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.