Effect of Cognitive Counseling and Childbirth Preparation Classes on the Fear of Childbirth and Depression during Pregnancy in Primiparous Women; an Experimental Study

Fear of childbirth (FOC) is a common problem during pregnancy, with higher prevalence in primiparous women. The present study was designed to determine the effect of cognitive counseling and childbirth preparation classes on the fear of childbirth in primiparous women.

This was an interventional study which included 154 eligible primiparous pregnant women. Participants were divided into cognitive-behavioral counseling, childbirth preparation classes participants, and control groups. In this study we used simple random sampling method. At the beginning of the study and before the initiation of the intervention every group of pregnant woman at  the 20-24 weeks of gestational age completed the demographic questionnaire, Wijima delivery expectation questionnaire and Edinburgh depression assessment scale. After implementation of the intervention and 4 weeks later, the levels of fear and depression in the participants were assessed. We used SPSS v.22 for data analysis.

There were no significant differences among the groups in regard to the mean age, literacy level, gestational age and type of participant's occupation at the baseline. The mean values for fear of childbirth and depression scores were not significantly different among the three groups before the intervention. The fear of childbirth and the depression scores decreased significantly at the end and also one month after the end of the intervention (P=0.001, P=0.01, respectively). Participation in childbirth preparation classes reduced the level of fear and depression in participants, which was not significant.

Cognitive counseling can effectively and significantly reduce women's fear of childbirth and depression during pregnancy. Therefore, inclusion of cognitive counseling in the health care programs of pregnant women can effectively promote the health status of mother and child.