Psychological, educational, and alternative interventions for reducing fear of childbirth in pregnant women: A systematic review

J Clin Psychol. 2021 Mar;77(3):525-555. doi: 10.1002/jclp.23071. Epub 2020 Oct 20.

Abstract

Objective: This review aims to identify non-medical interventions that may reduce the fear of childbirth, directly or indirectly (through its factors).

Methods: This review followed the PRISMA guidance and a rigorous protocol that was registered in PROSPERO. Searches were done in ProQuest, the International Clinical Trials Registry Platform, and Google Scholar. All RCTs published in the last 5 years, in English or Spanish, regarding women with a low-risk pregnancy and without mental disorders were included.

Results: From 5147 articles found, only 69 were full-text assessed. Finally, 18 studies were included suggesting that prenatal education, psychoeducation, and counseling might be effective, whereas cognitive-behavioral therapy and some alternative therapies require more research. The results of relaxation techniques were contradictory. Results also suggest that social support and exposure (through education) might have an important role in the efficacy of interventions.

Conclusions: More appropriately randomized and blinded trials are necessary that use a prespecified definition of fear of childbirth and comprehensive measurement tools specific for pregnant women.

Keywords: anxiety; childbirth; fear; pregnancy; systematic review; tocophobia.

Publication types

  • Review
  • Systematic Review

MeSH terms

  • Fear*
  • Female
  • Humans
  • Parturition / psychology*
  • Pregnancy
  • Pregnant Women / psychology*
  • Prenatal Education*
  • Relaxation Therapy