Reducing Fear of Childbirth among Pregnant Women: Women's Lived Experience, Predictors, and Effects of Mindfulness-Based Childbirth Education

Fear of childbirth is a common clinical problem among perinatal women and link to adverse health effects on mother’s and offspring’s wellbeing. Recently, reducing the childbirth fear becomes a highly important maternity care issues as a result of the fact that the birth rate has been declining rapidly as well as Cesarean rate increased steadily. However, the studies on fear of childbirth among perinatal population in Taiwan were limited. In this proposal we plan to conduct a 3-phase comprehensive study, including a qualitative study using in-depth interview among pregnant women in phase 1, the prospective cohort study on the associations between change of childbirth fear over time with the predictors and health outcomes in phase 2, and a randomized controlled study examining the effects of mindfulness-based childbirth education in phase 3 study. In the first year, the lived experiences of fear of childbirth as well as their coping strategies will be explored among prenatal women. A qualitative study design using phenomenological approach and a life world perspective will be adopted. Data will be collected via tape-recorded interviews and will be analyzed using the Colaizzi approach. A prospective follow-up study on 150 perinatal women from 25 weeks gestation to postpartum 1 week will be conducted in the second year. Trajectory analysis will be applied to identify the distinct groups of fear of childbirth. The psychosocial predictors for the high risk groups and change pattern of childbirth fear will be examined. In the last year we will conduct the randomized controlled study on the efficacy of the mindfulness-based childbirth education. A total of 40 women will be recruited and randomized into the experiment group (receiving mindfulness-based childbirth education and traditional childbirth education), whereas the 40 women will be allocated in the control group receiving traditional childbirth education. Intention-to-treat analysis as well as mixed regression modeling will be used to estimate the effectiveness of the interventions. The information on the inter-individual variations in the fear associated with pregnancy and childbirth, the empirical evidence on the predictors on the high risk groups, distinctive patterns of childbirth fear, as well as the effectiveness of mindfulness education will be valuable for the pregnant women and health professionals.