Assessment of education program based on the salutogenic theory on fear of childbirth and choice of birth method among nulliparous women: A randomized controlled trial

Background: Fear of childbirth significantly affects nulliparous women and can have repercussions for both mothers and children. Drawing on evidence, the salutogenic theory has been proposed as a framework to address and manage this fear. Aim: Thia study aimed to assess the efficacy of an educationa...

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Main Authors: Safieh Kananikandeh, Farkhondeh Amin Shokravi, Mojgan Mirghafourvand, Shayesteh Jahanfar
Format: Article
Language:English
Published: Elsevier 2025-07-01
Series:Heliyon
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Online Access:http://www.sciencedirect.com/science/article/pii/S2405844025018341
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author Safieh Kananikandeh
Farkhondeh Amin Shokravi
Mojgan Mirghafourvand
Shayesteh Jahanfar
author_facet Safieh Kananikandeh
Farkhondeh Amin Shokravi
Mojgan Mirghafourvand
Shayesteh Jahanfar
author_sort Safieh Kananikandeh
collection DOAJ
description Background: Fear of childbirth significantly affects nulliparous women and can have repercussions for both mothers and children. Drawing on evidence, the salutogenic theory has been proposed as a framework to address and manage this fear. Aim: Thia study aimed to assess the efficacy of an educational program grounded in the salutogenic theory in mitigating fear of childbirth and influencing the choice of birth method among nulliparous women. Design: A randomized clinical trial was used. Participant/setting: This study involved 63 nulliparous women attending health centers in Bostanabad city in East Azerbaijan Province, Iran. Methods: This intervention comprised four group sessions lasting 30–45 min each, guided by the principles of the salutogenic theory. Participants were randomly assigned to either the intervention or control group. Data were collected through self-reports using the Wijma Delivery Expectancy/Experience Questionnaire, Antonovsky's Sense of Coherence scale, and a birth method choice checklist. The analysis involved independent sample t-tests, ANCOVA, repeated measures tests, chi-square tests, Cochran's Q tests, and SPSS 27 software. Results: In the intervention group, the mean score for childbirth fear significantly decreased (MD= 10.10, 95 % CI= 1.88–18.31), and the sense of coherence mean score was higher compared to the control group (MD= 9.10, 95 % CI= 1.71–16.49). However, the frequency of choosing vaginal birth remained consistent post-intervention. Conclusions: An intervention grounded in the salutogenic theory proved effective in assisting nulliparous women in realizing their chosen birth method by addressing fear and enhancing their sense of coherence. Trial registration: IRCT20210506051202N1. The trial registration date was 22/08/2021.
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spelling doaj-art-96e9c5c7506b4e7a835b4d25f058171e2025-08-20T02:37:02ZengElsevierHeliyon2405-84402025-07-011112e4344810.1016/j.heliyon.2025.e43448Assessment of education program based on the salutogenic theory on fear of childbirth and choice of birth method among nulliparous women: A randomized controlled trialSafieh Kananikandeh0Farkhondeh Amin Shokravi1Mojgan Mirghafourvand2Shayesteh Jahanfar3Health Education and Health Promotion, Department of Health Education and Health Promotion, Faculty of Medical Sciences, Tarbiat Modares University, Tehran, IranHealth Education and Health Promotion, Department of Health Education and Health Promotion, Faculty of Medical Sciences, Tarbiat Modares University, Tehran, Iran; Corresponding author.Reproductive Health, Social Determinants of Health Research Center, Faculty of Nursing and Midwifery, Tabriz University of Medical Sciences, Tabriz, IranMPH Program, Department of Public Health and Community Medicine, Tufts University School of Medicine, Boston, United StatesBackground: Fear of childbirth significantly affects nulliparous women and can have repercussions for both mothers and children. Drawing on evidence, the salutogenic theory has been proposed as a framework to address and manage this fear. Aim: Thia study aimed to assess the efficacy of an educational program grounded in the salutogenic theory in mitigating fear of childbirth and influencing the choice of birth method among nulliparous women. Design: A randomized clinical trial was used. Participant/setting: This study involved 63 nulliparous women attending health centers in Bostanabad city in East Azerbaijan Province, Iran. Methods: This intervention comprised four group sessions lasting 30–45 min each, guided by the principles of the salutogenic theory. Participants were randomly assigned to either the intervention or control group. Data were collected through self-reports using the Wijma Delivery Expectancy/Experience Questionnaire, Antonovsky's Sense of Coherence scale, and a birth method choice checklist. The analysis involved independent sample t-tests, ANCOVA, repeated measures tests, chi-square tests, Cochran's Q tests, and SPSS 27 software. Results: In the intervention group, the mean score for childbirth fear significantly decreased (MD= 10.10, 95 % CI= 1.88–18.31), and the sense of coherence mean score was higher compared to the control group (MD= 9.10, 95 % CI= 1.71–16.49). However, the frequency of choosing vaginal birth remained consistent post-intervention. Conclusions: An intervention grounded in the salutogenic theory proved effective in assisting nulliparous women in realizing their chosen birth method by addressing fear and enhancing their sense of coherence. Trial registration: IRCT20210506051202N1. The trial registration date was 22/08/2021.http://www.sciencedirect.com/science/article/pii/S2405844025018341FearChildbirthEducationSense of coherencePregnancy
spellingShingle Safieh Kananikandeh
Farkhondeh Amin Shokravi
Mojgan Mirghafourvand
Shayesteh Jahanfar
Assessment of education program based on the salutogenic theory on fear of childbirth and choice of birth method among nulliparous women: A randomized controlled trial
Heliyon
Fear
Childbirth
Education
Sense of coherence
Pregnancy
title Assessment of education program based on the salutogenic theory on fear of childbirth and choice of birth method among nulliparous women: A randomized controlled trial
title_full Assessment of education program based on the salutogenic theory on fear of childbirth and choice of birth method among nulliparous women: A randomized controlled trial
title_fullStr Assessment of education program based on the salutogenic theory on fear of childbirth and choice of birth method among nulliparous women: A randomized controlled trial
title_full_unstemmed Assessment of education program based on the salutogenic theory on fear of childbirth and choice of birth method among nulliparous women: A randomized controlled trial
title_short Assessment of education program based on the salutogenic theory on fear of childbirth and choice of birth method among nulliparous women: A randomized controlled trial
title_sort assessment of education program based on the salutogenic theory on fear of childbirth and choice of birth method among nulliparous women a randomized controlled trial
topic Fear
Childbirth
Education
Sense of coherence
Pregnancy
url http://www.sciencedirect.com/science/article/pii/S2405844025018341
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