Keywords
Family-centered prenatal education
Primigravida
Childbirth fear questionnaire
China
Submitted : 2025-12-16
Accepted : 2025-12-31
Published : 2026-01-15
Abstract
Objectives: Childbirth fear affects 34.2% of Chinese primigravida women, leading to adverse birth outcomes. Family-centered prenatal education (FCPE) may reduce fear through enhanced support systems. Methods: This quasi-experimental study examined the effectiveness of FCPE among 120 primigravida women (14–20 weeks’ gestation) at Yancheng Third People’s Hospital. Participants with elevated Childbirth Fear Questionnaire (CFQ) scores (≥ 81) were assigned to either the experimental group (FCPE + standard care, n = 60) or the control group (standard care only, n = 60). FCPE consisted of five weekly 2-hour sessions involving pregnant women and family members. Results: Both groups showed moderate baseline fear levels (experimental: 85.68 ± 6.30; control: 88.57 ± 6.41, p = 0.112). Post-intervention, the experimental group achieved significantly lower fear scores (80.43 ± 8.53 vs. 87.35 ± 6.91, p = 0.001, Cohen’s d = 0.88). 58.3% of experimental participants transitioned to low fear levels, compared to 16.7% in the control group. Educational level significantly moderated the outcomes within the experimental group (p = 0.031). Conclusion: FCPE effectively reduces anticipatory childbirth fear with a large effect size, supporting implementation in Chinese prenatal care for improving maternal psychological well-being.
References
Nilsson C, Hessman E, Sjöblom H, et al., 2018, Definitions, Measurements, and Prevalence of Fear of Childbirth: A Systematic Review. BMC Pregnancy and Childbirth, 18(1): 28.
Fenwick J, Gamble J, Nathan E, et al., 2009, Pre- and Postpartum Levels of Childbirth Fear and the Relationship to Birth Outcomes in Australian Women. Journal of Clinical Nursing, 18(5): 667–677.
Shi Y, Wang D, Yuan Y, et al., 2015, Effects of Prenatal Education on Prenatal Examination Utilization, Delivery Mode, and Recovery Status in China. Environmental Health and Preventive Medicine, 20(6): 397–403.
Xu R, Wang J, Li Y, et al., 2023, Pre- and Postpartum Fear of Childbirth and Its Predictors Among Rural Women in China. BMC Pregnancy and Childbirth, 23: 197.
Zhang S, Liu J, 2021, Paternal Involvement in Pregnancy and Childbirth Among Chinese Couples: A Qualitative Study. International Journal of Nursing Sciences, 8(2): 181–188.
Liu P, Wen W, Yu K, et al., 2020, Effectiveness of a Family-Centered Behavioral and Educational Counselling Approach to Improve Periodontal Health in Pregnant Women. BMC Oral Health, 20(1): 284.
Fairbrother N, Collardeau F, Albert A, et al., 2022, Screening for Perinatal Anxiety Using the Childbirth Fear Questionnaire: A New Measure of Fear of Childbirth. International Journal of Environmental Research and Public Health, 19(4): 2223.
Johnson B, Abraham M, Conway J, et al., 2008, Partnering with Patients and Families to Design a Patient- and Family-Centered Health Care System: Recommendations and Promising Practices. Institute for Patient- and Family-Centered Care.
Cohen S, Wills T, 1985, Stress, Social Support, and the Buffering Hypothesis. Psychological Bulletin, 98(2): 310–357.
Thoits P, 2011, Perceived Social Support and Voluntary, Mixed, or Pressured Use of Mental Health Services. Society and Mental Health, 1: 4–19.
Bandura A, 1977, Self-Efficacy: Toward a Unifying Theory of Behavioral Change. Psychological Review, 84(2): 191–215.
Polit D, Beck C, 2017, Nursing Research: Generating and Assessing Evidence for Nursing Practice. Wolters Kluwer.
Kuo T, Au H, Chen S, et al., 2022, Effects of an Integrated Childbirth Education Program on Fear of Childbirth, Anxiety, Depression, and Mindfulness: A Single-Blind Randomized Controlled Trial. Midwifery, 113: 103438.