Investigating the Effect of Art Therapy on Women With Fear of Childbirth During Pregnancy: A Mixed Method Study

Summary

Childbirth is a multifaceted experience and could involve both positive and negative feelings. Feelings of limited capability in the face of childbirth may result in a condition termed as Fear of Childbirth (FOC), which contributes to significantly higher risks of birth complications resulting in psychological trauma. This study aims to examine the effects of Art Therapy (AT) on FOC, perceived maternal parental self-efficacy, postpartum maternal infant bonding and postpartum depression. A mixed-methods sequential explanatory design will be used. Phase one will adopt a quasi-experimental study design. Women who are aged 21 and above, English literate and having a singleton pregnancy will be approached to fill in the Fear of Birth Scale (FOBS). Participants with FOBS score of 60 and above will be considered as having FOC and will be invited to participate in the AT intervention. Participants who are agreeable to receive AT will be recruited in the experimental group. Participants who declined to participate in AT will receive routine antenatal care (control group). Outcomes that will be measured in both groups include perceived maternal self-efficacy, maternal infant bonding, and maternal depression after childbirth. A qualitative descriptive design will be used in phase two. Semi-structured interviews will be conducted with the participants to explore their experiences of the AT. Descriptive analysis, independent sample t-test, paired sample t-test, and regression analysis will be used for analysis of the quantitative data in phase one. Qualitative data from phase two will be analysed using thematic analysis. Findings of this study may provide evidence on the use of AT to cope with FOC during pregnancy. If proven to be beneficial, AT may potentially be introduced and advocated as an intervention for women with FOC.

Eligibility

Phase I

Inclusion Criteria:

1. Aged between 21 and 50 years old
2. English literate
3. Having an intrauterine singleton live pregnancy
4. Currently in the second trimester of the pregnancy (between 13 to 27 weeks of pregnancy)
5. Fear of Birth Scale (FOBS) score of 60 and above

Exclusion Criteria:

1. With contraindication for vaginal birth (for example placenta covering cervix)
2. With obstetric complications during pregnancy such as fetal anomaly that is incompatible with life
3. With current depression requiring medical intervention
4. Who had stillborn delivery

Phase II Inclusion Criteria Enrolled participants who had undergone the Art Therapy intervention in phase one

Conditions5

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