The number of the women who want to have a cesarean due to the fear and anxiety of childbirth has increased. And on the other hand, based on the studies, there is relation between fear and anxiety during pregnancy and outcome childbirth. Cognitive Behavioral Therapy (CBT) seems to be a good method to overcome or reduce the fear and anxiety of childbirth. This study was aimed at determining the effect of Cognitive behavior therapy with a With a Focus on self-care on fear, anxiety and delivery outcome in nulliparous women.
The inclusion criteria are the pregnant women 28-30 w, age 18 to 35, with no history of congenital malformations, singleton pregnancy, without the background of the disease, no history of infertility, The ability to read and write, fear score higher than 85 and finally anxiety higher than 25 , no indication for cesarean delivery.
Exclusion criteria consisted of: Stillbirth, prenatal death, Known mental illness, not wanting to continue the study, pregnant women, and the risk of pregnancy poisoning, drugs that can cause symptoms of depression. This study is a clinical trial consisting of 64 nulliparous women. The fear of childbirth will assess using the Wijma Delivery Expectancy/Experience Questionnaire (W-DEQ). And anxiety of childbirth will assess using BAI anxiety questionnaire. The samples randomly will divide into two groups (case and control). Each group included 32 members. The intervention group will receive eight sessions of cognitive behavioral therapy with a focus on self-care and control group will received prenatal care. During labor the fear and anxiety score groups will evaluate using questionnaires fear and anxiety, and Birth outcomes in both groups will record. And finally fear and anxiety scores and delivery outcomes will compare in two groups.