Midwife-led continuity education on fear and birth outcomes in primiparas

The aim of this study was to examine the effects of midwife-led continuity education on fear of childbirth, mode of delivery, and postpartum trauma among primiparous women.

A single-blind randomized controlled trial was conducted at Adana City Hospital, Turkey, between December 2023 and November 2024. Ninety-two primiparous pregnant women were enrolled and randomized to an intervention group (n=46) or a control group (n=46). Inclusion criteria were age 18-35 years, singleton low-risk pregnancy, Turkish literacy, and no medical or obstetric contraindications to vaginal birth. Women with high-risk pregnancies, psychiatric disorders, systemic diseases, or prior structured childbirth education were excluded. The intervention group received a four-module education program based on the Midwife-Led Continuity of Care Model, while the control group received routine antenatal care.

Baseline childbirth fear scores were comparable between groups. Following the intervention, mean childbirth fear scores were lower in the intervention group than in the control group. One month postpartum, mean City Birth Trauma Scale scores were 5.43±5.69 in the intervention group and 22.93±9.92 in the control group. Vaginal birth occurred in 69.6% of women in the intervention group compared with 24.4% in the control group. Among women who had vaginal births, postpartum fear scores remained lower in the intervention group.

Midwife-led continuity education is associated with reduced fear of childbirth, lower postpartum trauma symptoms, and higher vaginal birth rates among primiparous women. These findings support the integration of continuity-based midwifery education into routine maternity care.