Effect of Psychoeducational Childbirth Preparation with Relaxation on PTSD and Childbirth Fear After Traumatic Birth: A Randomized Controlled Trial
Abstract
Background: Traumatic childbirth significantly elevates the risk of developing post‑traumatic stress disorder (PTSD) and fear of childbirth (FOC). This study aimed to investigate the effects of a psychoeducational intervention, incorporating relaxation training, on PTSD and FOC in pregnant women with a history of traumatic childbirth. Materials and Methods: This randomized controlled trial included 70 pregnant women in Hamadan, Iran, with a history of traumatic childbirth. Participants were randomly assigned to either an intervention group (n = 35) or a control group (n = 35). The intervention group underwent an 8‑session psychoeducation protocol that integrated relaxation training, delivered between 24 and 32 weeks of gestation, while the control group received standard prenatal care. PTSD symptoms were assessed using the PSS‑SR, and FOC was measured with the CAQ at baseline and at 36 weeks of gestation (4 weeks’ postintervention). Data analysis was conducted using ANCOVA in Stata‑13. Results: Four weeks’ postintervention, the intervention group exhibited a statistically significant reduction in PTSD scores compared to the control group (adjusted mean difference: –9.23; 95% CI: –11.28, –7.18; p < 0.001; Cohen’s d = 2.29). Similarly, FOC scores were significantly lower in the intervention group (adjusted mean difference: –5.02; 95% CI: –7.00, –3.05; p < 0.001; Cohen’s d = 1.30). Conclusions: A structured psychoeducational intervention for childbirth preparation that incorporates relaxation training effectively alleviates PTSD symptoms and reduces fear of childbirth in pregnant women with a history of traumatic childbirth. The substantial effect sizes observed underscore its clinical relevance.
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