Fear of childbirth, nonurgent obstetric interventions, and newborn outcomes: A randomized controlled trial comparing mindfulness-based childbirth and parenting with enhanced care as usual.
Study Goal
The researchers aimed to determine whether mindfulness-based childbirth and parenting (MBCP) reduces fear of childbirth, nonurgent obstetric interventions, and improves newborn outcomes compared to enhanced care as usual (ECAU).
Results Summary
MBCP significantly reduced fear of childbirth, labor pain catastrophizing, and preference for nonurgent interventions while increasing pain acceptance. It also lowered rates of epidural analgesia and self-requested cesarean births and improved 1-minute Apgar scores compared to ECAU.
Population
Pregnant women with high fear of childbirth (n=141) and their partners in midwifery settings in the Netherlands.
Effective Dosage
Not specified
Duration
April 2014-July 2017 (intervention duration not explicitly stated)
Interactions
None mentioned
| Intervention | Direction | Endpoint | Population | Dosage | Impact | Claim # |
|---|---|---|---|---|---|---|
mindfulness-based childbirth and parenting (MBCP) | decrease | fear of childbirth (FOC) | pregnant women with high FOC and partners | - | significantly superior to ECAU in decreasing | #1 |
mindfulness-based childbirth and parenting (MBCP) | decrease | catastrophizing of labor pain | pregnant women with high FOC and partners | - | significantly superior to ECAU in decreasing | #2 |
mindfulness-based childbirth and parenting (MBCP) | decrease | preference for nonurgent obstetric interventions | pregnant women with high FOC and partners | - | significantly superior to ECAU in decreasing | #3 |
mindfulness-based childbirth and parenting (MBCP) | increase | acceptance of labor pain | pregnant women with high FOC and partners | - | significantly superior to ECAU in increasing | #4 |
mindfulness-based childbirth and parenting (MBCP) | decrease | epidural analgesia (EA) | MBCP participants | 36% | were 36% less likely to undergo | #5 |
mindfulness-based childbirth and parenting (MBCP) | decrease | self-requested cesarean birth (sCB) | MBCP participants | 51% | were 51% less likely to undergo | #6 |
mindfulness-based childbirth and parenting (MBCP) | increase | unmedicated childbirth | MBCP participants | twice as likely | were twice as likely to have | #7 |
mindfulness-based childbirth and parenting (MBCP) | increase | newborn's 1-minute Apgar scores | - | - | were higher in | #8 |
mindfulness-based childbirth and parenting (MBCP) | decrease | mothers' fear of childbirth | pregnant couples | - | reduces | #9 |
mindfulness-based childbirth and parenting (MBCP) | decrease | nonurgent obstetric interventions during childbirth | pregnant couples | - | reduces | #10 |
mindfulness-based childbirth and parenting (MBCP) | increase | childbirth outcomes | pregnant couples | - | may improve | #11 |
OBJECTIVE: To investigate whether mindfulness-based childbirth and parenting (MBCP) or enhanced care as usual (ECAU) for expectant couples decreases fear of childbirth (FOC) and nonurgent obstetric interventions during labor and improves newborn outcomes. DESIGN: Randomized controlled trial. SETTING: Midwifery settings, the Netherlands, April 2014-July 2017. POPULATION: Pregnant women with high FOC (n = 141) and partners. METHODS: Allocation to MBCP or ECAU. Hierarchical multilevel and intention-to-treat (ITT) and per-protocol (PP) analyses. MAIN OUTCOME MEASURES: Primary: pre-/postintervention FOC, labor anxiety disorder, labor pain (catastrophizing and acceptance), and preferences for nonurgent obstetric interventions. Secondary: rates of epidural analgesia (EA), self-requested cesarean birth (sCB), unmedicated childbirth, and 1- and 5-minute newborn's Apgar scores. RESULTS: MBCP was significantly superior to ECAU in decreasing FOC, catastrophizing of labor pain, preference for nonurgent obstetric interventions, and increasing acceptance of labor pain. MBCP participants were 36% less likely to undergo EA (RR 0.64, 95% CI [0.43-0.96]), 51% less likely to undergo sCB (RR 0.49, 95% CI [0.36-0.67]), and twice as likely to have unmedicated childbirth relative to ECAU (RR 2.00, 95% CI [1.23-3.20]). Newborn's 1-minute Apgar scores were higher in MBCP (DM -0.39, 95% CI [-0.74 to -0.03]). After correction for multiple testing, results remained significant in ITT and PP analyses, except EA in ITT analyses and 1-minute Apgar. CONCLUSIONS: MBCP for pregnant couples reduces mothers' fear of childbirth, nonurgent obstetric interventions during childbirth and may improve childbirth outcomes. MBCP adapted for pregnant women with high FOC and their partners appears an acceptable and effective intervention for midwifery care.