Evaluation of the effect of childbirth preparation educational program on self-efficacy, anxiety, and birth outcomes among first time Jordanian mothers.

Status

Not yet recruiting

Phases

Unknown

Study type

Interventional

Source

ANZCTR

Registry ID

ACTRN12616001255471

Enrollment

128

Registered

2016-09-07

Start date

2016-10-01

Completion date

Unknown

Last updated

2020-01-13

For informational purposes only — not medical advice. Sourced from public registries and may not reflect the latest updates. Terms

Conditions

None listed

Brief summary

Background: Childbirth education is crucial in maternity health services for first-time mothers, its primary goal focused on facilitating a positive childbirth experience which will affect their future health and well-being. Childbirth education classes which based on self-efficacy theory discussed a range of educational and supportive measures which aid the new parents in understanding their own social, emotional, psychological, and physical needs during preconception, pregnancy, labour and postpartum period. The perceived level of state anxiety and self-efficacy in coping with childbirth, and maternal and neonatal outcomes are the common outcome variables in childbirth research. Aim: The aim of this research is to compare self-efficacy, state anxiety, and birthoutcomes between attendee and non attendee of childbirth preparation program among first time Jordanian mothers. Design: A randomized controlled trial design will be used in this study with pretest-posttest repeated measure, to investigate the estimated effect of childbirth preparation program on state anxiety and self-efficacy in coping with labor and level of. Sampling: For this study, the researcher will use the consecutive sampling technique to recruit participants in this study, the inclusion criteria will include participants who are healthy primiparous, aged 18-45 years, pregnant for at least 32 weeks and have low risk singleton pregnancy. Only woman who planned to deliver at king Hussien Medical Center, and who possess a smart phone will be recruited. Then a random assignment technique based in computer soft ware randomizer will be used to divid the women into two groups the experimental and the control groups. Variables: Independent variable: Attending childbirth preparation program. Dependent variable: The primary outcomes of this study are self-efficacy and state anxiety, and the secondary outcomes are the birth outcomes. Settings: Data will be collected from obstetric and gynacologic department and clinics at king Hussien Medical Center. Implications: The findings of this study will demonstrate the effect of childbirth preparation program in improving the level of self-efficacy in coping with labor among Jordanian primiparas. It will help them to cope with labour process with a minimum anxiety and better birth outcomes added to its effect on enhancing maternal and neonatal outcomes. Based on these supposed findings, decision makers may facilitate change in antenatal care in Jordan to indicate reorganizing it to help women in preparing themselves to cope with the realities that they may confront at the time of birth. Ethical Considerations Voluntary participation in the study is an essential and women who are willing to participate will give informed consent and will be randomly allocated to control or experimental group without bias. Maximum effort will be taken to ensure confidentiality and anonymity of participants. There will be no physical, psychological, economic or social risks for the participants if they agreed to participate in the study. At any time women will be free to withdraw without affecting their care also, the study will take approval from Jordan University of science and technology Institutional Review Board (IRB). Based on IRB approval, administrative approvals will be obtained from the Royal Medical Services. Keywords: antenatal education; childbirth preparation; antenatal classes; state anxiety; self –efficacy; birth outcomes.

Interventions

Study Procedures The researcher will have the permission from the head nurse of maternity ward at king Hussein Medical Center (KHMC) to access the study participants. The study will advertise in a poster which will be placed at antenatal clinics at KHMC. It will include the study title, aims, benefits and the inclusion criteria. Recruitment will be conducted by the researcher between June and July 2016. Pregnant women who met the inclusion criteria will be approached and kindly asked to participate. If the women agreed to participate, they will receive a letter explaining the study, as well as the consent form, which they accordingly will sign. Subsequently, the women will complete their basic demographic sheet and will be randomly assigned into two groups. Upon recruitment a pre-intervention questionnaire of Childbirth Self-Efficacy Inventory (CBSEI) and State Anxiety Inventory will be administered to women allocated to the intervention group and the control groups at antenatal clinics. Sessions will be scheduled with women (interventional group) agreement according to their clinic appointments. After that women (interventional group) will have an orientation round for the maternity ward and they will have a pamphlet with educational session’s schedule. At the end of intervention (attending childbirth educational program) the post-intervention questionnaires; Childbirth Self-Efficacy Inventory (CBSEI) and State Anxiety inventory will be administered. Women who allocated to the control group will receive usual antetnatal care and there will be no attempt to control information from other sources but if women in the control group asked about any obstetric procedure, the usual information or care will be provided. Each woman in both groups will be provided a contact number to call the researcher once she gets in labour. Birth outcomes which are the time of admission (no signs of labour, or latent first stage or active first stage), type of labour (augmented or induced) length of labour, type of delivery (Vaginally, Caesarean section, Instrumental), indication for cesarean section, type of labour (spontaneous or induced), using antibiotic or analgesic medications, type and duration of fetal monitoring, labour complications (perineal tears or hemorrhage), length of hospital stay, and neonatal outcomes (gestational age, birth weight, APGAR score, birth trauma, initiation of breastfeeding) will be obtained from medical records. Audio visual materials The researcher will provide the childbirth educational program for the women who allocated to the intervention group and will be scheduled into four educational sessions; it will be weekly, individualized, and for thirty minutes duration. The content of the educational program was derived from the standards of preparing the pregnant women for labour and delivery which was recommended within the Standards of Care for Health Centers and was published in (2002) by USAID and the Jordanian ministry of health; the Arabic version will be used in this study. During sessions a range of techniques will be used such as verbal information, discussion of issues or questions raised by the women and practical demonstration of breathing exercises. Women will be encouraged to ask questions about childbirth process. They will be educated about the anatomy and physiology of the reproductive system, signs of labour, labor and delivery process, labor relaxation techniques, postpartum care, breastfeeding, and how to pack her hospital bag. After each session the women will receive a pamphlet containing detailed information about what being explained and the content of each session will be shared with the women through their smart phone applications. the role/qualification of the person running the education sessions, is (registered nurse/midwife) the format of sessions will be face-to-face at antenatal clinics. the smartphone applications used is (whatsapp) Messenger; a cross-platform mobile messaging app which allows to exchange messages without having to pay for SMS. WhatsApp users can create groups, send each other unlimited images, video and audio media messages. strategies used to monitor adherence will be by checking attendance at education sessions. the orientation round of the maternity ward for the intervention group will involves visiting admission room, labour room, and post-partum ward ; brief explanation about equipment, procedures, who will provide care for the mother at each room. brief explanation about the the routine care at maternity ward will be provided for the mothers. the researcher will take the mother for orientation round immediately following enrollment approximately for ten minutes duration.

Study design

Allocation

Randomised controlled trial

Intervention model

Parallel

Primary purpose

Treatment

Masking

Open (masking not used)

Eligibility

Sex/Gender

All

Age

18 Years to 45 Years

Healthy volunteers

Yes

Inclusion criteria

The target population is all Jordanian primigravida pregnant women and the accessable population is the women who attend the antenatal clinics at king Hussein medical center. To overcome the effect of extraneous variables on the study outcomes, the inclusion criteria will include participants who are healthy primiparous, aged 18-45 years, pregnant for at least 32 weeks and have low risk singleton pregnancy. Only woman who planned to deliver at king Hussien Medical Center, and who possess a smart phone will be recruited.

Exclusion criteria

high risk pregnancy

Outcome results