Effects of an Experience-focused Prenatal Program on Stress, Anxiety, Childbirth Confidence, and Maternal-Fetal Attachment on Women in Their First Pregnancy

Mira Park; Sunok Lee

doi:10.4069/kjwhn.2018.24.2.126

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Park and Lee: Effects of an Experience-focused Prenatal Program on Stress, Anxiety, Childbirth Confidence, and Maternal-Fetal Attachment on Women in Their First Pregnancy

Orginal Article

Korean J Women Health Nurs 2018;24(2):126-137.

Published online: 20 June 2018

DOI: https://doi.org/10.4069/kjwhn.2018.24.2.126

Effects of an Experience-focused Prenatal Program on Stress, Anxiety, Childbirth Confidence, and Maternal-Fetal Attachment on Women in Their First Pregnancy

Mira Park¹, Sunok Lee^2,

¹Department of Nursing, Mirero Woman's Hospital, Busan, Korea

²Department of Nursing, Silla University, Busan, Korea

Corresponding author: Lee, Sunok Department of Nursing, Silla University, 140 Baegyang-daero, 700 beon-gil, Sasang-gu, Busan 46958, Korea. Tel: +82-51-999-5870, Fax: +82-51-999-6241, E-mail: solee@silla.ac.kr

Received 2 March 201830 April 2018 Accepted 26 May 2018

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Purpose

To evaluate the effectiveness of an experience-focused prenatal program on stress, anxiety, childbirth confidence, and maternal-fetal attachment for women in their first pregnancy.

Methods

The participants were 57 pregnant women at 32 weeks or more of a first pregnancy who agreed to participate in this study. The data were analyzed with descriptive statistics, t-test, x² test, and Fisher's exact test using the SPSS 21.0 program.

Results

The experimental group showed significant differences in stress, anxiety, childbirth confidence, and maternal-fetal attachment from the control group.

Conclusion

The four-week experience-focused prenatal program can be used for women in their first pregnancy to reduce their stress and anxiety and to increase their childbirth confidence and maternal-fetal attachment.

Keywords: Prenatal program, Stress, Anxiety, Confidence, Attachment

References

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Figure 1.

Study design.

Table 1.

Contents of Experience-focused Prenatal Program

Session	Subjects	Contents	Method	Time/min
1st week	Normal pregnancy	․ Introduction the program	Pretest, Lecture: PPT	50
		․ Communication each for stress, anxiety
		․ Normal pregnancy process
	Rest	․ Offer of beverage		10
	Experience-focused	․ Fetus nicknames & self introduction	Practice	30
	education	․ 1 stage of labor slow respiration & relaxation practice	Discussion	10
2nd week	Naturalism birth	․ Comprehension of birth	Lecture: PPT, video	50
	care	․ Premonitory signs of labor
		․ Admission sign
		․ Breathing & position of delivery
	Rest	․ Offer of beverage		10
	Experience-focused	․ Feedback	Practice	30
	education	․ 1 stage of labor rapid respiration & relaxation practice	Discussion	10
		․ 2 stage of labor pushing & respiration practice
3rd week	Baby massage	․ Neonatal management	Lecture: PPT, baby	50
		․ Baby massage method	model
	Rest	․ Offer of beverage		10
	Experience-focused	․ Feedback	Practice	30
	education	․ Baby massage practice	Discussion	10
		․ Tour to the delivery room & newborn unit	Field trip
		․ Delivery experience practice
4th week	Breast feeding	․ Comprehension of breast feeding method	Posttest, Lecture: PPT,	50
		․ Comprehension of breast care & fundus massage	baby model, breast
		․ Comprehension of correct breast feeding posture	model
	Rest	․ Offer of beverage		10
	Experience-focused	․ Feedback	Practice	30
	education	․ Correct breast feeding posture practice	Discussion	10
		․ Process of labor respiration & relaxation practice

Table 2.

Homogeneity Test for General and Obstetric Variables (N=57)

Characteristics	Categories	Exp. (n=28)	Cont. (n=29)	x² or t	p
Characteristics	Categories	n (%)	n (%)	x² or t	p
Age (year)	25∼29	9 (32.1)	13 (44.8)	8.22	.941
	30∼34	11 (39.3)	10 (34.5)
	35∼41	8 (28.6)	6 (20.7)
Job	Yes	12 (42.9)	11 (37.9)	0.14	.790
	No	16 (57.1)	18 (62.1)
Education^†	High school	4 (14.3)	5 (17.2)	0.22	.982
	College	21 (75.0)	21 (72.4)
	≥University	3 (10.7)	3 (10.4)
Monthly household income	≤300	12 (42.9)	13 (44.8)	1.27	.914
(10,000 won)	301∼339	7 (25.0)	6 (20.7)
	≥400	9 (32.1)	10 (34.5)
Perceived health state^†	Good	18 (69.3)	16 (55.3)	1.61	.892
	Moderate	8 (28.5)	11 (37.9)
	Not good	2 (7.2)	2 (6.8)
Satisfaction of marital state	7∼8	11 (39.3)	17 (58.6)	4.26	.566
(score)	9∼10	17 (60.7)	12 (41.4)
Gestational period (week)	32	9 (32.1)	10 (34.5)	0.44	.931
	33	5 (17.9)	6 (20.7)
	34	6 (21.4)	5 (17.2)
	35	8 (28.6)	8 (27.6)
Prenatal education	Yes	13 (46.4)	10 (34.5)	0.84	.424
	No	15 (53.6)	19 (65.5)
Breast feeding plan (month)	2∼6	20 (71.5)	17 (58.6)	10.71	.203
	10∼24	8 (28.5)	12 (41.4)
Provider of postpartum care	Mother	5 (17.9)	5 (17.2)	3.67	.558
	Postpartum caregiver	23 (82.1)	24 (82.8)

Exp.=experimental group; Cont.=control group;

^† Fisher's exact test.

Table 3.

Homogeneity test for Stress, State Anxiety, Childbirth Confidence and Maternal-Fetal Attachment between Two Groups(N=57)

Characteristics	Categories	Exp. (n=28)	Cont. (n=29)	t	p
Characteristics	Categories	M±SD	M±SD	t	p
Stress	26∼130	67.96±15.63	63.73±11.70	1.25	.214
State anxiety	20∼80	38.28±8.04	38.27±8.08	0.01	.996
Childbirth confidence	15∼60	43.21±8.35	41.03±6.83	1.08	.285
Maternal-fetal attachment	24∼96	75.92±10.56	71.96±13.31	1.24	.220

Exp.=experimental group; Cont.=control group.

Table 4.

Differences in Stress, State Anxiety, Childbirth Confidence and Maternal-Fetal Attachment between Two Groups (N=57)

Variables	Groups	Pretest	Posttest	Difference	t	p
Variables	Groups	M±SD	M±SD	M±SD	t	p
Stress	Exp.	67.96±15.63	60.07±14.52	–7.89±14.02	–6.08	＜.001
	Cont.	63.37±11.70	81.03±15.88	17.66±17.43
State anxiety	Exp.	38.28±8.04	36.57±8.02	–1.71±6.56	–4.48	＜.001
	Cont.	38.27±8.08	46.10±8.57	7.83±9.23
Childbirth	Exp.	43.21±8.35	46.85±9.00	3.64±9.91	5.06	＜.001
confidence	Cont.	41.03±6.83	32.75±6.40	–8.28±7.77
Maternal-fetal	Exp.	75.92±10.56	81.75±12.22	5.83±13.14	4.13	＜.001
attachment	Cont.	71.96±13.31	63.93±13.65	–8.03±12.12

Exp.=experimental group; Cont.=control group.

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