Effect of Hypnobirthing Training on Fear, Pain, Satisfaction and, Birth Outcomes
Condition: Prenatal Education; Pregnancy Related; Labor Pain
MeSH terms: Labor Pain
Study type: Interventional

Summary: 
      Background and Purpose: Hypnobirthing is childbirth education model. This model aims for
      women to have a painless, calm and more comfortable birth. In this study is aimed to
      determine the effect of Hypnobirthing training on fear of childbirth, birth pain, birth
      satisfaction and birth outcomes.

      Materials and Methods: This randomized controlled experimental study was performed in
      Maternity Hospital (Bursa, Turkey) . The minimum required sample size to be included in the
      study will calculated with G* power. The simple randomization method was use in the
      assignment of healthy and nulliparous pregnant women at 28-32 weeks of gestation to the
      groups. The assignment of the participants to the experimental group or control group was
      carried out with a computer-aided program. The nulliparous women was divided into two groups
      as the control group contained women who received the hospital's usual care, and the
      experimental group contained women who received the hypnobirthing training intervention. The
      fear of birth was measured with the Wijma Birth Expectancy/Experience Scale A and B (W-DEQ);
      labor pain was measured with Visual Analogue Scale (VAS); birth satisfaction was measured
      with Short Form of Birth Satisfaction Scale (BSS-R); birth outcomes will measure with
      postpartum Information form. The Statistical Package for the Social Sciences program (version
      25.00) was use in data analysis.
    

Detailed description: 
      Fear of childbirth and labor pain are big problem that needs to be resolved as a priority
      since this situation continues by starting the vicious cycle of fear-anxiety-pain during
      childbirth. The persistence of the cycle increases the fear and pain related to childbirth,
      and thus delivery may result in emergency cesarean or elective cesarean. According to the
      data of Economic Development and Cooperation (OECD), the cesarean section rate in Turkey is
      53.1% and so higher than the recommended rate, even Turkey has the highest rate among the
      OECD countries . High cesarean rates are an important problem that negatively affects
      maternal and infant health and increase health expenditures and costs. Therefore, the
      pregnant women education programs aimed at lowering the rate of cesarean section are still
      important in Turkey as in other countries. While the childbirth education programs for
      pregnant women are not widely practiced in Turkey, the Turkish Ministry of Health (TMOH)
      started to provide childbirth preparation courses to reduce the rate of cesarean section in
      recent years. In the circular issued by the TMOH in 2018, it was determined that these
      programs should be managed by physicians, obstetrics nurses, and midwives. Nurses are
      actively involved in pregnancy training programs where different methods are applied in
      Turkey as well as all over the world. The most common training methods applied in other
      countries are Lamaze Method, Bradly Method, and Hypnobirthing.

      Hypnobirthing is a childbirth preparation method that aims to prepare pregnant women for
      delivery mentally and physically and to give birth in a less painful, conscious, and
      fear-free way. This method was developed based on the fear-stress-pain cycle. The persistence
      of this cycle exacerbates stress and pain, prolongs the birth period, and negatively affects
      the success, way, preference, course, and satisfaction of the birth. Thus, the birth does not
      proceed properly and results in an emergency or elective cesarean section. Hypnobirthing can
      prepare women for childbirth to eliminate all these negativities.

      Hypnobirthing training can be considered as a new technique for Turkey and therefore we
      conducted this study to determine its effects on the pain, fear, satisfaction related to
      childbirth and childbirth outcomes.
    

Intervention name(s): Standart care; Hypnobirthig training
Intervention type(s): Other; Behavioral
Intervention description(s): This group will leave in the hospital's usual care and no intervention will be applied.; Hypnobirthing training of the Hypnobirthing group will carry out with its partner. Hypnobirthig training will be given in small groups of 5 or 6 couples for 4 weeks and 3 hours a week. In addition, the usual care will be provided by healthcare professionals to this group.
Breathing, relaxation exercises, birth stories and birth videos will be used to reduce fears of chlildbirt women.
Deepening and endorphin massage techniques will be given for labor pain. After the endorphin massage technique will be applied individually by the researcher, it will be applied by the couples and they will ask for repeating all exercises at home.
In the last week of the training, there will be a birth rehearsal with Hynobirthing methods with the partners.
The second meeting will take place when labor begins and after labor.
Allocation: Randomized
Intervention model: Parallel Assignment
Masking: None (Open Label)
Primary purpose: Treatment
Keywords: Childbirth; Labor Pain; Fear of childbirth; Satisfaction; Prenatal education; Hypnobirthing