8
views
0
recommends
+1 Recommend
1 collections
    0
    shares
      • Record: found
      • Abstract: found
      • Article: found
      Is Open Access

      Effects of midwife-led psychological intervention on delivery outcomes: a meta-analysis

      research-article

      Read this article at

      ScienceOpenPublisher
      Bookmark
          There is no author summary for this article yet. Authors can add summaries to their articles on ScienceOpen to make them more accessible to a non-specialist audience.

          Abstract

          Highlights

          Midwife-led psychological interventions can improve the natural delivery rate of pregnant women, shorten the duration of the first stage of delivery, and decrease postpartum hemorrhage.

          Editor’s Summary

          This meta-analysis illustrates the importance of midwife-led psychological interventions for the natural delivery, providing reliable evidence for its clinical use.

          Abstract

          Objective: To systematically review the influence of psychological intervention of midwives on the delivery mode and outcomes. Methods: Databases including Cochrane Library, PubMed, Medline, EMBASE, CINAHL, CNKI, Wangfang, and VIP were searched for randomized controlled trials studying the effects of midwife-led psychological nursing on puerpera. Two evaluators independently searched and screened the papers, extracted relevant data, and quality assessment of the included studies, followed by a meta-analysis of the papers using RevMan 5.3 software. Results: 12 studies with 1,395 patients were included. The results of the meta-analysis showed that compared to conventional nursing, midwife-led psychological intervention can improve the number of people who choose natural delivery [Z = 7.53, 95% CI (2.07, 3.45), P < 0. 001], shorten the duration of the first stage of delivery [Z = 45.10, 95% CI (-4.43, -4.06), P < 0. 001), reduce postpartum hemorrhage after delivery for two hours [Z = 21.68, 95% CI (-63.92, -53.32), P < 0. 001]; these differences were statistically significant. Conclusion: Psychological interventions led by midwives can improve the natural delivery rate of pregnant women, shorten the duration of the first stage of delivery, and decrease postpartum hemorrhage after delivery for two hours; thus, it can be popularized for clinical use.

          Related collections

          Most cited references 27

          • Record: found
          • Abstract: found
          • Article: not found

          The prevalence of posttraumatic stress disorder in pregnancy and after birth: A systematic review and meta-analysis.

          Previous reviews have provided preliminary insights into risk factors and possible prevalence of Post-traumatic Stress Disorder (PTSD) postpartum with no attempt to examine prenatal PTSD. This study aimed to assess the prevalence of PTSD during pregnancy and after birth, and the course of PTSD over this time.
            Bookmark
            • Record: found
            • Abstract: found
            • Article: found
            Is Open Access

            A Randomized Controlled Trial of a Psycho-Education Intervention by Midwives in Reducing Childbirth Fear in Pregnant Women

            Background Childbirth fear is associated with increased obstetric interventions and poor emotional and psychological health for women. The purpose of this study is to test an antenatal psycho-education intervention by midwives in reducing women's childbirth fear. Methods Women (n = 1,410) attending three hospitals in South East Queensland, Australia, were recruited into the BELIEF trial. Participants reporting high fear were randomly allocated to intervention (n = 170) or control (n = 169) groups. All women received a decision-aid booklet on childbirth choices. The telephone counseling intervention was offered at 24 and 34 weeks of pregnancy. The control group received usual care offered by public maternity services. Primary outcome was reduction in childbirth fear (WDEQ-A) from second trimester to 36 weeks’ gestation. Secondary outcomes were improved childbirth self-efficacy, and reduced decisional conflict and depressive symptoms. Demographic, obstetric & psychometric measures were administered at recruitment, and 36 weeks of pregnancy. Results There were significant differences between groups on postintervention scores for fear of birth (p < 0.001) and childbirth self-efficacy (p = 0.002). Decisional conflict and depressive symptoms reduced but were not significant. Conclusion Psycho-education by trained midwives was effective in reducing high childbirth fear levels and increasing childbirth confidence in pregnant women. Improving antenatal emotional well-being may have wider positive social and maternity care implications for optimal childbirth experiences.
              Bookmark
              • Record: found
              • Abstract: found
              • Article: found
              Is Open Access

              Effects of a midwife psycho-education intervention to reduce childbirth fear on women’s birth outcomes and postpartum psychological wellbeing

              Background High levels of childbirth fear impact birth preparation, obstetric outcomes and emotional wellbeing for around one in five women living in developed countries. Higher rates of obstetric intervention and caesarean section (CS) are experienced in fearful women. The efficacy of interventions to reduce childbirth fear is unclear, with no previous randomised controlled trials reporting birth outcomes or postnatal psychological wellbeing following a midwife led intervention. Method Between May 2012 and June 2013 women in their second trimester of pregnancy were recruited. Women with a fear score ≥ 66 on the Wijma Delivery Expectancy / Experience Questionnaire (W-DEQ) were randomised to receive telephone psycho-education by a midwife, or usual maternity care. A two armed non-blinded parallel (1:1) multi-site randomised controlled trial with participants allocated in blocks of ten and stratified by hospital site and parity using an electronic centralised computer service. The outcomes of the RCT on obstetric outcomes, maternal psychological well-being, parenting confidence, birth satisfaction, and future birth preference were analysed by intention to treat and reported here. Results 1410 women were screened for high childbirth fear (W-DEQ ≥66). Three hundred and thirty-nine (n = 339) women were randomised (intervention n = 170; controls n = 169). One hundred and eighty-four women (54 %) returned data for final analysis at 6 weeks postpartum (intervention n = 91; controls n = 93). Compared to controls the intervention group had a clinically meaningful but not statistically significant reduction in overall caesarean section (34 % vs 42 %, p = 0.27) and emergency CS rates (18 % vs 25 %, p = 0.23). Fewer women in the intervention group preferred caesarean section for a future pregnancy (18 % vs 30 %, p = 0.04). All other obstetric variables remained similar. There were no differences in postnatal depression symptoms scores, parenting confidence, or satisfaction with maternity care between groups, but a lower incidence of flashbacks about their birth in the intervention group compared to controls (14 % vs 26 %, p = 0.05). Postnatally women who received psycho-education reported that the ‘decision aid’ helped reduce their fear (53 % vs 37 %, p = 0.02). Conclusion Following a brief antenatal midwife-led psycho-education intervention for childbirth fear women were less likely to experience distressing flashbacks of birth and preferred a normal birth in a future pregnancy. A reduction in overall CS rates was also found. Psycho-education for fearful women has clinical benefits for the current birth and expectations of future pregnancies. Trial registration Australian New Zealand Controlled Trials Registry ACTRN12612000526875, 17th May 2012
                Bookmark

                Author and article information

                Contributors
                Journal
                TMR Publishing Group
                TMR Non-Drug Therapy
                TMR Publishing Group (Cockle Bay Rd, Auckland, New Zealand )
                2538-0583
                6 September 2018
                6 September 2018
                : 1
                : 3
                : 109-118
                Affiliations
                1Tianjin University of Traditional Chinese Medicine, Tianjin, China.
                Author notes
                *Correspondence to: Fan-Jie Meng, Director of Teacher Evaluation and Development Center, Graduate School of Tianjin University of Traditional Chinese Medicine. E-mail: mfj1127@ 123456126.com.
                Article
                2538-0583-1-3-109
                10.12032/TMRND201801015

                This work is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 Unported License. To view a copy of this license, visit http://creativecommons.org/licenses/by/4.0/

                Product
                Categories
                Psychotherapy and meditation therapy

                Comments

                Comment on this article