The effectiveness of cognitive-behavioral therapy on fear of childbirth, fear of pain, self-efficacy of childbirth and tendency to caesarean in nulliparous women

Over the past decades, the rate of caesarean section has increased in industrialized and developing countries. There are many reasons for the global rise in caesarean section rates, but an important and influential factor is the fear of childbirth. Fear of childbirth itself is created for reasons such as fear of pain and low self-efficacy of childbirth. Therefore, this study was performed with aim to determine the effectiveness of cognitive-behavioral therapy on fear of childbirth, fear of pain, self-efficacy of childbirth and tendency toward caesarean section in nulliparous women.
This clinical randomized study was performed on 25 nulliparous women in Mashhad. The subjects were assigned to two groups of case and control. 9 sessions of cognitive-behavioral therapy was performed on intervention group by the researcher (clinical psychologist). Wijma fear of childbirth questionnaire, self-efficacy of childbirth questionnaire and fear of pain Scale were used as tools in post and pretest. Women's tendency to mode of delivery was assessed by a question at the beginning of sampling and at the end of treatment. In addition, the final mode of delivery was asked by phone call at the end of pregnancy. Data were analyzed by SPSS software (16 version) and covariance analysis and Fisher exact test. P Fear of childbirth, fear of pain, tendency to cesarean and cesarean rate ere reduced in the intervention group compared with the control group (P Cognitive-behavioral therapy decreases unnecessary cesarean sections by reducing the fear of childbirth, fear of pain and increasing self-efficacy of childbirth.