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Treatment of severe fear of childbirth with haptotherapy: design of a multicenter randomized controlled trial.

Klabbers GA, Wijma K, Paarlberg KM, Emons WH, Vingerhoets AJ - BMC Complement Altern Med (2014)

Bottom Line: The present study has been designed to evaluate the effects of such intervention.Secondary study outcomes are distress, general anxiety, depression, somatization, social support, mother-child bonding, pregnancy and delivery complications, traumatic anxiety symptoms, duration of delivery, birth weight, and care satisfaction.The control group has care as usual according to the standards of the Royal Dutch Organisation of Midwives and the Dutch Organization of Obstetrics and Gynaecology.

View Article: PubMed Central - PubMed

Affiliation: Therapy Center Ietje Kooistraweg 25, 7311 GZ Apeldoorn, the Netherlands. praktijk@gertklabbers.nl.

ABSTRACT

Background: About six percent of pregnant women suffer from severe fear of childbirth. These women are at increased risk of obstetric labour and delivery interventions and pre- and postpartum complications, e.g., preterm delivery, emergency caesarean section, caesarean section at maternal request, severe postpartum fear of childbirth and trauma anxiety. During the last decade, there is increasing clinical evidence suggesting that haptotherapy might be an effective intervention to reduce fear of childbirth in pregnant women. The present study has been designed to evaluate the effects of such intervention.

Methods/design: Included are singleton pregnant women with severe fear of childbirth, age ≥ 18 year, randomised into three arms: (1) treatment with haptotherapy, (2) internet psycho-education or (3) care as usual. The main study outcome is fear of childbirth. Measurements are taken at baseline in gestation week 20-24, directly after the intervention is completed in gestation week 36, six weeks postpartum and six months postpartum. Secondary study outcomes are distress, general anxiety, depression, somatization, social support, mother-child bonding, pregnancy and delivery complications, traumatic anxiety symptoms, duration of delivery, birth weight, and care satisfaction.

Discussion: The treatment, a standard haptotherapeutical treatment for pregnant women with severe fear of childbirth, implies teaching a combination of skills in eight one hour sessions. The internet group follows an eight-week internet course containing information about pregnancy and childbirth comparable to childbirth classes. The control group has care as usual according to the standards of the Royal Dutch Organisation of Midwives and the Dutch Organization of Obstetrics and Gynaecology.

Trial registration: This trial was entered in the Dutch Trial Register and registered under number NTR3339 on March 4th, 2012.

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Related in: MedlinePlus

Two examples of the pictorial representation of attachment measure.
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Fig1: Two examples of the pictorial representation of attachment measure.

Mentions: Emotional bonding is measured by the Pictorial Representation of Attachment Measure (PRAM) [44]. The PRAM measures mother-child bonding in a quick and easy way [44] (see Figure 1). A pregnant woman is shown a white screen with a big circle which represents her life as it currently is. A yellow circle in the centre of the big circle represents the woman's 'Self'. She is handed a green circle and is instructed to imagine that the green circle represents the unborn baby. Subsequently she was asked: "where would you place the baby in your life at this moment?" For quantitative use, the outcome measure is the Self-Baby-Distance (SBD), i.e., the distance (in centimetres) between the centres of the 'Baby' and 'Self' circles.Figure 1


Treatment of severe fear of childbirth with haptotherapy: design of a multicenter randomized controlled trial.

Klabbers GA, Wijma K, Paarlberg KM, Emons WH, Vingerhoets AJ - BMC Complement Altern Med (2014)

Two examples of the pictorial representation of attachment measure.
© Copyright Policy - open-access
Related In: Results  -  Collection

License 1 - License 2
Show All Figures
getmorefigures.php?uid=PMC4209021&req=5

Fig1: Two examples of the pictorial representation of attachment measure.
Mentions: Emotional bonding is measured by the Pictorial Representation of Attachment Measure (PRAM) [44]. The PRAM measures mother-child bonding in a quick and easy way [44] (see Figure 1). A pregnant woman is shown a white screen with a big circle which represents her life as it currently is. A yellow circle in the centre of the big circle represents the woman's 'Self'. She is handed a green circle and is instructed to imagine that the green circle represents the unborn baby. Subsequently she was asked: "where would you place the baby in your life at this moment?" For quantitative use, the outcome measure is the Self-Baby-Distance (SBD), i.e., the distance (in centimetres) between the centres of the 'Baby' and 'Self' circles.Figure 1

Bottom Line: The present study has been designed to evaluate the effects of such intervention.Secondary study outcomes are distress, general anxiety, depression, somatization, social support, mother-child bonding, pregnancy and delivery complications, traumatic anxiety symptoms, duration of delivery, birth weight, and care satisfaction.The control group has care as usual according to the standards of the Royal Dutch Organisation of Midwives and the Dutch Organization of Obstetrics and Gynaecology.

View Article: PubMed Central - PubMed

Affiliation: Therapy Center Ietje Kooistraweg 25, 7311 GZ Apeldoorn, the Netherlands. praktijk@gertklabbers.nl.

ABSTRACT

Background: About six percent of pregnant women suffer from severe fear of childbirth. These women are at increased risk of obstetric labour and delivery interventions and pre- and postpartum complications, e.g., preterm delivery, emergency caesarean section, caesarean section at maternal request, severe postpartum fear of childbirth and trauma anxiety. During the last decade, there is increasing clinical evidence suggesting that haptotherapy might be an effective intervention to reduce fear of childbirth in pregnant women. The present study has been designed to evaluate the effects of such intervention.

Methods/design: Included are singleton pregnant women with severe fear of childbirth, age ≥ 18 year, randomised into three arms: (1) treatment with haptotherapy, (2) internet psycho-education or (3) care as usual. The main study outcome is fear of childbirth. Measurements are taken at baseline in gestation week 20-24, directly after the intervention is completed in gestation week 36, six weeks postpartum and six months postpartum. Secondary study outcomes are distress, general anxiety, depression, somatization, social support, mother-child bonding, pregnancy and delivery complications, traumatic anxiety symptoms, duration of delivery, birth weight, and care satisfaction.

Discussion: The treatment, a standard haptotherapeutical treatment for pregnant women with severe fear of childbirth, implies teaching a combination of skills in eight one hour sessions. The internet group follows an eight-week internet course containing information about pregnancy and childbirth comparable to childbirth classes. The control group has care as usual according to the standards of the Royal Dutch Organisation of Midwives and the Dutch Organization of Obstetrics and Gynaecology.

Trial registration: This trial was entered in the Dutch Trial Register and registered under number NTR3339 on March 4th, 2012.

Show MeSH
Related in: MedlinePlus