Richtlijn en wetenschappelijk onderzoek
Richtlijn Haptotherapie bij Bevallingsangst
Deze richtlijn dient als ondersteuning voor gz-haptotherapeuten die zich gespecialiseerd hebben in de therapeutische begeleiding van zwangeren met angst voor de bevalling en biedt informatie aan collega’s die zich willen specialiseren. Voor verloskundigen en gynaecologen en alle andere zorgprofessionals rondom zwangerschap en geboorte verschaft deze richtlijn informatie die van belang kan zijn bij een mogelijke verwijzing.
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Haptotherapy as a new intervention for treating fear of childbirth (a randomized controlled trial)
Abstract
Objective: To evaluate the effect of haptotherapy on severe fear of childbirth in pregnant women. Design: Randomized controlled trial. Setting: Community midwifery practices and a teaching hospital in the Netherlands. Population or Sample: Primi- and multigravida, suffering from severe fear of childbirth (N = 134). Methods: Haptotherapy, psycho-education via Internet and care as usual were randomly assigned at 20-24 weeks of gestation and the effects were compared at 36 weeks of gestation and 6 weeks and 6 months postpartum. Repeated measurements ANOVA were carried out on the basis of intention to treat. Since there were crossovers from psycho-education via Internet and care as usual to haptotherapy, the analysis was repeated according to the as treated principle. Main Outcome Measures: Fear of childbirth score at the Wijma Delivery Expectancy/Experience Questionnaire. Results: In the intention to treat analysis, only the haptotherapy group showed a significant decrease of fear of childbirth, F(2,99) = 3.321, p = .040. In the as treated analysis, the haptotherapy group showed a greater reduction in fear of childbirth than the other two groups, F(3,83) = 6.717, p < .001.
Conclusion: Haptotherapy appears to be more effective in reducing fear of childbirth than psycho-education via Internet and care as usual. Keywords: Pregnant women, fear of childbirth, haptotherapy, treatment, birth. Clinical trial registration: Dutch Trial Register, NTR3339.
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Severe Fear of Childbirth: Its Features, Assesment, Prevalence, Determinants, Consequences and Possible Treatments
This review summarizes the relevant literature regarding fear of childbirth. A substantial number of (pregnant) women are more or less afraid of childbirth and a significant minority; report a severe fear of childbirth. The focus will be on definition problems, its features, prevalence, assessment methods and measurements, determinants, consequences and treatment methods. To date, there is still no consensus about the exact definition of severe fear of childbirth. However, there is agreement that women with severe fear of childbirth are concerned about the well-being of themselves and their infants, the labor process, and other personal and external conditions. In studies on prenatal anxiety and fear of childbirth, various kinds of diagnostic methods have been used in the past. Recently, there is a consensus to determine severe fear of childbirth by using the Wijma Delivery Expectancy/Experience Questionnaire. The aetiology of fear of childbirth is likely to be multi-factorial and may be related to more general anxiety proneness, as well as to very specific fears. Furthermore, pregnant women are influenced by the many healthcare professionals, such as midwives, nurses, gynaecologists, therapists and pregnancy counselors and the interactions with them. Trying to design a universal treatment for fear of childbirth will not likely be the ultimate solution; therefore, future research is needed into multidisciplinary treatment and predictors to establish which therapies at the individual level are most effective and appropriate.
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