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The Effect of Childbirth Preparation Classes on Anxiety and Labor Pain in Primigravid Pregnant Women: A Quasi-Experimental Study
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Mojtaba Mousavi Bazaz1    , Raheleh Zabihi Joshaghan *2 , Abbas Makarem3 , Samira Ebrahimzadeh Zagami4 |
1- Associate Professor, Department of Community Medicine, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
2- Department of Population Rejuvenation, Family and School Health, Esfarayen Faculty of Medical Sciences, Esfarayen, Iran & Behvarz training center, Esfarayen Faculty of Medical Sciences, Esfarayen, Iran
3- Professor of pedodontics, Department of pediatric dentistry, Mashhad University of Medical Science, Mashhad Iran.
4- Nursing and Midwifery Care Research Center, Mashhad University of Medical Sciences, Mashhad, Iran |
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Abstract: (43 Views) |
Background and Objectives: Natural childbirth is still recommended as the preferred mode of delivery; however, despite advances in prenatal education emphasizing physiological aspects, the psychological aspects of pregnant women have received less attention. This study aimed to determine the effect of childbirth preparation classes on anxiety and labor pain in primigravid pregnant women.
Materials and Methods: This quasi-experimental study with a control group and a pretest–posttest design was conducted in 2020 in two comprehensive health service centers in Esfarayen County. Seventy urban primigravid pregnant women with gestational age >20 weeks were assigned without random allocation to an intervention group (n=35) and a control group (n=35). The intervention group, selected from among participants who attended all eight sessions, received eight 90-minute childbirth preparation classes from 20 weeks of gestation, including theoretical education and practical training in breathing techniques, neuromuscular relaxation, massage, concentration, and stretching exercises; the control group received routine prenatal care. Anxiety was measured using the anxiety subscale of the Hospital Anxiety and Depression Scale (HADS; 7 items), and labor pain was measured using the Visual Analogue Scale (VAS) and the affective dimension of the McGill Pain Questionnaire (MPQ). Data were analyzed using paired t-test, Fisher’s exact test, and univariate and multivariate analysis of covariance (ANCOVA/MANCOVA) with adjustment for pretest scores in SPSS version 20 (significance level 0.05).
Results: The two groups did not differ significantly in age, education, or baseline pain and anxiety scores. The mean (SD) pain score in the intervention group decreased from 9.40 ± 2.72 to 4.63 ± 1.91 (P<0.001), whereas no significant change was observed in the control group (9.94 ± 2.61 to 10.50 ± 2.32; P=0.081). The anxiety score in the intervention group decreased from 10.31 ± 2.42 to 6.60 ± 1.68 (P<0.001), and no significant change was observed in the control group (10.83 ± 3.49 to 10.60 ± 3.04; P=0.494). After adjustment for pretest scores, the effect of group on posttest pain and anxiety was simultaneously significant (Pillai’s trace = 0.839; P<0.001). The adjusted mean pain score in the intervention group was 5.52 units lower (95% CI: 4.87 to 6.17; partial η² = 0.81) and the adjusted mean anxiety score was 3.67 units lower (95% CI: 2.94 to 4.39; partial η² = 0.60) than in the control group (both P<0.001).
Conclusion: Childbirth preparation classes were associated with reduced labor pain and anxiety in primigravid women, and incorporating them into routine prenatal care is recommended. However, due to non-random allocation, lack of blinding, and limited sample size, confirmation of these findings in randomized trials with larger samples and long-term follow-up is essential.
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| Keywords: prenatal education, childbirth preparation class, labor pain, anxiety, primigravid women |
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Full-Text [PDF 776 kb]
(16 Downloads)
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Type of Study: Research Article |
Subject:
health
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