2015; 22(4): 260–9. https://doi.org/10.1111/jpm.12211
• Çapık A, Apay SE, Sakar T. Gebelerde distress düzeyinin belirlenmesi. Anadolu Hemşirelik ve Sağlık Bilimleri Dergisi. 2015;18(3):196–203. https://doi.org/10.17049/ahsbd.97570
• Comrey AL, Lee HB. A First Course in Factor Analysis. 2nd edition. New York: Lawrance Erlbaum Associates 1992:217.
• Uçar T, Taşhan ST. Gebelik öncesi Doğum Korkusu Ölçeğinin Türkçe uyarlaması: Kadın ve erkeklerde geçerlik ve güvenirlik çalışması. Acıbadem Üniversitesi Sağlık Bilimleri Dergisi 2018; 9: 289-296. https://doi.org/10.31067/0.2018.43
• Hong K, Hwang H, Han H, Chae J, Choi J, Jeong Y, Lee J, Lee KJ. Perspectives on antenatal education associated with pregnancy outcomes: Systematic review and meta-analysis. Women Birth 2021; 34(3): 219-230. https://doi.org/10.1016/j.wombi.2020.04.002
• Yesildag B, Golbasi Z. Effects of the web-based birth preparation programme and motivational interviews on primigravida women: Randomized-controlled study. Int J Nurs Pract 2024; 30(1): e13207. https://doi.org/10.1111/ijn.13207
• .Alizadeh-Dibazari Z, Abdolalipour S, Mirghafourvand M. The effect of prenatal education on fear of childbirth, pain intensity during labour and childbirth experience: a scoping review using systematic approach and meta-analysis. BMC Pregnancy Childbirth 2023; 23(1): 541. https://doi.org/10.1186/s12884-023-05867-0
• Serçekuş P, Başkale H. Effects of antenatal education on fear of childbirth, maternal self-efficacy and parental attachment. Midwifery 2016; 34: 166-172. https://doi.org/10.1016/j.midw.2015.11.016
• Hassanzadeh R, Abbas-Alizadeh F, Meedya S, Mohammad-Alizadeh-Charandabi S, Mirghafourvand M. Fear of childbirth, anxiety and depression in three groups of primiparous pregnant women not attending, irregularly attending and regularly attending childbirth preparation classes. BMC Womens Health 2020; 20(1): 180. https://doi.org/10.1186/s12905-020-01048-9
• Adams SS, Eberhard-Gran M, Eskild A. Fear of childbirth and duration of labour: a study of 2206 women with intended vaginal delivery. BJOG 2012; 119(10): 1238-1246. https://doi.org/10.1111/j.1471-0528.2012.03433.x
• Saisto T, Kaaja R, Ylikorkala O, Halmesmäki E. Reduced pain tolerance during and after pregnancy in women suffering from fear of labor. Pain 2001; 93(2): 123-127. https://doi.org/10.1016/S0304-3959(01)00302-5
• Saisto T, Halmesmäki E. Fear of childbirth: a neglected dilemma. Acta Obstet Gynecol Scand 2003; 82(3): 201-208.
• Räisänen S, Lehto SM, Nielsen HS, Gissler M, Kramer MR, Heinonen S. Fear of childbirth in nulliparous and multiparous women: a population-based analysis of all singleton births in Finland in 1997-2010. BJOG 2014; 121(8): 965-970. https://doi.org/10.1111/1471-0528.12599
• Sydsjö G, Sydsjö A, Gunnervik C, Bladh M, Josefsson A. Obstetric outcome for women who received individualized treatment for fear of childbirth during pregnancy. Acta Obstet Gynecol Scand 2012; 91(1): 44-49. https://doi.org/10.1111/j.1600-0412.2011.01242.x
• Zhang L, Zhang L, Li M, Xi J, Zhang X, Meng Z et al. A cluster-randomized field trial to reduce cesarean section rates with a multifaceted intervention in Shanghai, China. BMC Med 2020; 18(1): 27. https://doi.org/10.1186/s12916-020-1491-6
• .Chaillet N, Dumont A, Abrahamowicz M, Pasquier JC, Audibert F, Monnier P et al. A cluster-randomized trial to reduce cesarean delivery rates in Quebec. N Engl J Med 2015; 372: 1710–21. https://doi.org/10.1056/NEJMoa1407120
• .Til A, Bostanci M. The effect of structured delivery preparation education on birth preference. Int J Gynaecol Obstet 2021; 154(3): 459-465. https://doi.org/10.1002/ijgo.13569