Effect of Cognitive-Behavioral Therapy Focused on Self-esteem on Fear of Childbirth: A Counseling Approach in Prenatal Care and a Randomized Clinical Trial

This study aimed to evaluate the effect of cognitive-behavioral therapy focused on self-esteem (CBT-S) on fear of childbirth in nulliparous women.

In this randomized clinical trial, 24 nulliparous women willing to cesarean section delivery referred to Milad hospital, Tehran, Iran, between July to August 2015 were enrolled with a convenient sampling method. Participants were assigned into two CBT-S and control groups (24 in each group) using randomized blocks of 4. Seven sessions were performed for the CBT-S group, but the control group received routine prenatal classes. FOC was assessed using Harman’s childbirth attitudes questionnaire. The Rosenberg self-esteem scale was used to assess self-esteem at the beginning of the study. Two weeks after the intervention, both groups filled out the FOC and self-esteem questionnaire.

The mean score of fear at the end of the study in the CBT-S and control group was significantly different (P=0.001). Also, selfesteem scores increased after intervention in the CBT-S counseling group (4.77 ± 4.07vs -1.79 ± 2.26; P=0.001).

This study confirms the importance of the CBT-S approach focusing on self-esteem in reducing FOC.