Psychodrama as a new intervention for reducing fear of childbirth: a randomised controlled trial

Abstract

This study was designed to examine the potential benefit of the addition of psychodrama classes to antenatal education as a new technique to address fear of childbirth. This was a randomised controlled trial. A total of 150 women were initially enrolled in two groups. Psychodrama sessions were added to standard antenatal education in the experiment group. The control group participated only in routine antenatal education classes. Birth outcomes and fear of childbirth were measured and analysed to assess the impact. The analysis was completed with an experimental group of 50 women and a control group of 49 women. At the conclusion of the training, it was observed that there was a greater decrease in fear of childbirth in the experiment group than in the control group. Additionally, in the postpartum period, the experimental group had a higher rate of vaginal childbirth and a shorter childbirth time than the control group. Psychodrama may be an effective means of reducing fear of childbirth and reduced caesarean section childbirth. Psychoeducation should be added antenatal education programs. Thus, it may represent an important tool in the efforts to improve maternal mental health and also provide broader social benefits.

IMPACT STATEMENT

• What is already known on this subject? Studies examining means to reduce fear of childbirth have found that psychoanalysis, cognitive behavioural therapy, eye movement desensitisation and reprocessing, haptotherapy and art therapy were useful.

• What the results of this study add? Psychodrama as a new intervention may be beneficial decreased of fear of childbirth, increased of normal birth rate and at improving the experience of pregnancy and childbirth.

• What the implications are of these findings for clinical practice and/or further research? Protecting and caring for the mental health of the mother and child benefits the entire community. It has been reported that 1 in 5 mothers experience psychiatric difficulties during the postpartum period, and 7 of 10 do not receive treatment, which has a negative impact on the mother, the child and family. Assesment of the mental health of women during the postpartum period is not regularly performed in many countries and women are frequently left to struggle on their own. The identification of pregnant women who have a high fear of childbirth and who are at risk of developing a psychiatric disorder by nurses is an important element of providing of appropriate, high-quality care.

Keywords:

• Antenatal education
• psychodrama
• psychoeducation
• fear of childbirth
• mode of childbirth

Acknowledgement

The authors would like to offer special thanks to all of the participants who contributed to this study of a very special part of their life.

Ethical considerations

The clinical research ethics committee of the Marmara University Faculty of Medicine and the Istanbul Health Directorate granted approval for this research. The study was also registered with ClinicalTrials.gov (NCT04690881). All of the participants were provided with information about the study, gave verbal consent, and were free to withdraw at any point.

Disclosure statement

The authors declare that there are no conflicts of interest.